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Download UHC 2025 Medicare Basics Exam – 21 Questions and Answers. and more Exams Medicine in PDF only on Docsity!
Which part of Medicare helps with inpatient hospital stays, hospice care, and provides limited home health benefits? Part A(Right) PartC Which statement is true about a member of a Medicare Advantage (MA) Plan who wants to enroll ina Medicare Supplement Insurance Plan? t the same time. -Whena consumer enrolls in a Medicare Supplement Insurance Plan, he/she is not automatically disenrolled from his/her MA Plan. -A member does not need a valid election period to disenroll from an MA plan. -When a consumer enrolls in a Medicare Supplement Insurance Plan, he/she is automatically disenrolled from his/her MA Plan.(wrong) ALS(right) -Only consumers age 65 or older with certain disabilities and consumers of all ages with ESRD or ALS -Consumers age 62 or older, consumers under 62 years of age with certain disabilities and consumers of all ages with ESRD or ALS Which of the following defines a Medicare Advantage (MA) Plan? (Select 3) Correct ans - An MA Plan does not have to provide benefits equivalent to Original Medicare.(wrong) rig Janice wants to enroll ina 2021 Medicare Advantage plan. What eligibility requirements must she 2 apply.) GGRSeUBRS_RENGEHVelEneStSB=IREHal Disease (Eset Wediesr= PSA erallCSAPSRBIAEHE] ene tec vo Mecicare Parca and/or is enrolled in Part B Which of the eae statements is correct about HMO MA Plans? . SBpayMenE. (wrong) -Most benefits are covered out-of-network but at a higher cost. -Members must receive covered services from contracted network providers. -There are no exceptions to the provider network requirement for obtaining certain services from out-ofnetwork providers. Which type of MA Plan is an HMO plan that also covers some benefits out-ofnetwork, generally ata higher cost? Correct ans - -Private Fee-forService (PFFS) -Medicare Supplement Insurance Plan -Preferred Provider Organization (PPO) -Point-of-Service (POS) Plan(right) When does Medicare Supplement Open Enrollment take place? © Correctans - -During the first three months a consumer is 65 or older and enrolled in Medicare Part B. -During the first six months a consumer is 65 or older and enrolled in Medicare Part B.(right) -Annually from October 15 to December 7. -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. Aconsumer with Original Medicare might be interested inan MAPlan because: Correctans - - MA Plans eliminate Medicare Part A premiums. -By joining an MA Plan they will no longer be a part of the Medicare program. -MA Plans typically provide additional coverage beyond Original Medicare and often have established copayments for some benefits.(right) -It has a larger network of providers and skilled nursing facilities. Which of the following statements is true about a Medicare Supplement Insurance Plan member who wants to enrollinan MAPlan? — Correct ans - -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 ta their Medicare Supplement Insurance carrier a written request to cancel his/her policy.(right) -The member must submit a written request to cancel their Medicare Supplement Insurance Plan the same day they submit their MA Plan enrollment application. -When a member enrolls in the MA Plan their current Medicare Supplement Insurance Plan will automatically cancel. -The member should not cancel their Medicare Supplement Insurance Plan because Medicare Supplement Insurance can be used in conjunction with an MA Plan. Which of the following best defines Medicare PartD? = Correctans - -Itisa government program, offered only through a private insurance company or other private company approved by Medicare, which provides medical coverage. -It is a government program, offered only through a private insurance company or other private company approved by Medicare, which provides prescription drug coverage.(right) -Itis a government program, offered anly through a private insurance company or other private company approved by Medicare, which provides hospitalization coverage. -It is a government program, offered only through a private insurance company or other private company approved by Medicare, which provides medical and hospitalization coverage. Which of the following is a fact about Medicare Prescription Drug Plans? available as of January 1, 2021 -By receiving annual checks with a refund based ona predetermined percentage of Part D costs -Through subsidies such as lower or no monthly plan premiums and lower or no copayments(right) -Through a combination of subsidies and annual refund checks Which of the following lists drug tiers from least expensive cost share to most expensive cost share? Correct ans - -Specialty, Non-Preferred Drug (and some higher-cost generics), Preferred Brand (and some higher-cost generics), Generics, Preferred Generics -Preferred Generics, Generics, Preferred Brand (and some higher-cost generics), Non-Preferred Drug (and some higher-cost generics), Specialty(right) -Generics, Preferred Generics, Nan-Preferred Drug (and some higher-cost generics), Brand (and some higher cost generics), Specialty -Preferred Generics, Preferred Brand (and some higher-cost generics), Generics, Non-Preferred Drug (and some higher-cost generics), Specialty Which of the following is true about Medicare Supplement Insurance underwriting criteria in states where underwriting applies? © Correct ans - -Underwriting is required if the consumer is not in his/her Medicare Supplement Open Enrollment period or does not meet Guaranteed Issue criteria.(right) -During Medicare Supplement Open Enrollment, consumers will only be required to answer the underwriting eligibility questions. -Consumers will never be underwritten to determine their rate. -If the consumer meets Guaranteed Issue criteria, he/she may be underwritten to determine his/her rate. The new MACRA legislation, which went into effect January 1, 2020, applies to all carriers offering Medicare supplement plans. Correctans - TRUE(right) FALSE Which of the following is true about Medicare Supplement Insurance Plans? Correct ans - They are regulated by the Centers for Medicare & Medicaid Services (CMS). -They can only be purchased during the Annual Election Period (AEP). -To see a specialist, insured members must obtain referrals from a primary care physician. -Plan benefit amounts automatically update when Medicare changes cost sharing amounts, such as deductibles, coinsurance and copayments.(right) 
