Medicare Agent & Broker Certification
Exam Question & Answers 2026
A prospective beneficiary asks an agent if plan XYZ has
an urgent care benefit and if so, what the benefit
includes. Where would the agent find this information for
plan XYZ? - CORRECT ANSWERS ✔✔Evidence of
Coverage
Because the beneficiary asked if plan XYZ has an urgent
care benefit and what the benefit includes.
If the beneficiary only wanted to know if plan XYZ has an
urgent care benefit, the answer would be Summary of
Benefits & Evidence of Coverage.
If a beneficiary who is enrolled in an HMO tells you that
she wants to see a specialist, you should tell her: -
CORRECT ANSWERS ✔✔You will likely need a referral
from your primary care physician (PCP) to see a
specialist. If you see your specialist without this referral,
the plan may not pay for your visit.
Because the beneficiary is enrolled in an HMO, she should
work with her PCP prior to seeing a specialist (except in
an emergency).
True or False?
, Medicare Agent & Broker Certification
Exam Question & Answers 2026
Once a beneficiary is enrolled in an MA plan and has paid
his plan-specific monthly premium, he no longer needs to
pay his Part B premium. - CORRECT ANSWERS
✔✔False
Beneficiaries are required to continue paying their Part B
premium (unless they receive Extra Help) in addition to
any plan-specific premium.
Define: Medicare Part A - CORRECT ANSWERS ✔✔Part
A of Medicare covers hospital inpatient care, some SNF
care, and home health and hospice care
Define: Medicare Part B - CORRECT ANSWERS ✔✔Part
B of Medicare covers physician services, outpatient
hospital care, lab tests, mental health services, some
preventative services, and medical equipment considered
medically necessary to treat a disease or condition
Define: Medicare Part C - CORRECT ANSWERS ✔✔Part
C of Medicare provides an option for beneficiaries to
receive private health plan coverage in lieu of Original
Medicare
Exam Question & Answers 2026
A prospective beneficiary asks an agent if plan XYZ has
an urgent care benefit and if so, what the benefit
includes. Where would the agent find this information for
plan XYZ? - CORRECT ANSWERS ✔✔Evidence of
Coverage
Because the beneficiary asked if plan XYZ has an urgent
care benefit and what the benefit includes.
If the beneficiary only wanted to know if plan XYZ has an
urgent care benefit, the answer would be Summary of
Benefits & Evidence of Coverage.
If a beneficiary who is enrolled in an HMO tells you that
she wants to see a specialist, you should tell her: -
CORRECT ANSWERS ✔✔You will likely need a referral
from your primary care physician (PCP) to see a
specialist. If you see your specialist without this referral,
the plan may not pay for your visit.
Because the beneficiary is enrolled in an HMO, she should
work with her PCP prior to seeing a specialist (except in
an emergency).
True or False?
, Medicare Agent & Broker Certification
Exam Question & Answers 2026
Once a beneficiary is enrolled in an MA plan and has paid
his plan-specific monthly premium, he no longer needs to
pay his Part B premium. - CORRECT ANSWERS
✔✔False
Beneficiaries are required to continue paying their Part B
premium (unless they receive Extra Help) in addition to
any plan-specific premium.
Define: Medicare Part A - CORRECT ANSWERS ✔✔Part
A of Medicare covers hospital inpatient care, some SNF
care, and home health and hospice care
Define: Medicare Part B - CORRECT ANSWERS ✔✔Part
B of Medicare covers physician services, outpatient
hospital care, lab tests, mental health services, some
preventative services, and medical equipment considered
medically necessary to treat a disease or condition
Define: Medicare Part C - CORRECT ANSWERS ✔✔Part
C of Medicare provides an option for beneficiaries to
receive private health plan coverage in lieu of Original
Medicare
