Health Care > QUESTIONS & ANSWERS > UHC certification 2022/2023 with complete solution (All)

UHC certification 2022/2023 with complete solution

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Medicare –  ANSWER Federal health insurance program Medicare is administered by whom? –  ANSWER CMS (Centers for Medicare and Medicaid services) Parts A & B of Medicare are –  ANSWER federal health insurance program referred to as original Medicare Part A? –  ANSWER Hospital insurance Part B? –  ANSWER Medical insurance What doesn’t Medicare cover? –  ANSWER routine dental, eye care hearing exam, deductibles, coinsurance and copayments Part C? –  ANSWER Medicare Advantage Plans MA covers? –  ANSWER Part A &B coverage, and some part D coverage MA plans are not? –  ANSWER Medicare supplement insurance plans What offers lower monthly premiums MADP or supplement? –  ANSWER MADP do MAP's have a annual maximum OOP maximum that limits the amount of money a member must spend every year for covered services? –  ANSWER YES MA plans integrate what type of additional coverage? –  ANSWER part D prescription drug coverage If a customer wants to keep their standalone prescription drug plan, what may the customer want to enroll in? –  ANSWER MA-only PFFS plan What is a standalone drug plan called? –  ANSWER PDP What is PFFS? –  ANSWER Private Fee for Service (PFFS) - Plans that allow you to go to any doctor or hospital that accepts their terms If a customer lives in a rural area, what type of plan may they want because it gives them freedom to access doctors that may not be in their network? –  ANSWER PFFS plan Do HMO's require referrals? –  ANSWER Yes Do PPO's require a referral? –  ANSWER No 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 another plan? –  ANSWER Part B MA plans have a maximum annual limit on OOP costs called a? –  ANSWER MOOP amount (Maximum 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

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