Business > QUESTIONS & ANSWERS > Certification Reference Guide United Health Care 2022 with complete solution (All)
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. 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 What is the amount added to the member's monthly plan..........etc. – ANSWER Late Enrollment Penalty (LEP) What are two options for Medicare consumers to get Part D prescription drug coverage (Select 2) – ANSWER Enroll in a Medicare Advantage Plan or other Medicare health plan that includes prescription coverage and Enroll in a stand-alone Medicare Prescription Drug Plan (PDP) Which of the following is a fact about Medicare Prescription Drug Plans? – ANSWER To enroll, the consumers must reside in the plan's service area What is Medicare Part D? – ANSWER A voluntary program ............ When is Mary's Medicare Supplement Open Enrollment period is she turns 65 on September 23,2021, and her Medicare – ANSWER September 2021 through February2022 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 Medications that are covered in a Plan's formulary have various levels – ANSWER Out of pocket expenses Which statements true of Medicare Supplement Insurance Plans? – ANSWER To see a specialist, insured members must obtain referrals from primary care providers. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) – ANSWER TRUE How does a consumer who qualifies for low income subsidy receive financial assistance for their part of Medicare Part D costs – ANSWER Through subsides such as lower or no monthly plan premiums and lower copayments Which of the following statements is true about a Medicare Supplement Insurance Plan member who wants to enroll in an MA plan – ANSWER Medicare Supplement Insurance cannot be used in conjunction with an MA Plan; therefore .... ect Lisa turned 65 and is now eligible for Medicare. She already receives Social Security – ANSWER Her enrollment in Medicare Being 65 or older, being under 5 years of age with certain disabilities for more than 24 – ANSWER Original Medicare Which of the following defines a Medicare advantage (MA) plan? – ANSWER MA Plans are health plan options approved by Medicare and offered by private insurance companies *Which of the following statements does Not correctly define prescription drug stages? – ANSWER Initial coverage is the stage when the plan pays part and the member pays part, usually as coinsurance or copayments or A deductible is the amount the member must pay for every prescription medication, regardless of what stage they are in. *Aside from a standalone Medicare Prescription drug plan – ANSWER They could enroll in a Medicare Advantage Plan or other Medicare health plan that includes prescription drug coverage or There is no other way a Medicare consumer could get Part d prescription drug coverage *Which of the following statements is true about eligibility requirements for stand-alone Medicare Prescription Drug Plans? – ANSWER A consumer must be entailed to Medicare Part A and/ or enrolled in Medicare Part B * Which of the following best defines Medicare Part D? – ANSWER . which provides prescription drug coverage Roger wants to know what counts toward the Out of pocket Maximum on the Medicare - ANSWER The out of pocket maximum includes costs the member pays for any Medicare-covered Part A or B service When does Medicare supplement Insurance take place? – ANSWER During the first six moths ***Which type of MA Plan is an HMO Plan that also covers some benefit out of network, generically at a higher cost. – ANSWER Point of service (POS) Plan Janice wants to enroll in a Medicare Advantage plan Which of the following is NOT an Eligibility requirement? – ANSWER Its not "Entailed to Medicare Part A" Which of the following consumers are eligible for Medicare if other eligibility requirements are met? – ANSWER Consumers age 65 or older eligibility requirements are met? Which of the following defines a Medicare Advantage (MA) Plan? (Select 3) – ANSWER Go back to pictures 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 plan's service area Which plan is being described? – ANSWER Medicare Advantage A consumer currently has original Medicare and is enrolled in a standalone Prescription drug coverage? – ANSWER The consumer will be automatically disenrolled from their standalone PDP upon enrollment Which consumer is eligible for a stand-alone Med [Show More]
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