Latest 2026/2027 AHIP Medicare Certification Practice Exam verified with correct
answers instant pdf
1. A beneficiary is enrolled in Original Medicare and wants additional coverage for
Medicare cost-sharing. Which type of policy is specifically designed to supplement Original
Medicare?
A. Medicare Advantage
B. Medicare Part D
C. Medigap
D. Medicaid
Rationale: Medigap policies supplement Original Medicare by helping cover certain Medicare
cost-sharing amounts. They are not designed to supplement Medicare Advantage plans.
2. A beneficiary enrolled in a Medicare Advantage plan asks whether they can also
purchase a Medigap policy to cover the MA plan's costs. What is the appropriate response?
A. Yes, Medigap automatically pays all MA cost-sharing
B. Yes, but only during the Annual Enrollment Period
C. Medigap is designed to work with Original Medicare, not Medicare Advantage
D. Medigap replaces Part D
Rationale: Medigap policies supplement Original Medicare. They generally cannot be used to
pay Medicare Advantage plan cost-sharing.
3. Medicare Part A primarily provides coverage for:
A. Physician services only
B. Outpatient prescription drugs
C. Inpatient hospital and certain other facility-based services
D. Routine dental care
Rationale: Part A is Medicare's hospital insurance component and covers eligible inpatient
hospital care and certain other services.
4. Medicare Part B primarily covers:
A. Inpatient hospital room charges only
B. Physician and outpatient medical services
,C. Most long-term custodial care
D. Medigap premiums
Rationale: Part B generally covers medically necessary physician services, outpatient care,
preventive services, and durable medical equipment.
5. Medicare Part D primarily provides:
A. Hospital insurance
B. Outpatient prescription drug coverage
C. Medigap coverage
D. Long-term custodial care
Rationale: Part D provides Medicare prescription drug coverage through private plans
approved by Medicare.
6. Medicare Advantage is also known as:
A. Part A
B. Part B
C. Part C
D. Part D
Rationale: Medicare Advantage is Medicare Part C and is offered by Medicare-approved private
health plans.
7. A person enrolled in Medicare Advantage generally receives Medicare-covered services
through:
A. Only the federal government directly
B. The private Medicare Advantage plan
C. A Medigap insurer
D. Medicaid exclusively
Rationale: Medicare Advantage plans are offered by private organizations that contract with
Medicare to provide Medicare-covered benefits.
, 8. A beneficiary wants prescription drug coverage but remains enrolled in Original
Medicare. Which option may provide that coverage?
A. Medigap alone
B. A standalone Medicare Part D plan
C. Medicare Supplement Part A
D. Medicaid automatically
Rationale: Beneficiaries in Original Medicare can generally obtain prescription drug coverage
through a standalone Part D prescription drug plan.
9. A beneficiary enrolls in a Medicare Advantage plan that includes prescription drug
coverage. The beneficiary generally receives Part A, Part B, and the plan's covered Part D
benefits through:
A. Separate Medigap policies
B. The Medicare Advantage plan
C. A Part A-only insurer
D. The Social Security Administration
Rationale: An MA-PD plan combines Medicare Advantage medical coverage with prescription
drug coverage.
10. Which statement about Medicare Advantage plans is correct?
A. They are all identical
B. Plans can differ in premiums, provider networks, cost-sharing, and covered
supplemental benefits
C. They never use provider networks
D. They replace Social Security
Rationale: Medicare Advantage plans have different structures and benefit designs, so
beneficiaries should compare plan-specific costs, networks, rules, and benefits.
11. A Medicare beneficiary asks about a plan's provider network. Why is this important?
A. Networks determine Social Security eligibility
B. Network rules can affect where the beneficiary can obtain covered services and the
amount they pay
answers instant pdf
1. A beneficiary is enrolled in Original Medicare and wants additional coverage for
Medicare cost-sharing. Which type of policy is specifically designed to supplement Original
Medicare?
A. Medicare Advantage
B. Medicare Part D
C. Medigap
D. Medicaid
Rationale: Medigap policies supplement Original Medicare by helping cover certain Medicare
cost-sharing amounts. They are not designed to supplement Medicare Advantage plans.
2. A beneficiary enrolled in a Medicare Advantage plan asks whether they can also
purchase a Medigap policy to cover the MA plan's costs. What is the appropriate response?
A. Yes, Medigap automatically pays all MA cost-sharing
B. Yes, but only during the Annual Enrollment Period
C. Medigap is designed to work with Original Medicare, not Medicare Advantage
D. Medigap replaces Part D
Rationale: Medigap policies supplement Original Medicare. They generally cannot be used to
pay Medicare Advantage plan cost-sharing.
3. Medicare Part A primarily provides coverage for:
A. Physician services only
B. Outpatient prescription drugs
C. Inpatient hospital and certain other facility-based services
D. Routine dental care
Rationale: Part A is Medicare's hospital insurance component and covers eligible inpatient
hospital care and certain other services.
4. Medicare Part B primarily covers:
A. Inpatient hospital room charges only
B. Physician and outpatient medical services
,C. Most long-term custodial care
D. Medigap premiums
Rationale: Part B generally covers medically necessary physician services, outpatient care,
preventive services, and durable medical equipment.
5. Medicare Part D primarily provides:
A. Hospital insurance
B. Outpatient prescription drug coverage
C. Medigap coverage
D. Long-term custodial care
Rationale: Part D provides Medicare prescription drug coverage through private plans
approved by Medicare.
6. Medicare Advantage is also known as:
A. Part A
B. Part B
C. Part C
D. Part D
Rationale: Medicare Advantage is Medicare Part C and is offered by Medicare-approved private
health plans.
7. A person enrolled in Medicare Advantage generally receives Medicare-covered services
through:
A. Only the federal government directly
B. The private Medicare Advantage plan
C. A Medigap insurer
D. Medicaid exclusively
Rationale: Medicare Advantage plans are offered by private organizations that contract with
Medicare to provide Medicare-covered benefits.
, 8. A beneficiary wants prescription drug coverage but remains enrolled in Original
Medicare. Which option may provide that coverage?
A. Medigap alone
B. A standalone Medicare Part D plan
C. Medicare Supplement Part A
D. Medicaid automatically
Rationale: Beneficiaries in Original Medicare can generally obtain prescription drug coverage
through a standalone Part D prescription drug plan.
9. A beneficiary enrolls in a Medicare Advantage plan that includes prescription drug
coverage. The beneficiary generally receives Part A, Part B, and the plan's covered Part D
benefits through:
A. Separate Medigap policies
B. The Medicare Advantage plan
C. A Part A-only insurer
D. The Social Security Administration
Rationale: An MA-PD plan combines Medicare Advantage medical coverage with prescription
drug coverage.
10. Which statement about Medicare Advantage plans is correct?
A. They are all identical
B. Plans can differ in premiums, provider networks, cost-sharing, and covered
supplemental benefits
C. They never use provider networks
D. They replace Social Security
Rationale: Medicare Advantage plans have different structures and benefit designs, so
beneficiaries should compare plan-specific costs, networks, rules, and benefits.
11. A Medicare beneficiary asks about a plan's provider network. Why is this important?
A. Networks determine Social Security eligibility
B. Network rules can affect where the beneficiary can obtain covered services and the
amount they pay
