2023 UHC certifications Exam Questions and Answers 100% Correct/Verified Latest Update 202, Exams of Nursing

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Which statement is true about medicare supplements? - correct answer ✅Insured members have the freedom to choose any doctor who accepts Medicare patients. Cynthia is turning 65 on July 5. Her Medicare Part A and Part B will be effective on July 1. Using her Initial Election Period (IEP), when can she submit an application for a Medicare Advantage or Prescription Drug plan? - correct answer ✅April 1 through October 31 Being 65 or older, being under 65 years of age with certain disabilities for more than 24 months, and being any age with ESRD or ALS are each eligibility requirements for which program? - correct answer ✅Original Medicare Which of the following defines a Medicare Advantage (MA) Plan? (Select 2) - correct answer ✅1. MA Plans must provide benefits equivalent to Original Medicare, and most plans also offer additional benefits.

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Which of the following is NOT an eligibility requirement for enrollment in a Medicare Advantage Plan? - correct answer ✅Does not have any pre-existing conditions such as diabetes or End Stage Renal Disease (ESRD) Which of the following statements is correct about HMO MA Plans? - correct answer ✅Members must receive covered services from contracted network providers with limited exceptions. Which of the following is NOT a correct statement about in-network provider services? - correct answer ✅(INCORRECT) Network-based MA plans have a provider network the member can use, and some plans also cover certain services outside the network. What is true about Medicare supplement open enrollment? - correct answer ✅(INCORRECT) A consumer who waits to enroll in Medicare Part B until age 66 or older cannot qualify for Medicare Supplement Open Enrollment. (INCORRECT) It is the only time a consumer is eligible to purchase a Medicare Supplement Insurance Plan.

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Jennifer is enrolling into a Medicare Advantage (MA) plan and wants to know what counts toward the Out-of-Pocket Maximum. Which of the following is accurate? - correct answer ✅The Out-of-Pocket Maximum will include her costs toward any Medicare-covered Part A or B services. Which of the following statements is true about a Medicare Supplement Insurance Plan member who wants to enroll in an MA Plan? - correct answer ✅Medicare Supplement Insurance cannot be used in conjunction with an MA Plan; therefore, after receiving confirmation of enrollment into the MA Plan, the member must cancel their Medicare Supplement Insurance policy according to their carrier's rules. Which of the following best defines Medicare Part D? - correct answer ✅It is a government program, offered only through a private insurance company or other private company approved by Medicare, which provides prescription drug coverage. Which of the following is a fact about Medicare Prescription Drug Plans? - correct answer ✅To enroll, member must be in plans service area

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What are two options for Medicare consumers to get Part D prescription drug coverage (assuming they meet all eligibility requirements)? (Select 2) - correct 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. Which of the following statements does NOT correctly define prescription drug stages? - correct answer ✅A deductible is the amount the member must pay for every prescription medication, regardless of what stage they are in. Which of these statements is NOT true about the drug utilization management (UM) rules? - correct answer ✅(INCORRECT) Prior authorization, quantity limit, and step therapy are some examples of UM rules 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? - correct answer ✅Late Enrollment Penalty (LEP)

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Can a consumer who qualifies for Low Income Subsidy receive financial assistance for their part of Medicare Part D costs? - correct answer ✅Yes, through subsidies such as lower or no monthly plan premiums and lower or no copayments Formulary is defined as: - correct answer ✅A list of medications covered within the benefit plan, based on CMS guidelines and developed in collaboration with physicians and pharmacists. Which of the following is true about Medicare Supplement Insurance underwriting criteria in states where underwriting applies? - correct answer ✅Underwriting is required if the consumer is not in their Medicare Supplement Open Enrollment period or does not meet Guaranteed Issue criteria. 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. - correct answer ✅True Which of the following is NOT true of Medicare Supplement Insurance Plans?

• correct answer ✅(INCORRECT) Plan benefit amounts automatically update

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Which of the following are MA Plans that focus on using network providers to maximize the benefits and reduce out-of-network expenses? - correct answer ✅HMO, POS, PPO Margaret currently has an MAPD Plan. What would happen if you enrolled her into a stand-alone PDP? - correct answer ✅She would be disenrolled automatically from her MAPD Plan. What is Medicare Part D? - correct answer ✅A voluntary program, offered by private insurance companies that are contracted with the federal government, that provides prescription drug coverage for an additional monthly plan premium Which of the following statements is true about eligibility requirements for stand-alone Medicare Prescription Drug Plans? - correct answer ✅A consumer must be entitled to Medicare Part A and/or enrolled in Medicare Part B Aside from a Medicare Advantage Plan or other health plan that includes prescription drug coverage, how else could a Medicare-eligible consumer get

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Part D prescription drug coverage? - correct answer ✅They could enroll in a stand-alone Medicare Prescription Drug Plan (PDP). In what order do the four prescription drug coverage stages occur? - correct answer ✅Deductible, Initial Coverage, Coverage Gap, Catastrophic Coverage Step Therapy, Prior Authorization, Quantity Limit, 7-day limit, Dispensing Limit and Limited Access are all examples of what? - correct answer ✅Utilization Management Rules A consumer may have to pay a Late Enrollment Penalty (LEP) 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. - correct answer ✅63 or more continuous days Through which means is financial assistance offered to a consumer who qualifies for Low Income Subsidy for their part of Medicare Part D costs? - correct answer ✅Through subsidies such as lower or no monthly plan premiums and lower or no copayments

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Mrs. Violet asks agent Bob where she can find the Star Rating for the plan he has been presenting. Which statement is correct? - correct answer ✅Mrs. Violet can access the Star Rating for a plan on Medicare.gov or in the Enrollment Guide. Which of the following food and beverage options may be provided at an educational event if the nominal retail value of the items when combined with other giveaways does not exceed $15 per person? (Select 2) - correct answer ✅Coffee, juice, fresh fruit, and pastries Boxed lunch with assorted non-alcoholic beverages If you conduct an educational event and invite a provider or vendor to be a part of the event, the provider/vendor must not do which of the following? - correct answer ✅Provide free health screenings such as blood pressure checks or hearing tests as a marketing activity Agent John Rogers is planning a formal marketing/sales event and has decided to place an advertisement in the local paper. What disclaimers must John include in the advertisement? - correct answer ✅"For accommodation of persons with special needs at sales meetings, call 555-555-1234, TTY 711."

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Janine is conducting a marketing/sales event in a senior center cafeteria. The cafeteria generally provides a dinner meal from 5pm to 6pm. Can Janine conduct her marketing/sales meeting in the cafeteria between 5pm and 6pm? - correct answer ✅No, she can conduct an event that ends no later than 5pm or wait until after 6pm. Agent Rita Garcia must not do which of the following while conducting a marketing/sales event? - correct answer ✅State the plan she is presenting is the best plan on the market. At a formal marketing/sales event, an agent presented information about prescription drug coverage. Which statement is not accurate? - correct answer ✅Members and providers are not able to ask the plan for exceptions to any utilization management rules At an informal marketing/sales event, which of the following activities is not permitted? - correct answer ✅Approaching consumers as they pass by your booth/kiosk/table Agent Santana has developed a relationship with Dr. Westberry, a Primary Care Provider contracted with several Medicare Advantage Plans. Dr. Westberry is

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In which of the following situations can telephonic contact be made with a Medicare eligible consumer? - correct answer ✅When the consumer consented to be contacted for sales activities and the permission has not yet expired. Which statement is true about discussing benefits with the consumer before an enrollment? - correct answer ✅The agent must accurately and completely disclose any benefits discussed. When completing an enrollment application in LEAN, why is an agent prohibited from entering his or her own email address in a field available for the consumer's email address? - correct answer ✅The consumer/member would not receive plan related correspondence intended for him/her. The ensures that when consumers provide their verbal agreement during the telephonic enrollment, they acknowledge and understand they are actually enrolling, in which plan they are enrolling, as well as the standard disclosures. - correct answer ✅Statement of Understanding

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What is Scope of Appointment? - correct answer ✅The agreement obtained from the consumer to that identifies the scope of products that can be discussed at a personal/individual marketing appointment Jane, an agent, is speaking to Albert about a Prescription Drug plan. Albert seems confused and is struggling to understand the information Jane is explaining. Which option should Jane consider? - correct answer ✅Jane should ask Albert if someone, such as an Authorized Legal Representative, helps him make health care or insurance-related decisions and should be present. Melanie is currently enrolled in a Medicare Supplement Insurance Plan and a PDP. Assuming she has a valid election period, what would happen if she enrolled in an HMO MAPD plan? - correct answer ✅(INCORRECT) She would be automatically disenrolled from the Medicare Supplement Insurance Plan and the PDP. Medicare Advantage (MA) organization must disenroll a member from an MA plan in which situation? - correct answer ✅The member loses entitlement to either Medicare Part A or Part B.

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AARP expects agents offering AARP-branded products to demonstrate five key behaviors when interacting with customers. AARP wants customers we work with to feel their relationship with AARP is. - correct answer ✅Effortless and inspiring Which of the following are part of being straightforward when servicing a customer? (Select 3) - correct answer ✅Being upfront about what information means. Communicating clearly to alleviate any confusion. Providing the right information. Do consumers have to be an AARP member to enroll in an AARP-branded plan with UnitedHealthcare? - correct answer ✅Yes, if the consumer is enrolling in a Medicare Supplement Plan. How many status levels are in the Authorized to Offer Program? - correct answer ✅ 2

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According to AARP, there are how many individual AARP members? - correct answer ✅Nearly 37 million Which of the following statements about AARP are TRUE? (Select 2) - correct answer ✅The AARP motto is to serve, not be served. AARP advocates for the 50+ population in congress for legislation to lower medical costs. Which of the following is TRUE about the production requirement for the Authorized to Offer Elite status? - correct answer ✅Each calendar year, agents need to have at least 30 commission-eligible, accepted, and paid AARP Medicare Supplement Plan and/or Medicare Select Plan sales or retain a book of business of 150 or more active members. The value proposition for the AARP brand is seen in what kinds of benefits for the members? (Select 3) - correct answer ✅ Which AARP-branded Medicare products does UnitedHealthcare offer? (Select 3) - correct answer ✅MA, PDP, Supplements