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UHC CERTIFICATION EX AM
QUESTIONS & ANSWERS
Question: Medicare
CORRECT ANSWER : Federal health insurance
program
Question: Medicare is administered by whom?
CORRECT ANSWER : CMS (Centers for Medicare and
Medicaid Services)
Question: Parts A & B of Medicare are
CORRECT ANSWER : federal health insurance program
referred to as original Medicare
Question: Part A?
CORRECT ANSWER : Hospital insurance
Question: Part B?
CORRECT ANSWER : Medical insurance
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Question: What doesn’t Medicare cover?
CORRECT ANSWER : routine dental, eye care hearing
exam, deductibles, coinsurance and copayments
Question: Part C?
CORRECT ANSWER : Medicare Advantage Plans
Question: MA covers?
CORRECT ANSWER : Part A & B coverage, and some
part D coverage
Question: MA plans are not?
CORRECT ANSWER : Medicare supplement insurance
plans
Question: What offers lower monthly premiums, MADP
or supplement?
CORRECT ANSWER : MADP
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Question: Do MAPs have an annual maximum OOP
maximum that limits the amount of money a member must spend every year for covered services?
CORRECT ANSWER : YES
Question: MA plans integrate what type of additional
coverage?
CORRECT ANSWER : part D prescription drug
coverage
Question: If a customer wants to keep their stand-alone
prescription drug plan, what may the customer want to enroll in?
CORRECT ANSWER : MA-only PFFS plan
Question: What is a stand-alone drug plan called?
CORRECT ANSWER : PDP
Question: What is PFFS?
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CORRECT ANSWER : Private Fee for Service (PFFS) -
Plans that allow you to go to any doctor or hospital that accepts their terms
Question: 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?
CORRECT ANSWER : PFFS plan
Question: Do HMOs require referrals?
CORRECT ANSWER : Yes
Question: Do PPOs require a referral?
CORRECT ANSWER : No
Question: When a member enrolls in a MA plan, they
receive their coverage from Medicare or the MA plan?