UHC 2024 AHIP Medicare Basics Assessment (Medicare

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UHC 2024 AHIP - Medicare BasicsAssessment (Medicare Advantage[non-SNP], Prescription Drug andMedicare Supplement Plans) Q & ALisa turned 65 and is now eligible for Medicare. She already receives Social Securitybenefits. How does she enroll in Original Medicare? Answer- Her enrollment inMedicare Parts A and B is generally automatic if she meets all eligibilityrequirements.Which statement is true about a member of a Medicare Advantage (MA) Plan whowants to enroll in a Medicare Supplement Insurance Plan? Answer- When aconsumer enrolls in a Medicare Supplement Insurance Plan, they are notautomatically disenrolled from their MA Plan.Being 65 or older, being under 65 years of age with a qualifying disability or beingany age with ESRD or ALS are each eligibility requirements for which program?Answer- Original MedicareWhich of the following defines a Medicare Advantage (MA) Plan? (Select 3) Answer--An MA Plan is part of Medicare and is also called Part C.-An MA Plan is a health plan option approved by Medicare and offered by privateinsurance companies.-An MA Plan provides Medicare hospital and medical insurance (Medicare Part Aand Part B) and often includes Medicare prescription drug coverage (Part D).To be eligible for this plan type, consumers must meet the following requirements: beentitled to Medicare Part A and enrolled in Part B, and reside in the plans servicearea. Which plan is being described? Answer- Medicare AdvantageWhich of the following is a correct statement about in-network provider services?Answer- HMO Plans cover only in-network services. In most cases, members paythe full cost of any out- of-network services received, with a few important exceptions.Which of the following is NOT a correct statement about in-network providerservices? Answer- HMO-POS Plans only cover in-network services.

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Which statement is true about Medicare Supplement Open Enrollment? Answer- Itis the six-month period that starts the month the consumer is 65 or older and isenrolled in Medicare Part B.Which statement is true about the Medicare Advantage (MA) Out-of-PocketMaximum? Answer- All MA plans have an Out-of-Pocket Maximum to help limit themember's out-of-pocket costs for Medicare-covered medical services.Margaret currently has an MAPD Plan. What would happen if you enrolled her into astand-alone PDP?Answer- She would be disenrolled automatically from her MAPDPlan.What is Medicare Part D? Answer- A voluntary program, offered by privateinsurance companies that are contracted with the federal government, that providesprescription drug coverage for an additional monthly plan premium.Which of the following best describes eligibility to enroll in a stand-alone PrescriptionDrug Plan? Answer- Entitled to Part A and/or enrolled in Part B and reside in theplan service area.Aside from a stand-alone Medicare Prescription Drug Plan, how else could aMedicare-eligible consumer get Part D prescription drug coverage? Answer- Theycould enroll in a Medicare Advantage Plan or other Medicare health plan thatincludes prescription drug coverage.Which of the following statements accurately describes a prescription drug stage?Answer- Starting in 2024, the catastrophic coverage stage is when the member willpay nothing for covered drugs for the remainder of the plan year.Which of these statements is NOT true about the drug utilization management (UM)rules? Answer- If a medication has a UM rule, the member will not be able to getthat medication.What is the amount added to the member's monthly plan premium if they did NOTenroll in a Medicare Advantage plan with Part D benefits or stand-alone prescriptiondrug plan when they were first eligible for Medicare Parts A and/or B or went withoutcreditable prescription drug coverage for 63 or more continuous days? Answer- LateEnrollment Penalty (LEP)What kind of financial assistance does a consumer receive who qualifies for LowIncome Subsidy? Answer- Lower or no monthly plan premiums and lower or nocopaymentsWhich of the following lists drug tiers from least expensive cost share to mostexpensive cost share? Answer- Preferred Generics, Generics, Preferred Brand (andsome higher-cost generics), Non-Preferred Drug (and some higher-cost generics),SpecialtyIn states where Medicare Supplement Insurance underwriting criteria can apply, allof the following underwriting criteria apply EXCEPT: Answer- Most consumers who

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