AHIP Medicare Certification 2027 2028
Questions & Answers PDF Study Guide
(Latest Updated Pack, Score A+)
1. Which part of Medicare primarily provides hospital insurance?
A. Part A
B. Part B
C. Part C
D. Part D
Answer: _A. Part A_
Rationale: Medicare Part A is Hospital Insurance and generally covers inpatient
hospital services, skilled nursing facility care following qualifying circumstances,
hospice care, and certain home health services.
2. Which Medicare part provides medical insurance for physician and
outpatient services?
A. Part A
B. Part B
C. Part C
D. Part D
Answer: _B. Part B_
Rationale: Part B is Medicare Medical Insurance and generally covers medically
necessary physician, outpatient, preventive, and other covered medical services.
3. Medicare Advantage is also known as which Medicare part?
A. Part A
B. Part B
,C. Part C
D. Part D
Answer: _C. Part C_
Rationale: Medicare Advantage plans are Medicare Part C plans offered by
Medicare-approved private organizations.
4. Which Medicare part provides outpatient prescription drug coverage?
A. Part A
B. Part B
C. Part C
D. Part D
Answer: _D. Part D**_
Rationale: Medicare Part D provides prescription drug coverage through stand-
alone Prescription Drug Plans and Medicare Advantage Prescription Drug plans.
5. Which combination is generally required for an individual to enroll in a
Medicare Advantage plan?
A. Part A only
B. Part B only
C. Part A and Part B
D. Part D only
Answer: _C. Part A and Part B_
Rationale: CMS states that an individual generally must have Medicare Part A and
Part B to enroll in a Medicare Advantage plan, along with meeting other eligibility
requirements.
6. Which organization administers the federal Medicare program?
A. CMS
B. OSHA
C. FDA
D. FTC
,Answer: _A. CMS_
Rationale: The Centers for Medicare & Medicaid Services (CMS) administers
Medicare and establishes requirements for Medicare Advantage and Part D
organizations.
7. A beneficiary wants Original Medicare and separate prescription drug
coverage. Which arrangement is appropriate?
A. Part A only
B. Part A and B with a stand-alone Part D plan
C. Part C without Part B
D. Medigap without Original Medicare
Answer: _B. Part A and B with a stand-alone Part D plan_
Rationale: One recognized way to receive Medicare is Original Medicare—Parts
A and B—combined with a stand-alone Prescription Drug Plan.
8. Which type of Medicare Advantage plan commonly uses a network of
providers and emphasizes coordinated care?
A. HMO
B. Medigap
C. Stand-alone PDP
D. Original Medicare
Answer: _A. HMO_
Rationale: Medicare Advantage HMOs generally use provider networks and
coordinate members’ healthcare through the plan's care-delivery structure.
9. What does PDP stand for in Medicare terminology?
A. Primary Doctor Program
B. Prescription Drug Plan
C. Preventive Drug Program
D. Provider Drug Policy
Answer: _B. Prescription Drug Plan_
, Rationale: PDP commonly refers to a stand-alone Medicare Prescription Drug
Plan under Part D.
10. What is an MA-PD plan?
A. A Medigap plan with dental coverage
B. A Medicare Advantage plan that includes Part D prescription drug coverage
C. Original Medicare with Medicaid
D. A Part B supplement
Answer: _B. A Medicare Advantage plan that includes Part D prescription drug
coverage_
Rationale: MA-PD refers to Medicare Advantage plans that provide prescription
drug coverage as part of the plan.
11. Which Medicare option is designed to supplement certain out-of-pocket
costs associated with Original Medicare?
A. Medigap
B. Part D
C. HMO
D. PFFS
Answer: _A. Medigap_
Rationale: Medigap policies are Medicare Supplement Insurance policies designed
to help pay certain healthcare costs that Original Medicare does not cover.
12. Which organization publishes the Medicare Agent/Broker Training &
Testing Guidelines?
A. CMS
B. IRS
C. OSHA
D. CDC
Answer: _A. CMS_
Questions & Answers PDF Study Guide
(Latest Updated Pack, Score A+)
1. Which part of Medicare primarily provides hospital insurance?
A. Part A
B. Part B
C. Part C
D. Part D
Answer: _A. Part A_
Rationale: Medicare Part A is Hospital Insurance and generally covers inpatient
hospital services, skilled nursing facility care following qualifying circumstances,
hospice care, and certain home health services.
2. Which Medicare part provides medical insurance for physician and
outpatient services?
A. Part A
B. Part B
C. Part C
D. Part D
Answer: _B. Part B_
Rationale: Part B is Medicare Medical Insurance and generally covers medically
necessary physician, outpatient, preventive, and other covered medical services.
3. Medicare Advantage is also known as which Medicare part?
A. Part A
B. Part B
,C. Part C
D. Part D
Answer: _C. Part C_
Rationale: Medicare Advantage plans are Medicare Part C plans offered by
Medicare-approved private organizations.
4. Which Medicare part provides outpatient prescription drug coverage?
A. Part A
B. Part B
C. Part C
D. Part D
Answer: _D. Part D**_
Rationale: Medicare Part D provides prescription drug coverage through stand-
alone Prescription Drug Plans and Medicare Advantage Prescription Drug plans.
5. Which combination is generally required for an individual to enroll in a
Medicare Advantage plan?
A. Part A only
B. Part B only
C. Part A and Part B
D. Part D only
Answer: _C. Part A and Part B_
Rationale: CMS states that an individual generally must have Medicare Part A and
Part B to enroll in a Medicare Advantage plan, along with meeting other eligibility
requirements.
6. Which organization administers the federal Medicare program?
A. CMS
B. OSHA
C. FDA
D. FTC
,Answer: _A. CMS_
Rationale: The Centers for Medicare & Medicaid Services (CMS) administers
Medicare and establishes requirements for Medicare Advantage and Part D
organizations.
7. A beneficiary wants Original Medicare and separate prescription drug
coverage. Which arrangement is appropriate?
A. Part A only
B. Part A and B with a stand-alone Part D plan
C. Part C without Part B
D. Medigap without Original Medicare
Answer: _B. Part A and B with a stand-alone Part D plan_
Rationale: One recognized way to receive Medicare is Original Medicare—Parts
A and B—combined with a stand-alone Prescription Drug Plan.
8. Which type of Medicare Advantage plan commonly uses a network of
providers and emphasizes coordinated care?
A. HMO
B. Medigap
C. Stand-alone PDP
D. Original Medicare
Answer: _A. HMO_
Rationale: Medicare Advantage HMOs generally use provider networks and
coordinate members’ healthcare through the plan's care-delivery structure.
9. What does PDP stand for in Medicare terminology?
A. Primary Doctor Program
B. Prescription Drug Plan
C. Preventive Drug Program
D. Provider Drug Policy
Answer: _B. Prescription Drug Plan_
, Rationale: PDP commonly refers to a stand-alone Medicare Prescription Drug
Plan under Part D.
10. What is an MA-PD plan?
A. A Medigap plan with dental coverage
B. A Medicare Advantage plan that includes Part D prescription drug coverage
C. Original Medicare with Medicaid
D. A Part B supplement
Answer: _B. A Medicare Advantage plan that includes Part D prescription drug
coverage_
Rationale: MA-PD refers to Medicare Advantage plans that provide prescription
drug coverage as part of the plan.
11. Which Medicare option is designed to supplement certain out-of-pocket
costs associated with Original Medicare?
A. Medigap
B. Part D
C. HMO
D. PFFS
Answer: _A. Medigap_
Rationale: Medigap policies are Medicare Supplement Insurance policies designed
to help pay certain healthcare costs that Original Medicare does not cover.
12. Which organization publishes the Medicare Agent/Broker Training &
Testing Guidelines?
A. CMS
B. IRS
C. OSHA
D. CDC
Answer: _A. CMS_
