CMP™ Examination Questions
CERTIFIED MEDICAID PLANNER (CMP™)
EXAMINATION
Questions & Answers| Latest Update| Pass Guaranteed
Question 1. Which federal statute establishes the Medicaid program and
delegates significant administrative authority to the states?
A. Title XVIII of the Social Security Act
B. Title XIX of the Social Security Act
C. The Employee Retirement Income Security Act (ERISA)
D. The Older Americans Act
Correct Answer: B
Rationale: Title XIX of the Social Security Act (42 U.S.C. §1396 et seq.), enacted in
1965, created Medicaid as a joint federal-state program. Title XVIII is Medicare.
States administer Medicaid under approved state plans, giving rise to significant
state-to-state variation that a CMP must track.
Question 2. A Certified Medicaid Planner is helping a client understand the
difference between an 'institutional' Medicaid applicant and a 'community'
(HCBS waiver) applicant. Which statement best distinguishes the two?
A. Institutional applicants must reside in a Medicaid-certified nursing facility
for eligibility purposes, while community applicants receive services in their
home or an assisted living setting under a waiver
B. Institutional applicants are always children, while community applicants are
always adults
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, CMP™ Examination Questions
C. There is no meaningful distinction; both use identical income and resource
limits nationwide
D. Community applicants are never subject to a look-back period
Correct Answer: A
Rationale: Institutional Medicaid covers nursing facility care, while Home and
Community-Based Services (HCBS) waivers extend Medicaid financed long-term
care to individuals in the community. Both are subject to the same core
income/resource methodology in most states, but waiver slots are capped and
states may apply the special income rule differently.
Question 3. Under the ACA's Modified Adjusted Gross Income (MAGI)
methodology, which Medicaid population is generally exempt from MAGI-based
counting rules?
A. Children under age 19
B. Pregnant women
C. Aged, blind, and disabled individuals seeking long-term care Medicaid
D. Newly eligible adults under expansion
Correct Answer: C
Rationale: MAGI rules apply to most non-elderly, non-disabled populations
covered under ACA expansion categories. Aged, blind, and disabled (ABD)
applicants — the population most relevant to Medicaid planning — remain
subject to traditional (non-MAGI) income and resource counting rules, which is
why asset and trust planning remains viable for them.
Question 4. A single applicant in a §209(b) state may face which additional
eligibility hurdle not present in §1634 or SSI-criteria states?
A. A more restrictive income or resource standard than the SSI federal benefit
rate, since §209(b) states may use pre-1972 state standards that are more
restrictive than SSI
B. A mandatory six-month waiting period before any Medicaid application
may be filed
C. An absolute prohibition on Miller Trusts
D. Ineligibility for any HCBS waiver
Correct Answer: A
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, CMP™ Examination Questions
Rationale: Section 209(b) of the 1972 Social Security Amendments lets a state use
eligibility criteria more restrictive than SSI as long as they are no stricter than the
state's 1972 Medicaid plan. §209(b) states must, however, allow a spend-down
(medically needy) option, which is a hallmark distinguishing them from SSI-criteria
states.
Question 5. What is the primary purpose of a 'medically needy' pathway to
Medicaid eligibility?
A. It allows applicants whose income exceeds the categorical limit to 'spend
down' excess income on medical expenses to qualify, functioning like a
deductible
B. It guarantees automatic eligibility for anyone diagnosed with a terminal
illness
C. It eliminates the resource limit entirely for elderly applicants
D. It replaces the need for a Medicaid application in states that offer it
Correct Answer: A
Rationale: The medically needy option, available at state discretion under 42 U.S.C.
§1396a(a)(10)(C), lets individuals with income above the categorical limit incur
medical or remedial expenses until their remaining countable income falls to the
state's medically needy income level, at which point they become eligible, similar
in concept to an insurance deductible.
Question 6. Which of the following is NOT one of the core eligibility categories a
CMP must evaluate for an aged/disabled long-term care Medicaid applicant?
A. Categorical (non-financial) eligibility, such as age, citizenship, and state
residency
B. Income eligibility relative to the applicable income cap or medically needy
limit
C. Resource (asset) eligibility relative to the countable resource limit
D. Employer sponsorship of the applicant's prior health insurance plan
Correct Answer: D
Rationale: Prior employer-sponsored insurance is not a Medicaid eligibility factor.
The three pillars a planner must assess are categorical/non-financial criteria (age,
citizenship, state residency, medical/functional need), income eligibility, and
resource eligibility, each governed by distinct federal and state rules.
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, CMP™ Examination Questions
Question 7. An applicant's state uses an 'income cap' (special income rule)
methodology rather than medically needy. If the applicant's gross income
exceeds 300% of the SSI federal benefit rate, what planning tool is most directly
indicated?
A. A qualifying income trust (Miller Trust / QIT) to redirect excess income so it
is not counted against the cap
B. Immediate denial with no further planning options available
C. Conversion of income into a countable resource
D. A spousal refusal election, regardless of marital status
Correct Answer: A
Rationale: In income-cap states, an applicant whose gross income exceeds the cap
(commonly 300% of the SSI FBR) is categorically ineligible regardless of medical
need unless excess income is diverted into an irrevocable Qualified Income Trust
(Miller Trust). Funds deposited into the trust are not counted toward the income
cap.
Question 8. For long-term care Medicaid, which document most commonly
establishes an applicant's functional (medical) eligibility?
A. A level-of-care assessment demonstrating the applicant requires nursing-
facility level care
B. A copy of the applicant's most recent federal tax return
C. A marriage certificate
D. A deed to the applicant's homestead
Correct Answer: A
Rationale: Beyond financial criteria, an applicant must be certified as needing a
nursing-facility level of care (or equivalent for HCBS waivers) through a state-
administered functional/level-of-care assessment, typically performed by a nurse
or the state's designated assessment agency.
Question 9. Which statement about state residency requirements for Medicaid
is most accurate?
A. An applicant must have lived in the state for at least twelve consecutive
months prior to applying
Page 4 of 54
CERTIFIED MEDICAID PLANNER (CMP™)
EXAMINATION
Questions & Answers| Latest Update| Pass Guaranteed
Question 1. Which federal statute establishes the Medicaid program and
delegates significant administrative authority to the states?
A. Title XVIII of the Social Security Act
B. Title XIX of the Social Security Act
C. The Employee Retirement Income Security Act (ERISA)
D. The Older Americans Act
Correct Answer: B
Rationale: Title XIX of the Social Security Act (42 U.S.C. §1396 et seq.), enacted in
1965, created Medicaid as a joint federal-state program. Title XVIII is Medicare.
States administer Medicaid under approved state plans, giving rise to significant
state-to-state variation that a CMP must track.
Question 2. A Certified Medicaid Planner is helping a client understand the
difference between an 'institutional' Medicaid applicant and a 'community'
(HCBS waiver) applicant. Which statement best distinguishes the two?
A. Institutional applicants must reside in a Medicaid-certified nursing facility
for eligibility purposes, while community applicants receive services in their
home or an assisted living setting under a waiver
B. Institutional applicants are always children, while community applicants are
always adults
Page 1 of 54
, CMP™ Examination Questions
C. There is no meaningful distinction; both use identical income and resource
limits nationwide
D. Community applicants are never subject to a look-back period
Correct Answer: A
Rationale: Institutional Medicaid covers nursing facility care, while Home and
Community-Based Services (HCBS) waivers extend Medicaid financed long-term
care to individuals in the community. Both are subject to the same core
income/resource methodology in most states, but waiver slots are capped and
states may apply the special income rule differently.
Question 3. Under the ACA's Modified Adjusted Gross Income (MAGI)
methodology, which Medicaid population is generally exempt from MAGI-based
counting rules?
A. Children under age 19
B. Pregnant women
C. Aged, blind, and disabled individuals seeking long-term care Medicaid
D. Newly eligible adults under expansion
Correct Answer: C
Rationale: MAGI rules apply to most non-elderly, non-disabled populations
covered under ACA expansion categories. Aged, blind, and disabled (ABD)
applicants — the population most relevant to Medicaid planning — remain
subject to traditional (non-MAGI) income and resource counting rules, which is
why asset and trust planning remains viable for them.
Question 4. A single applicant in a §209(b) state may face which additional
eligibility hurdle not present in §1634 or SSI-criteria states?
A. A more restrictive income or resource standard than the SSI federal benefit
rate, since §209(b) states may use pre-1972 state standards that are more
restrictive than SSI
B. A mandatory six-month waiting period before any Medicaid application
may be filed
C. An absolute prohibition on Miller Trusts
D. Ineligibility for any HCBS waiver
Correct Answer: A
Page 2 of 54
, CMP™ Examination Questions
Rationale: Section 209(b) of the 1972 Social Security Amendments lets a state use
eligibility criteria more restrictive than SSI as long as they are no stricter than the
state's 1972 Medicaid plan. §209(b) states must, however, allow a spend-down
(medically needy) option, which is a hallmark distinguishing them from SSI-criteria
states.
Question 5. What is the primary purpose of a 'medically needy' pathway to
Medicaid eligibility?
A. It allows applicants whose income exceeds the categorical limit to 'spend
down' excess income on medical expenses to qualify, functioning like a
deductible
B. It guarantees automatic eligibility for anyone diagnosed with a terminal
illness
C. It eliminates the resource limit entirely for elderly applicants
D. It replaces the need for a Medicaid application in states that offer it
Correct Answer: A
Rationale: The medically needy option, available at state discretion under 42 U.S.C.
§1396a(a)(10)(C), lets individuals with income above the categorical limit incur
medical or remedial expenses until their remaining countable income falls to the
state's medically needy income level, at which point they become eligible, similar
in concept to an insurance deductible.
Question 6. Which of the following is NOT one of the core eligibility categories a
CMP must evaluate for an aged/disabled long-term care Medicaid applicant?
A. Categorical (non-financial) eligibility, such as age, citizenship, and state
residency
B. Income eligibility relative to the applicable income cap or medically needy
limit
C. Resource (asset) eligibility relative to the countable resource limit
D. Employer sponsorship of the applicant's prior health insurance plan
Correct Answer: D
Rationale: Prior employer-sponsored insurance is not a Medicaid eligibility factor.
The three pillars a planner must assess are categorical/non-financial criteria (age,
citizenship, state residency, medical/functional need), income eligibility, and
resource eligibility, each governed by distinct federal and state rules.
Page 3 of 54
, CMP™ Examination Questions
Question 7. An applicant's state uses an 'income cap' (special income rule)
methodology rather than medically needy. If the applicant's gross income
exceeds 300% of the SSI federal benefit rate, what planning tool is most directly
indicated?
A. A qualifying income trust (Miller Trust / QIT) to redirect excess income so it
is not counted against the cap
B. Immediate denial with no further planning options available
C. Conversion of income into a countable resource
D. A spousal refusal election, regardless of marital status
Correct Answer: A
Rationale: In income-cap states, an applicant whose gross income exceeds the cap
(commonly 300% of the SSI FBR) is categorically ineligible regardless of medical
need unless excess income is diverted into an irrevocable Qualified Income Trust
(Miller Trust). Funds deposited into the trust are not counted toward the income
cap.
Question 8. For long-term care Medicaid, which document most commonly
establishes an applicant's functional (medical) eligibility?
A. A level-of-care assessment demonstrating the applicant requires nursing-
facility level care
B. A copy of the applicant's most recent federal tax return
C. A marriage certificate
D. A deed to the applicant's homestead
Correct Answer: A
Rationale: Beyond financial criteria, an applicant must be certified as needing a
nursing-facility level of care (or equivalent for HCBS waivers) through a state-
administered functional/level-of-care assessment, typically performed by a nurse
or the state's designated assessment agency.
Question 9. Which statement about state residency requirements for Medicaid
is most accurate?
A. An applicant must have lived in the state for at least twelve consecutive
months prior to applying
Page 4 of 54
