AHIP Medicare + Fraud, Waste, and Abuse
(MFWA) Exam Questions with Correct Answers
(VerifiedAnswers) Plus Rationales 2026 Q&A
Instant Download PDF
Medicare + Fraud, Waste, and Abuse Practice Questions
Question 1
Which Medicare part primarily covers inpatient hospital care,
skilled nursing facility care following a qualifying inpatient stay,
hospice care, and certain home health services?
A. Medicare Part B
B. Medicare Part C
C. Medicare Part D
D. Medicare Part A
Correct answer: D. Medicare Part A
Rationale: Medicare Part A is the hospital insurance component
of Original Medicare. It generally covers inpatient hospital
services, qualifying skilled nursing facility services, hospice care,
and certain home health services. Part B primarily covers
physician and outpatient medical services. Part C refers to
Medicare Advantage, while Part D provides outpatient
,prescription drug coverage. Understanding the distinction
between the four parts is fundamental because beneficiaries
often have different coverage and cost-sharing rules depending
on which Medicare component is paying for a service.
Question 2
What is Medicare Part B primarily designed to cover?
A. Inpatient hospital services only
B. Physician services, outpatient care, preventive services, and
medically necessary services
C. Prescription drugs purchased at a retail pharmacy only
D. Long-term custodial nursing-home care
Correct answer: B. Physician services, outpatient care,
preventive services, and medically necessary services
Rationale: Part B is Medicare's medical insurance component. It
generally covers medically necessary physician and outpatient
services, preventive services, durable medical equipment, and
numerous other medical services. Part B does not function as
comprehensive long-term custodial care coverage, and
prescription drug coverage is generally addressed through Part
D or other applicable coverage. A strong understanding of Part
B helps agents accurately explain Original Medicare benefits
,without confusing them with Medicare Advantage or
prescription drug benefits.
Question 3
Medicare Part C is another name for:
A. Medicare Supplement Insurance
B. Medicaid
C. Medicare Advantage
D. Medicare Part D
Correct answer: C. Medicare Advantage
Rationale: Medicare Part C is Medicare Advantage (MA).
Medicare Advantage plans are offered by Medicare-approved
private organizations and provide Medicare-covered benefits
through the plan. Depending on the plan, beneficiaries may also
receive additional benefits beyond Original Medicare. Medigap
is separate supplemental insurance that works with Original
Medicare, while Part D is the Medicare prescription drug
benefit. Confusing Medigap with Medicare Advantage is a
common source of inaccurate beneficiary explanations.
Question 4
, Which Medicare component provides outpatient prescription
drug coverage?
A. Part A
B. Part B
C. Part C only
D. Part D
Correct answer: D. Part D
Rationale: Medicare Part D provides outpatient prescription
drug coverage through Medicare-approved prescription drug
plans and through many Medicare Advantage plans that include
prescription drug coverage. Part A can cover certain drugs
administered during covered inpatient stays, and Part B covers
specific categories of drugs under particular circumstances, but
Part D is the principal Medicare benefit for outpatient
prescription drugs. Agents must avoid suggesting that every
prescription is automatically covered under Part B.
Question 5
What is a Medicare Advantage plan?
A. A private health plan approved by Medicare to provide
Medicare-covered benefits
B. A Medigap policy that pays only deductibles
(MFWA) Exam Questions with Correct Answers
(VerifiedAnswers) Plus Rationales 2026 Q&A
Instant Download PDF
Medicare + Fraud, Waste, and Abuse Practice Questions
Question 1
Which Medicare part primarily covers inpatient hospital care,
skilled nursing facility care following a qualifying inpatient stay,
hospice care, and certain home health services?
A. Medicare Part B
B. Medicare Part C
C. Medicare Part D
D. Medicare Part A
Correct answer: D. Medicare Part A
Rationale: Medicare Part A is the hospital insurance component
of Original Medicare. It generally covers inpatient hospital
services, qualifying skilled nursing facility services, hospice care,
and certain home health services. Part B primarily covers
physician and outpatient medical services. Part C refers to
Medicare Advantage, while Part D provides outpatient
,prescription drug coverage. Understanding the distinction
between the four parts is fundamental because beneficiaries
often have different coverage and cost-sharing rules depending
on which Medicare component is paying for a service.
Question 2
What is Medicare Part B primarily designed to cover?
A. Inpatient hospital services only
B. Physician services, outpatient care, preventive services, and
medically necessary services
C. Prescription drugs purchased at a retail pharmacy only
D. Long-term custodial nursing-home care
Correct answer: B. Physician services, outpatient care,
preventive services, and medically necessary services
Rationale: Part B is Medicare's medical insurance component. It
generally covers medically necessary physician and outpatient
services, preventive services, durable medical equipment, and
numerous other medical services. Part B does not function as
comprehensive long-term custodial care coverage, and
prescription drug coverage is generally addressed through Part
D or other applicable coverage. A strong understanding of Part
B helps agents accurately explain Original Medicare benefits
,without confusing them with Medicare Advantage or
prescription drug benefits.
Question 3
Medicare Part C is another name for:
A. Medicare Supplement Insurance
B. Medicaid
C. Medicare Advantage
D. Medicare Part D
Correct answer: C. Medicare Advantage
Rationale: Medicare Part C is Medicare Advantage (MA).
Medicare Advantage plans are offered by Medicare-approved
private organizations and provide Medicare-covered benefits
through the plan. Depending on the plan, beneficiaries may also
receive additional benefits beyond Original Medicare. Medigap
is separate supplemental insurance that works with Original
Medicare, while Part D is the Medicare prescription drug
benefit. Confusing Medigap with Medicare Advantage is a
common source of inaccurate beneficiary explanations.
Question 4
, Which Medicare component provides outpatient prescription
drug coverage?
A. Part A
B. Part B
C. Part C only
D. Part D
Correct answer: D. Part D
Rationale: Medicare Part D provides outpatient prescription
drug coverage through Medicare-approved prescription drug
plans and through many Medicare Advantage plans that include
prescription drug coverage. Part A can cover certain drugs
administered during covered inpatient stays, and Part B covers
specific categories of drugs under particular circumstances, but
Part D is the principal Medicare benefit for outpatient
prescription drugs. Agents must avoid suggesting that every
prescription is automatically covered under Part B.
Question 5
What is a Medicare Advantage plan?
A. A private health plan approved by Medicare to provide
Medicare-covered benefits
B. A Medigap policy that pays only deductibles
