UHC Medicare Certification Exam
(2024/2025) Questions with Correct Detailed
Answers || 100% Guaranteed Pass!!
<RECENT UPDATE>
When a member enrolls in a MA plan, they receive their coverage from medicare
or the MA plan? - ANSWER MA plan
When a customer is enrolled in a...
When a member enrolls in a MA plan, they receive their coverage from medicare
or the MA plan? - ANSWER ✔ MA plan
When a customer is enrolled in a MA plan, they must continue paying their
premiums for what other plan? - ANSWER ✔ Part B
MA plans have a maxium annual limit on OOP costs called a? - ANSWER ✔
MOOP amount ( Maxium out of pocket)
When a member is enrolled in a MA plan, they are automatically disenrolled from
any other MA plan or PDP( prescription drug plan) in which they are enrolled as of
the new plans_____? - ANSWER ✔ effective date
An exception exisits for MA-only PFFS plans as a member can also be enrolled in
a what? - ANSWER ✔ Stand alone PDP
If a member enrolls in a MA plan, what must the member do? - ANSWER ✔
Cancel in writing their medicare supplement insurance policy with the carrier after
their request to enroll in MA plan has been approved.
, Medicare supplement insurance policies cannot be used in conjunction with what
type of plan? - ANSWER ✔ MA plan
A medicare supplement insurance plan helps to cover some of the OOP costs
associated with? - ANSWER ✔ original medicare.
A medicare supplement insurance plan does NOT pay the cost-sharing of what
type of plan? - ANSWER ✔ MA plan
when a client enrolls in a MA plan, will it automatically terminate their MA plan?
- ANSWER ✔ NO
Can a customer call to terminate their Med Sup plan? - ANSWER ✔ no it must be
done in writing
What are the different types of MA plans? - ANSWER ✔ HMO, POS, PPO,
RPPO, PFFS, SNP, and MSA
For an HMO, they customer must us IN network providers, what are the
exceptions to their rule? - ANSWER ✔ Emergencies, Urgent care, and renal
dialysis services.
In a HMO plan, does a member have to choose a PCP? and do they require
referrals to see a specialist? - ANSWER ✔ Yes
Which statement is accurate when a consumer has a Power of Attorney (POA)?
The POA may attend a personal/individual marketing appointment with the
consumer but has no authority to sign the Enrollment Application.
,If the POA signs the Enrollment Application, they must be able to provide
documentation upon request by the Plan that indicates authority under state law to
enroll the consumer.
The POA may sign the Enrollment Application and must submit documentation
that indicates his authority under state law to enroll his mother with the
application. - ANSWER ✔ If the POA signs the Enrollment Application, they must
be able to provide documentation upon request by the Plan that indicates authority
under state law to enroll the consumer.
Select the option that describes the coverage combinations a member can be
enrolled in at the same time.
MA-Only PFFS plan and a stand-alone PDP
MA-Only non-PFFS plan and a stand-alone PDP
Medicare Supplement plan and MA-PD plan - ANSWER ✔ Medicare Supplement
plan and MA-PD plan - WRONG
In which situation will a member be involuntarily dis enrolled from their MA
plan?
The member lost entitlement to either Medicare Part A or Part B.
The member did not pay plan premiums on a timely basis.
The member engaged in disruptive behavior.
Premiums are not paid on a timely basis. - ANSWER ✔ The member lost
entitlement to either Medicare Part A or Part B.
Rosanna is enrolled in a Medicare Advantage Only (MA-Only) Private Fee-for-
Service (PFFS) Plan. The plan is suitable for her needs and service area. She has
decided she wants to add prescription drug coverage. Which option is available to
Rosanna (assuming she is in a valid election period)?
, Rosanna could stay enrolled in her MA-Only PFFS plan and enroll in a stand-alone
PDP.
Rosanna could stay enrolled in her MA-Only PFFS plan and enroll in a Medicare
Advantage Prescription Drug (MA-PD) plan.
Rosanna could dis enroll from her MA-Only PFFS plan and enroll in an MA-Only
HMO plan and a stand-alone PDP.
Rosanna could stay enrolled in her MA-Only PFFS plan and enroll in a Medicare
Supplement Plan. - ANSWER ✔ Rosanna could stay enrolled in her MA-Only
PFFS plan and enroll in a Medicare Advantage Prescription Drug (MA-PD) plan. -
WRONG
Rosanna could stay enrolled in her MA-Only PFFS plan and enroll in a stand-alone
PDP - CORRECT
In what product should agents enroll consumers?
A product that meets the sales goal of the Centers for Medicare and Medicaid
Services, United Healthcare and the Social Security Administration.
A product that provides a financial advantage to a network of providers.
A product that meets the interest the agent has in the transaction, for example
commissions received for the sale.
A product that is suitable for the consumer's needs, goals and financial resources. -
ANSWER ✔ A product that is suitable for the consumer's needs, goals and
financial resources.
Why must an agent present accurate, complete, and factual plan information to
consumers? (Select 3)
To help avoid confusing the consumer
To help the consumer focus on plan-specific information, such as benefits and
costs
To help the consumer gain confidence in the agent's expertise
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller ProfBenjamin. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $9.99. You're not tied to anything after your purchase.
