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UHC Medicare Basics Exam
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UHC Medicare Basics Exam
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UHC Medicare Basics Exam 2024-2025Milton is retiring on his 65th birthday. He is eligible for Medicare and already receives
Social Security benefits. How does he enroll in Original Medicare?
-He can only sign up for Medicare Parts A and/or B at his local Social Security office.
-He can sign up for Medicare Parts A and/or B with any licensed insurance agent.
-His enrollment in Medicare Parts A and B is generally automatic if he meets all
eligibility requirements
-He must enroll in Medicare Parts A and B through his current or former employer. -
ANSWER-His enrollment in Medicare Parts A and B is generally automatic if he meets
all eligibility requirements
Which statement is true about a member of a Medicare Advantage (MA) Plan who
wants to enroll in a Medicare Supplement Insurance Plan?
When a consumer enrolls in a Medicare Supplement Insurance Plan, they are not
automatically disenrolled from their MA Plan.
When a consumer enrolls in a Medicare Supplement Insurance Plan, they are
automatically disenrolled from their MA Plan.
A consumer can use a Medicare Supplement Insurance Plan and an MA Plan at the
same time.
A member does not need a valid election period to disenroll from an MA plan. -
ANSWER-When a consumer enrolls in a Medicare Supplement Insurance Plan, they
are not automatically disenrolled from their MA Plan.
Being 65 or older, being under 65 years of age with certain disabilities for more than 24
months, and being any age with ESRD or ALS are each eligibility requirements for
which program?
Medicaid
Low Income Subsidy
Original Medicare - ANSWER-Original Medicare
Which of the following defines a Medicare Advantage (MA) Plan?
MA Plans provide Medicare hospital and medical insurance but never include any
Medicare prescription drug coverage.
MA Plans are health plan options approved by Medicare and offered by private
insurance companies.
MA Plans must only provide benefits equivalent to Original Medicare and are not
allowed to offer additional benefits.
MA Plans are part of Medicare and are also called Part B. - ANSWER-MA Plans are
health plan options approved by Medicare and offered by private insurance companies.
Which of the following is NOT an eligibility requirement for enrollment in a Medicare
Advantage Plan?
Does not have any pre-existing conditions such as diabetes or End Stage Renal
Disease (ESRD)
Is enrolled in Medicare Part B
Is entitled to Medicare Part A
, Resides in the plan's service area - ANSWER-Does not have any pre-existing
conditions such as diabetes or End Stage Renal Disease (ESRD)
Which of the following statements is correct about HMO MA Plans?
Members must receive covered services from contracted network providers. (??)
There are no exceptions to the provider network requirement for obtaining certain
services from out-of-network providers.
Most benefits are covered out-of-network but at a higher cost. (X)
Members that use out-of-network providers for routine office visits must pay a penalty in
addition to any copayment. (X) - ANSWER-...
Which of the following is NOT a correct statement about in-network provider services?
HMO-POS Plans only cover in-network services.
Network-based MA plans have a provider network the member can use, and some
plans also cover certain services outside the network.
PPO Plans cover in-network and out-of-network services, but out-of-network services
will generally have a high cost share to the member.
HMO Plans cover only in-network services. In most cases, members pay the full cost of
any out-of-network services received, with a few important exceptions. - ANSWER-
HMO-POS Plans only cover in-network services.
When does Medicare Supplement Open Enrollment take place?
During the first six months a consumer is 65 or older and enrolled in Medicare Part B.
During the first three months a consumer is 65 or older and enrolled in Medicare Part B.
During the three months prior to the consumer's 65th birthday, the month of their
birthday, and the three months following the month of their 65th birthday and enrolled in
Medicare Part B.
Annually from October 15 to December 7. - ANSWER-During the first six months a
consumer is 65 or older and enrolled in Medicare Part B.
Jennifer is enrolling into a Medicare Advantage (MA) plan and wants to know what
counts toward the Out-of-Pocket Maximum. Which of the following is accurate?
The Out-of-Pocket Maximum will include her costs toward any Medicare-covered Part A
or B services.
The Out-of-Pocket Maximum includes any costs she pays toward the plan, such as plan
premiums and health care expenses.
All Out-of-Pocket costs she pays toward her health care and prescription drug expenses
would count toward the Out-of-Pocket Maximum. (x)
Jennifer's costs for prescription drugs and any benefits not covered by Original
Medicare will count toward the Out-of-Pocket Maximum. - ANSWER-...
Margaret currently has an MAPD Plan. What would happen if you enrolled her into a
stand-alone PDP?
Nothing would happen, but she would only be able to use one coverage at a time.
The application for her stand-alone PDP would be denied.
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