UHC 2021 Medicare Basics Test
Questions and Answers with Complete
Solutions
a consumer currently has original Medicare and is enrolled in a stand alone prescription drug plan
what will happen if the consumer enrolls
...
UHC 2021 Medicare Basics Test
Questions and Answers with Complete
Solutions
a consumer currently has original Medicare and is enrolled in a stand alone prescription drug plan
what will happen if the consumer enrolls in an MA plan that has integrated prescription drug
coverage ✔✔the consumer will be automatically disenrolled from the standalone PDP upon in
Roman in the MA plan that has integrated prescription drug coverage
aside from a standalone Medicare prescription drug plan how else could a Medicare eligible
consumer get Part D prescription drug coverage ✔✔they can enroll in a Medicare Advantage plan
or other Medicare health plan that includes prescription drug coverage
which of the following statements is not true about the coverage gap ✔✔all members reach the
coverage gap
which of these statements is true about the drug utilization management UN rules ✔✔prior
authorization quantity limit and step therapy are some examples of the coverage rules
how does a consumer who qualifies for low income subsidy receive financial assistance through
their part of Medicare Part D costs ✔✔through subsidies such as lower or no monthly plan
premiums an lower or no copayments
which of the following list drug tiers from least expensive cost share to most expensive cost share
✔✔preferred generics generics preferred brand nonpreferred drug specialty
which of the following is true about Medicare supplement insurance plans ✔✔plan benefit
amounts automatically update when Medicare changes cost sharing amounts such as deductibles
coinsurance and copaymentswhich definition best describes Medicare Part A ✔✔the part of Medicare that helps with the cost
of inpatient hospital stays it also helps with Hospice care and some skilled care for homebound
which statement is true about members of a Medicare Advantage plan who wants to enroll in a
Medicare supplement insurance plan ✔✔the consumer must be in a valid MA election or
disenrollment.
Who is eligible for Medicare ✔✔consumers age 65 or older consumers under 65 years of age with
certain disabilities and consumers of all ages with ESRD or a LS
which of the following defines a Medicare Advantage plan select two ✔✔MA plans provide
Medicare hospital and medical insurance and often include Medicare prescription drug coverage
MA plans must provide benefits equivalent to original Medicare and most plans also offer
additional benefits
to be eligible for this plan type consumers must meet the following requirements entitled to
Medicare Part A and enrolled in Part B reside in the planned service area which plan is described
✔✔Medicare Advantage
Which type of MA plan is an HMO plan that also covers some benefits out of network generally
at a higher cost ✔✔point of service POS plan
when is Marys Medicare supplement open enrollment period if she turns 65 on September 23rd
2019 and her Medicare Part B effective date is September 1st 2019 ✔✔September 2019 through
February 2020
a consumer with original Medicare might be interested in an MA plan because ✔✔MA plans
typically provide additional coverage beyond original Medicare and often have established
copayments for some benefitswhich of the following statements is true about a Medicare supplement insurance plan member
who wants to enroll in an MA plan ✔✔Medicare supplement insurance cannot be used in
conjunction with an MA plan therefore after receiving confirmation of enrollment into the MA
plan the member should submit to their Medicare supplement insurance carrier a written request
to cancel his/her policy
which of the following statements does not correctly define prescription drug stages ✔✔a
deductible and the amount the member must pay for every prescription medication regardless of
what stage they are in
a consumer may have to pay a late enrollment penalty if they did not enroll in a Medicare
Advantage plan with the Part D benefits or stand alone prescription drug plan when they were first
eligible for Medicare parts A and or Part B or win without credible prescription drug coverage for
✔✔63 continuous days or more
being 65 or older being under 65 years of age with certain disabilities for more than 20 four months
and being any age with E SRD or LS or each eligibility requirements for which program
✔✔original Medicare
which of the following defines a medical advantage MA plan select two ✔✔MA plans or health
plan options approved by Medicare and offered by the Centers for Medicare and Medicaid Services
CMS
MA plans provide Medicare hospital and medical insurance and often include Medicare
prescription drug coverage
member Doug enrolled in a health maintenance organization HMO MA plan he saw an out of
network doctor and received a bill for the entire cost of the visit Doug called Medicare to complain
and stated that he was never told about these types of costs what should the agent a
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