AHIP Medicare Training
Comprehensive Practice Examination
Questions And Correct Answers
(Verified Answers) Plus Rationales
2026 Q&A | Instant Download Pdf
1. Which statement best describes Original Medicare?
A. It is a private insurance program offered only by employers.
B. It is a Medicare Advantage plan administered by private insurers.
C. It provides coverage only for prescription drugs.
D. It consists primarily of Medicare Part A and Part B administered
by the federal government.
Answer: D. It consists primarily of Medicare Part A and Part B
administered by the federal government.
Rationale: Original Medicare is the traditional federal Medicare
program consisting of Part A hospital insurance and Part B medical
insurance. Beneficiaries may also obtain Part D prescription drug
coverage and supplemental coverage separately.
2. What does Medicare Part A primarily cover?
A. Inpatient hospital and certain other institutional services
B. Routine dental services
C. Outpatient prescription drugs
D. Routine hearing aids
Answer: A. Inpatient hospital and certain other institutional services
,Rationale: Part A is Medicare hospital insurance. It generally covers
inpatient hospital care, skilled nursing facility care under qualifying
circumstances, hospice care, and certain home health services.
3. What is the primary purpose of Medicare Part B?
A. To provide long-term custodial nursing-home care
B. To cover all prescription medications
C. To cover physician services and other medically necessary
outpatient services
D. To replace Medicaid for low-income beneficiaries
Answer: C. To cover physician services and other medically
necessary outpatient services
Rationale: Part B is medical insurance. It generally covers physician
services, outpatient care, preventive services, durable medical
equipment, and other medically necessary services that fall within
Medicare's Part B benefit structure.
4. Which person generally may qualify for Medicare based on age?
A. Anyone who has received Social Security for one year
B. A person age 65 or older who meets applicable Medicare
eligibility requirements
C. Anyone age 55 or older
D. Anyone who has private health insurance
Answer: B. A person age 65 or older who meets applicable Medicare
eligibility requirements
Rationale: Age 65 is the principal age-based eligibility threshold for
Medicare. Additional requirements involving citizenship, lawful
residency, work history, or other eligibility rules may apply.
, 5. A beneficiary wants coverage for outpatient prescription drugs.
Which Medicare component is specifically designed for this
purpose?
A. Part A
B. Part B
C. Medigap
D. Part D
Answer: D. Part D
Rationale: Medicare Part D provides prescription drug coverage
through private Medicare-approved prescription drug plans and
Medicare Advantage plans that include drug coverage.
6. Which organization administers Medicare at the federal level?
A. The federal government through the Centers for Medicare &
Medicaid Services (CMS)
B. Individual hospitals
C. State insurance departments exclusively
D. Employers
Answer: A. The federal government through the Centers for
Medicare & Medicaid Services (CMS)
Rationale: CMS is the federal agency responsible for administering
Medicare and overseeing participating Medicare health and
prescription drug plans.
7. What is a Medicare Advantage plan?
A. A supplemental policy that pays only Medicare deductibles
B. A state Medicaid program
C. A Medicare health plan offered by a private Medicare-contracted
, organization
D. A standalone prescription discount card
Answer: C. A Medicare health plan offered by a private Medicare-
contracted organization
Rationale: Medicare Advantage, also called Medicare Part C, allows
eligible beneficiaries to receive Medicare-covered benefits through
private Medicare-contracted plans. Many plans also include Part D
prescription drug coverage.
8. Which statement about Medicare Advantage is generally correct?
A. It eliminates all Medicare cost sharing.
B. It must cover all medically necessary services that Original
Medicare covers, subject to applicable plan rules.
C. It is available only to people with employer coverage.
D. It provides only prescription drug benefits.
Answer: B. It must cover all medically necessary services that
Original Medicare covers, subject to applicable plan rules.
Rationale: Medicare Advantage plans must provide the Medicare-
covered benefits available under Parts A and B, although plans
generally establish their own cost-sharing structures and may use
provider networks or other managed-care requirements.
9. Which type of plan generally requires members to use a network
for routine care except in specified circumstances?
A. Health Maintenance Organization (HMO)
B. Original Medicare
C. Medigap policy
D. Standalone Part D plan
Answer: A. Health Maintenance Organization (HMO)
Comprehensive Practice Examination
Questions And Correct Answers
(Verified Answers) Plus Rationales
2026 Q&A | Instant Download Pdf
1. Which statement best describes Original Medicare?
A. It is a private insurance program offered only by employers.
B. It is a Medicare Advantage plan administered by private insurers.
C. It provides coverage only for prescription drugs.
D. It consists primarily of Medicare Part A and Part B administered
by the federal government.
Answer: D. It consists primarily of Medicare Part A and Part B
administered by the federal government.
Rationale: Original Medicare is the traditional federal Medicare
program consisting of Part A hospital insurance and Part B medical
insurance. Beneficiaries may also obtain Part D prescription drug
coverage and supplemental coverage separately.
2. What does Medicare Part A primarily cover?
A. Inpatient hospital and certain other institutional services
B. Routine dental services
C. Outpatient prescription drugs
D. Routine hearing aids
Answer: A. Inpatient hospital and certain other institutional services
,Rationale: Part A is Medicare hospital insurance. It generally covers
inpatient hospital care, skilled nursing facility care under qualifying
circumstances, hospice care, and certain home health services.
3. What is the primary purpose of Medicare Part B?
A. To provide long-term custodial nursing-home care
B. To cover all prescription medications
C. To cover physician services and other medically necessary
outpatient services
D. To replace Medicaid for low-income beneficiaries
Answer: C. To cover physician services and other medically
necessary outpatient services
Rationale: Part B is medical insurance. It generally covers physician
services, outpatient care, preventive services, durable medical
equipment, and other medically necessary services that fall within
Medicare's Part B benefit structure.
4. Which person generally may qualify for Medicare based on age?
A. Anyone who has received Social Security for one year
B. A person age 65 or older who meets applicable Medicare
eligibility requirements
C. Anyone age 55 or older
D. Anyone who has private health insurance
Answer: B. A person age 65 or older who meets applicable Medicare
eligibility requirements
Rationale: Age 65 is the principal age-based eligibility threshold for
Medicare. Additional requirements involving citizenship, lawful
residency, work history, or other eligibility rules may apply.
, 5. A beneficiary wants coverage for outpatient prescription drugs.
Which Medicare component is specifically designed for this
purpose?
A. Part A
B. Part B
C. Medigap
D. Part D
Answer: D. Part D
Rationale: Medicare Part D provides prescription drug coverage
through private Medicare-approved prescription drug plans and
Medicare Advantage plans that include drug coverage.
6. Which organization administers Medicare at the federal level?
A. The federal government through the Centers for Medicare &
Medicaid Services (CMS)
B. Individual hospitals
C. State insurance departments exclusively
D. Employers
Answer: A. The federal government through the Centers for
Medicare & Medicaid Services (CMS)
Rationale: CMS is the federal agency responsible for administering
Medicare and overseeing participating Medicare health and
prescription drug plans.
7. What is a Medicare Advantage plan?
A. A supplemental policy that pays only Medicare deductibles
B. A state Medicaid program
C. A Medicare health plan offered by a private Medicare-contracted
, organization
D. A standalone prescription discount card
Answer: C. A Medicare health plan offered by a private Medicare-
contracted organization
Rationale: Medicare Advantage, also called Medicare Part C, allows
eligible beneficiaries to receive Medicare-covered benefits through
private Medicare-contracted plans. Many plans also include Part D
prescription drug coverage.
8. Which statement about Medicare Advantage is generally correct?
A. It eliminates all Medicare cost sharing.
B. It must cover all medically necessary services that Original
Medicare covers, subject to applicable plan rules.
C. It is available only to people with employer coverage.
D. It provides only prescription drug benefits.
Answer: B. It must cover all medically necessary services that
Original Medicare covers, subject to applicable plan rules.
Rationale: Medicare Advantage plans must provide the Medicare-
covered benefits available under Parts A and B, although plans
generally establish their own cost-sharing structures and may use
provider networks or other managed-care requirements.
9. Which type of plan generally requires members to use a network
for routine care except in specified circumstances?
A. Health Maintenance Organization (HMO)
B. Original Medicare
C. Medigap policy
D. Standalone Part D plan
Answer: A. Health Maintenance Organization (HMO)
