1. Medicare - ANS ✔Federal health insurance program
2. Medicare is administered by whom? - ANS ✔CMS
( Centres for Medicare and Medicaid services)
3. Parts A & B of Medicare are - ANS ✔federal health
insurance program referred to as original Medicare
4. Part A? - ANS ✔Hospital insurance
5. Part B? - ANS ✔Medical insurance
UHC certification
, 2
UHC cert
6. What doesn’t Medicare cover? - ANS ✔routine dental, eye
care hearing exam, deductibles, coinsurance and co-
payments
7. Part C? - ANS ✔Medicare Advantage Plans
8. MA covers? - ANS ✔Part A &B coverage, and some part D
coverage
9. MA plans are not? - ANS ✔Medicare supplement insurance
plans
10. What offers lower monthly premiums MADP or
supplement? - ANS ✔MADP
11. do MAP's have a annual maximum OOP maximum
that limits the amount of money a member must spend
every year for covered services? - ANS ✔YES
12. MA plans integrate what type of additional
coverage? - ANS ✔part D prescription drug coverage
UHC certification
, 3
UHC cert
13. If a customer wants to keep their stand alone
prescription drug plan, what may the customer want to
enrol in? - ANS ✔MA-only PFFS plan
14. What is a stand alone drug plan called? - ANS ✔PDP
15. What is PFFS? - ANS ✔Private Fee for Service (PFFS) -
Plans that allow you to go to any doctor or hospital that
accepts their terms
16. If a customer lives in a rural area, what type of plan
may they want because it gives them freedom to access
doctors that may not be in their network? - ANS ✔PFFS
plan
17. Do HMO's require referrals? - ANS ✔Yes
18. Do PPO's require a referral? - ANS ✔No
UHC certification
, 4
UHC cert
19. When a member enrols in a MA plan, they receive
their coverage from Medicare or the MA plan? - ANS
✔MA plan
20. When a customer is enrolled in a MA plan, they
must continue paying their premiums for what other
plan? - ANS ✔Part B
21. MA plans have a maximum annual limit on OOP
costs called a? - ANS ✔MOOP amount ( Maximum out of
pocket)
22. When a member is enrolled in a MA plan, they are
automatically disenrolled from any other MA plan or
PDP( prescription drug plan) in which they are enrolled
as of the new plans_____? - ANS ✔effective date
23. An exception exists for MA-only PFFS plans as a
member can also be enrolled in a what? - ANS ✔Stand
alone PDP
UHC certification
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller DoctorKen. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $11.99. You're not tied to anything after your purchase.
