UHC Medicare MA 2026 – Medicare Advantage (MA)
and Part D Certification Review Actual Questions &
Answers with Rationales (2026/2027)
1. What does Medicare Advantage (MA) refer to?
A. Medicare Part A only
B. Medicare Part B only
C. Medicare Part C
D. Medicare Supplement insurance
Answer: C
Rationale: Medicare Advantage is Medicare Part C, offered by
Medicare-approved private organizations.
2. Which components make up Original Medicare?
A. Parts A and B
B. Parts B and C
C. Parts C and D
D. Parts A and D
Answer: A
Rationale: Original Medicare consists of Part A hospital insurance and
Part B medical insurance.
3. Medicare Part D primarily provides:
A. Hospital coverage
B. Outpatient prescription drug coverage
C. Medigap coverage
D. Long-term custodial care
Answer: B
Rationale: Part D provides Medicare prescription drug coverage
through approved plans.
,4. An MA-PD plan combines:
A. Medicare Advantage and prescription drug coverage
B. Medigap and Medicaid
C. Part A and employer coverage
D. Part B and Medigap
Answer: A
Rationale: MA-PD plans provide Medicare Advantage medical benefits
together with Part D prescription drug coverage.
5. A stand-alone PDP provides:
A. Part A benefits
B. Part B benefits
C. Part D prescription drug coverage
D. Medigap benefits
Answer: C
Rationale: A Prescription Drug Plan (PDP) is a stand-alone Medicare
Part D plan.
6. Who administers Medicare at the federal level?
A. CMS
B. FDA
C. IRS
D. OSHA
Answer: A
Rationale: The Centers for Medicare & Medicaid Services (CMS)
administers Medicare.
7. Which Medicare Advantage plan type generally uses a defined
provider network and care coordination?
A. HMO
B. PDP
,C. Medigap
D. Original Medicare
Answer: A
Rationale: HMOs generally use network providers and coordinated-
care structures.
8. Which plan type generally permits covered out-of-network care,
often at a higher cost?
A. HMO
B. PPO
C. PDP
D. Medigap
Answer: B
Rationale: PPOs generally allow both in-network and out-of-network
care subject to plan rules.
9. What is a Medicare Advantage service area?
A. The geographic area in which the plan is offered
B. Every state in the country
C. The beneficiary's physician network only
D. The area served by CMS headquarters
Answer: A
Rationale: MA plans have defined geographic service areas.
10. Why is a beneficiary's residence important when evaluating MA
eligibility?
A. It can determine which plans are available
B. It determines the beneficiary's diagnosis
C. It determines Part D drug tiers
D. It determines Social Security benefits
, Answer: A
Rationale: Plan availability is generally tied to the beneficiary's
residence and the plan's service area.
11. What is an SNP?
A. Special Needs Plan
B. Senior Network Premium
C. Supplemental Nursing Program
D. Standard Network Plan
Answer: A
Rationale: Special Needs Plans are Medicare Advantage plans designed
for specific qualifying populations.
12. Which SNP is designed for certain beneficiaries who are eligible for
both Medicare and Medicaid?
A. C-SNP
B. D-SNP
C. I-SNP
D. PDP
Answer: B
Rationale: D-SNP means Dual Eligible Special Needs Plan.
13. C-SNPs are designed primarily for beneficiaries with:
A. Qualifying chronic conditions
B. Employer insurance
C. Only Part A
D. No Medicare coverage
Answer: A
Rationale: Chronic Condition SNPs serve beneficiaries who meet
applicable chronic-condition eligibility requirements.
and Part D Certification Review Actual Questions &
Answers with Rationales (2026/2027)
1. What does Medicare Advantage (MA) refer to?
A. Medicare Part A only
B. Medicare Part B only
C. Medicare Part C
D. Medicare Supplement insurance
Answer: C
Rationale: Medicare Advantage is Medicare Part C, offered by
Medicare-approved private organizations.
2. Which components make up Original Medicare?
A. Parts A and B
B. Parts B and C
C. Parts C and D
D. Parts A and D
Answer: A
Rationale: Original Medicare consists of Part A hospital insurance and
Part B medical insurance.
3. Medicare Part D primarily provides:
A. Hospital coverage
B. Outpatient prescription drug coverage
C. Medigap coverage
D. Long-term custodial care
Answer: B
Rationale: Part D provides Medicare prescription drug coverage
through approved plans.
,4. An MA-PD plan combines:
A. Medicare Advantage and prescription drug coverage
B. Medigap and Medicaid
C. Part A and employer coverage
D. Part B and Medigap
Answer: A
Rationale: MA-PD plans provide Medicare Advantage medical benefits
together with Part D prescription drug coverage.
5. A stand-alone PDP provides:
A. Part A benefits
B. Part B benefits
C. Part D prescription drug coverage
D. Medigap benefits
Answer: C
Rationale: A Prescription Drug Plan (PDP) is a stand-alone Medicare
Part D plan.
6. Who administers Medicare at the federal level?
A. CMS
B. FDA
C. IRS
D. OSHA
Answer: A
Rationale: The Centers for Medicare & Medicaid Services (CMS)
administers Medicare.
7. Which Medicare Advantage plan type generally uses a defined
provider network and care coordination?
A. HMO
B. PDP
,C. Medigap
D. Original Medicare
Answer: A
Rationale: HMOs generally use network providers and coordinated-
care structures.
8. Which plan type generally permits covered out-of-network care,
often at a higher cost?
A. HMO
B. PPO
C. PDP
D. Medigap
Answer: B
Rationale: PPOs generally allow both in-network and out-of-network
care subject to plan rules.
9. What is a Medicare Advantage service area?
A. The geographic area in which the plan is offered
B. Every state in the country
C. The beneficiary's physician network only
D. The area served by CMS headquarters
Answer: A
Rationale: MA plans have defined geographic service areas.
10. Why is a beneficiary's residence important when evaluating MA
eligibility?
A. It can determine which plans are available
B. It determines the beneficiary's diagnosis
C. It determines Part D drug tiers
D. It determines Social Security benefits
, Answer: A
Rationale: Plan availability is generally tied to the beneficiary's
residence and the plan's service area.
11. What is an SNP?
A. Special Needs Plan
B. Senior Network Premium
C. Supplemental Nursing Program
D. Standard Network Plan
Answer: A
Rationale: Special Needs Plans are Medicare Advantage plans designed
for specific qualifying populations.
12. Which SNP is designed for certain beneficiaries who are eligible for
both Medicare and Medicaid?
A. C-SNP
B. D-SNP
C. I-SNP
D. PDP
Answer: B
Rationale: D-SNP means Dual Eligible Special Needs Plan.
13. C-SNPs are designed primarily for beneficiaries with:
A. Qualifying chronic conditions
B. Employer insurance
C. Only Part A
D. No Medicare coverage
Answer: A
Rationale: Chronic Condition SNPs serve beneficiaries who meet
applicable chronic-condition eligibility requirements.