UHC 2024/2025 AHIP - Medicare Basics Assessment (Medicare Advantage [non-SNP], Prescription Drug and Medicare Supplement PlAnswer)
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This document contains a detailed assessment of the 2024/2025 UHC Medicare Basics. It focuses on Medicare Advantage (non-SNP), Prescription Drug Plans, and Medicare Supplement coverage, based on the latest AHIP guidelines. It provides essential insights into the core concepts of Medicare, including...
UHC 2024/2025 AHIP - Medicare Basics Assessment (Medicare
Advantage [non-SNP], Prescription Drug and Medicare Supplement
PlAnswer) already graded A+
1. Lisa turned 65 and is now eligible for medicare. she already receives social security benefits. how
does she enroll in original medicare?
answer: Her enrollment in medicare parts a and b is generally automatic if she meets all eligibility
requirements.
2. Which statement is true about a member of a medicare advantage (ma) plan who wants to enroll in
a medicare supplement insurance plan?
answer: When a consumer enrolls in a medicare supplement insurance plan, they are not
automatically disenrolled from their ma plan.
3. Being 65 or older, being under 65 years of age with a qualifying disability or being any age with
esrd or als are each eligibility requirements for which program?
answer: Original medicare
4. Which of the following defines a medicare advantage (ma) plan? (select 3)
✓ -an ma plan is part of medicare and is also called part c.
✓ -an ma plan is a health plan option approved by medicare and offered by private insurance
companies.
✓ -an ma plan provides medicare hospital and medical insurance (medicare part a and part b)
and often includes medicare prescription drug coverage (part d).
5. To be eligible for this plan type, consumers must meet the following requirements: be entitled to
medicare part a and enrolled in part b, and reside in the plan's service area. which plan is being
described?
answer: medicare advantage
6. Which of the following is a correct statement about in-network provider services?
answer: hmo planswer 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.
7. Which of the following is not a correct statement about in-network provider services?
, answer: hmo-pos planswer only cover in-network services.
8. Which statement is true about medicare supplement open enrollment?
answer: it is the six-month period that starts the month the consumer is 65 or older and is enrolled in
medicare part b.
9. Which statement is true about the medicare advantage (ma) out-of-pocket maximum?
answer: all ma planswer have an out-of-pocket maximum to help limit the member's out-of-pocket
costs for medicare-covered medical services.
10. Margaret currently has an mapd plan. what would happen if you enrolled her into a stand-alone
pdp?
answer: she would be disenrolled automatically from her mapd plan.
11. What is medicare part d?
answer: a voluntary program, offered by private insurance companies that are contracted with the
federal government, that provides prescription drug coverage for an additional monthly plan premium.
12. Which of the following best describes eligibility to enroll in a stand-alone prescription drug plan?
answer: entitled to part a and/or enrolled in part b and reside in the plan service area.
13. Aside from a stand-alone medicare prescription drug plan, how else could a medicare-eligible
consumer get part d prescription drug coverage?
answer: they could enroll in a medicare advantage plan or other medicare health plan that includes
prescription drug coverage.
14. Which of the following statements accurately describes a prescription drug stage?
answer: starting in 2024, the catastrophic coverage stage is when the member will pay nothing for
covered drugs for the remainder of the plan year.
15. Which of these statements is not true about the drug utilization management (um) rules?
answer: if a medication has a um rule, the member will not be able
16. What is the amount added to the member's monthly plan premium if they did not enroll in a
medicare advantage plan with part d benefits or stand-alone prescription drug plan when they were
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