UHC CERTIFICATION LATEST 2023 REAL
EXAM 170 QUESTIONS AND CORRECT
ANSWERS(VERIFIED ANSWERS)
Mr. Davis is 52 years old and has recently been diagnosed with endstage renal disease (ESRD) and will soon begin dialysis. He is
wondering if he can obtain coverage under Medicare. What should you
tell him? – ANSWER- a. He may sign-up for Medicare at any time
however coverage usually begins on the fourth month after dialysis
treatments start.
Mr. Bauer is 49 years old, but eighteen months ago he was declared
disabled by the Social Security Administration and has been receiving
disability payments. He is wondering whether he can obtain coverage
under Medicare. What should you tell him? – ANSWER- d. After
receiving such disability payments for 24 months, he will be
automatically enrolled in Medicare, regardless of age.
Mr. Moy’s wife has a Medicare Advantage plan, but he wants to
understand what coverage Medicare Supplemental Insurance provides
since his health care needs are different from his wife’s needs. What
could you tell Mr. Moy? – ANSWER- b. Medicare Supplemental
Insurance would help cover his Part A and Part B cost sharing in
Original Fee-for-Service (FFS) Medicare as well as possibly some
services that Medicare does not cover.
Mr. Xi will soon turn age 65 and has come to you for advice as to what
services are provided under Original Medicare. What should you tell Mr.
Xi that best describes the health coverage provided to Medicare
beneficiaries? – ANSWER- c. Beneficiaries under Original Medicare
have no cost-sharing for most preventive services which include
immunizations such as annual flu shots.<\/p>\n\n\n\n
Mr. Wu is eligible for Medicare. He has limited financial resources but
failed to qualify for the Part D low-income subsidy. Where might he turn
for help with his prescription drug costs? – ANSWER- a. Mr. Wu may
still qualify for help in paying Part D costs through his State
Pharmaceutical Assistance Program.
Mrs. Quinn recently turned 66 and decided after many years of work to
begin receiving Social Security benefits. Shortly thereafter Mrs. Quinn
received a letter informing her that she has been automatically enrolled
in Medicare Part B. She wants to understand what this means. What
should you tell Mrs. Quinn? – ANSWER- c. Part B primarily covers
physician services. She will be paying a monthly premium and, with the
exception of many preventive and screening tests, generally will have
20% coinsurance for these services, in addition to an annual deductible.
Mr. Singh would like drug coverage but does not want to be enrolled in
a Medicare Advantage plan. What should you tell him? – ANSWER- b.
Mr. Singh can enroll in a stand-alone prescription drug plan and
continue to be covered for Part A and Part B services through Original
Fee-for-Service Medicare.
Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is
currently enrolled in Medicare Parts A and B. Jerry has also purchased a
Medicare Supplement (Medigap) plan which he has had for several
years. However, the plan does not provide drug benefits. How would
you advise Agent John Miller to proceed? – ANSWER- b. Tell prospect
Jerry Smith that he should consider adding a standalone Part D
prescription drug coverage policy to his present coverage.
Ms. Moore plans to retire when she turns 65 in a few months. She is in
excellent health and will have considerable income when she retires. She
is concerned that her income will make it impossible for her to qualify
for Medicare. What could you tell her to address her concern? –
ANSWER- a. Medicare is a program for people age 65 or older and<\/p>\n\n\n\n
those under age 65 with certain disabilities, end-stage renal disease, and
Lou Gehrig’s disease so she will be eligible for Medicare.
Mrs. Turner is comparing her employer’s retiree insurance to Original
Medicare and would like to know which of the following services
Original Medicare will cover if the appropriate criteria are met? What
could you tell her? – ANSWER- a. Original Medicare covers ambulance
services.
Madeline Martinez was widowed several years ago. Her husband
worked for many years and contributed into the Medicare system. He
also left a substantial estate which provides Madeline with an annual
income of approximately $130,000. Madeline, who has only worked
part-time for the last three years, will soon turn age 65 and hopes to
enroll in Original Medicare. She comes to you for advice. What should
you tell her? – ANSWER- a. You should tell Madeline that she will be
able to enroll in Medicare Part A without paying monthly premiums due
to her husband’s long work record and participation in the Medicare
system. You should also tell Madeline that she will pay Part B premiums
at more than the standard lowest rate but less than the highest rate due
her substantial income.
Mrs. Geisler’s neighbor told her she should look at her Part D options
during the annual Medicare enrollment period because features of Part D
might have changed. Mrs. Geisler can’t remember what Part D is so she
called you to ask what her neighbor was talking about. What could you
tell her? – ANSWER- d. Part D covers prescription drugs and she should
look at her premiums, formulary, and cost-sharing among other factors
to see if they have changed.
Mrs. Shields is covered by Original Medicare. She sustained a hip
fracture and is being successfully treated for that condition. However,
she and her physicians feel that after her lengthy hospital stay she will
need a month or two of nursing and rehabilitative care. What should you
tell them about Original Medicare’s coverage of care in a skilled nursing<\/p>\n\n\n\n
facility? – ANSWER- d. Medicare will cover Mrs. Shield’s skilled
nursing services provided during the first 20 days of her stay, after
which she would have a copay until she has been in the facility for 100
days.
Anita Magri will turn age 65 in August 2020. Anita intends to enroll in
Original Medicare Part A and Part B. She would also like to enroll in a
Medicare Supplement (Medigap) plan. Anita’s older neighbor Mel has
told her about the Medigap Part F plan in which he is enrolled. It not
only provides foreign travel emergency benefits but also covers his
Medicare Part B deductible. Anita comes to you for advice. What should
you tell her? – ANSWER- c. You are sorry to disappoint Anita but a
Medigap Part F plan is no longer available to those who turn age 65 after
January 1,2020. Anita might instead consider other Medigap plans that
offer foreign travel benefits but do not cover the Part B deductible.
Juan Perez, who is turning age 65 next month, intends to work for
several more years at Smallcap, Incorporated. Smallcap has a workforce
of 15 employees and offers employer-sponsored healthcare coverage.
Juan is a naturalized citizen and has contributed to the Medicare system
for over 20 years. Juan asks you if he will be entitled to Medicare and if
he enrolls how that will impact his employer-sponsored healthcare
coverage. How would you respond? – ANSWER- a. Juan is likely to be
eligible for Medicare once he turns age 65 and if he enrolls Medicare
would become the primary payor of his healthcare claims and Smallcap
does not have to continue to offer him coverage comparable to those
under age 65 under its employer-sponsored group health plan.
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been
employed full time, and paid taxes during that entire period. She is
concerned that she will not qualify for coverage under part A because
she was not born in the United States. What should you tell her? –
ANSWER- a. Most individuals who are citizens and age 65 or over are
covered under Part A by virtue of having paid Medicare taxes while
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