UHC Certifications 2023/2024 Exam| Actual Questions and Verified Answers| Graded A
UHC Certifications 2023/2024 Exam| Actual
Questions and Verified Answers| Graded A
Q: What are two options for Medicare consumers to get Part D prescription drug coverage
(assuming they meet all eligibility requirements)? (Select 2)
Answer:
Enroll in a stand-alone Medicare Prescription Drug Plan (PDP)
Enroll in a Medicare Advantage Plan or other Medicare health plan that includes prescription
drug coverage
Q: Which of the following statements does NOT correctly define prescription drug stages?
Answer:
A deductible is the amount the member must pay for every prescription medication, regardless of
what stage they are in.
Q: Which of these statements is NOT true about the drug utilization management (UM) rules?
Answer:
(INCORRECT) Prior authorization, quantity limit, and step therapy are some examples of UM
rules
Q: What is the amount added to the member’s monthly plan premium if they did NOT enroll in
a Medicare Advantage plan with Part D benefits or stand-alone prescription drug plan when they
were first eligible for Medicare Parts A and/or B or went without creditable prescription drug
coverage for 63 or more continuous days?
Answer:
Late Enrollment Penalty (LEP)
Q: Can a consumer who qualifies for Low Income Subsidy receive financial assistance for their
part of Medicare Part D costs?
Answer:
Yes, through subsidies such as lower or no monthly plan premiums and lower or no copayments
Q: Formulary is defined as:
Answer:
A list of medications covered within the benefit plan, based on CMS guidelines and developed in
collaboration with physicians and pharmacists.
Q: Which of the following is true about Medicare Supplement Insurance underwriting criteria
in states where underwriting applies?
Answer:
Underwriting is required if the consumer is not in their Medicare Supplement Open Enrollment
period or does not meet Guaranteed Issue criteria.
Q: The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which went into
effect January 1, 2020, applies to all carriers offering Medicare supplement plans.
Answer:
True
Q: Which of the following is NOT true of Medicare Supplement Insurance Plans?
Answer:
(INCORRECT) Plan benefit amounts automatically update when Medicare changes cost sharing
amounts, such as deductibles, coinsurance and copayments.
Q: Which of the following consumers are eligible for Medicare if other eligibility requirements
are met?
Answer:
Consumers age 65 or older, consumers under 65 years of age with certain disabilities for more
than 24 months and consumers of all ages with ESRD or ALS
Q: Which of the following defines a Medicare Advantage (MA) Plan? (Select 3)
Answer:
An MA Plan is a health plan option approved by Medicare and offered by private insurance
companies.
An MA Plan provides Medicare hospital and medical insurance (Medicare Part A and Part B)
and often includes Medicare prescription drug coverage (Part D).
An MA Plan is part of Medicare and is also called Part C.
Q: Janice wants to enroll in a Medicare Advantage plan. Which of the following is NOT an
eligibility requirement?
Answer:
Does not have any pre-existing conditions, such as diabetes or End Stage Renal Disease (ESRD)
Q: Which of the following are MA Plans that focus on using network providers to maximize
the benefits and reduce out-of-network expenses?
Answer:
HMO, POS, PPO
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