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AHIP MEDICARE CERTIFICATION Original Practice Questions with
Answers & Rationales
SECTION 1: MEDICARE PROGRAM BASICS
1. Medicare is administered by:
A) The Social Security Administration only
B) The Centers for Medicare & Medicaid Services (CMS)
C) The Department of Health and Human Services (HHS)
D) Private insurance companies only
Answer: B
Rationale: CMS, a federal agency within HHS, administers the
Medicare program. The Social Security Administration handles
enrollment but CMS oversees the program.
2. Medicare Part A provides coverage for:
A) Outpatient services only
B) Inpatient hospital care, skilled nursing facility, hospice, and
home health services
C) Prescription drugs only
D) Routine dental and vision care
Answer: B
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Rationale: Medicare Part A (Hospital Insurance) covers
inpatient hospital stays, skilled nursing facility care, hospice,
and some home health services.
3. Medicare Part B provides coverage for:
A) Inpatient hospital care
B) Physician services, outpatient care, preventive services, and
durable medical equipment
C) Prescription drugs only
D) Long-term custodial care
Answer: B
Rationale: Medicare Part B (Medical Insurance) covers physician
services, outpatient care, preventive services, and medical
supplies/equipment.
4. Medicare Part C is also known as:
A) Original Medicare
B) Medicare Advantage
C) Medigap
D) Prescription Drug Coverage
Answer: B
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Rationale: Medicare Part C (Medicare Advantage) allows
beneficiaries to receive Medicare benefits through private
insurance plans approved by Medicare.
5. Medicare Part D provides coverage for:
A) Hospital stays
B) Physician visits
C) Prescription drugs
D) Dental care only
Answer: C
Rationale: Medicare Part D provides prescription drug coverage
through private plans approved by Medicare.
6. A person is generally eligible for Medicare at age:
A) 55
B) 60
C) 62
D) 65
Answer: D
Rationale: Most people become eligible for Medicare at age 65.
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7. A person under 65 may qualify for Medicare if they:
A) Have a low income
B) Have been receiving Social Security Disability Insurance
(SSDI) for 24 months, have ESRD, or have ALS
C) Are unemployed
D) Have private insurance only
Answer: B
Rationale: Medicare is available to those under 65 who have
received SSDI for 24 months, have End-Stage Renal Disease
(ESRD), or have Amyotrophic Lateral Sclerosis (ALS).
8. Medicare Part A is premium-free for most beneficiaries
because:
A) It is always free
B) They or their spouse paid Medicare taxes while working (40
quarters)
C) The government subsidizes everyone
D) Private insurance pays for it
Answer: B
Rationale: Those who paid Medicare payroll taxes for at least
40 quarters (10 years) generally receive Part A premium-free.
AHIP MEDICARE CERTIFICATION Original Practice Questions with
Answers & Rationales
SECTION 1: MEDICARE PROGRAM BASICS
1. Medicare is administered by:
A) The Social Security Administration only
B) The Centers for Medicare & Medicaid Services (CMS)
C) The Department of Health and Human Services (HHS)
D) Private insurance companies only
Answer: B
Rationale: CMS, a federal agency within HHS, administers the
Medicare program. The Social Security Administration handles
enrollment but CMS oversees the program.
2. Medicare Part A provides coverage for:
A) Outpatient services only
B) Inpatient hospital care, skilled nursing facility, hospice, and
home health services
C) Prescription drugs only
D) Routine dental and vision care
Answer: B
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Rationale: Medicare Part A (Hospital Insurance) covers
inpatient hospital stays, skilled nursing facility care, hospice,
and some home health services.
3. Medicare Part B provides coverage for:
A) Inpatient hospital care
B) Physician services, outpatient care, preventive services, and
durable medical equipment
C) Prescription drugs only
D) Long-term custodial care
Answer: B
Rationale: Medicare Part B (Medical Insurance) covers physician
services, outpatient care, preventive services, and medical
supplies/equipment.
4. Medicare Part C is also known as:
A) Original Medicare
B) Medicare Advantage
C) Medigap
D) Prescription Drug Coverage
Answer: B
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Rationale: Medicare Part C (Medicare Advantage) allows
beneficiaries to receive Medicare benefits through private
insurance plans approved by Medicare.
5. Medicare Part D provides coverage for:
A) Hospital stays
B) Physician visits
C) Prescription drugs
D) Dental care only
Answer: C
Rationale: Medicare Part D provides prescription drug coverage
through private plans approved by Medicare.
6. A person is generally eligible for Medicare at age:
A) 55
B) 60
C) 62
D) 65
Answer: D
Rationale: Most people become eligible for Medicare at age 65.
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7. A person under 65 may qualify for Medicare if they:
A) Have a low income
B) Have been receiving Social Security Disability Insurance
(SSDI) for 24 months, have ESRD, or have ALS
C) Are unemployed
D) Have private insurance only
Answer: B
Rationale: Medicare is available to those under 65 who have
received SSDI for 24 months, have End-Stage Renal Disease
(ESRD), or have Amyotrophic Lateral Sclerosis (ALS).
8. Medicare Part A is premium-free for most beneficiaries
because:
A) It is always free
B) They or their spouse paid Medicare taxes while working (40
quarters)
C) The government subsidizes everyone
D) Private insurance pays for it
Answer: B
Rationale: Those who paid Medicare payroll taxes for at least
40 quarters (10 years) generally receive Part A premium-free.
