ORIGINAL 2024 MEDICARE CERTIFICATION PRACTICE ASSESSMENT
AHIP-STYLE 2024
Medicare Certification
Practice Final
90 Original Scenario-Based Questions • Answer & Rationale Immediately Below Every Question
Medicare Basics • MA & Part D • Enrollment • Marketing • Compliance • FWA
1
, ORIGINAL 2024 MEDICARE CERTIFICATION PRACTICE ASSESSMENT
Section I - Medicare Foundations & Plan Types
1. A beneficiary says, “I want hospital and physician coverage from the federal Original Medicare
program, and I will decide separately whether I need drug coverage.” Which pairing correctly identifies
the two core Original Medicare components?
A. Part A and Part B
B. Part B and Part C
C. Part A and Part D
D. Part C and Part D
Answer: A — Part A and Part B
Rationale: Original Medicare is built from Part A (hospital insurance) and Part B (medical insurance). Part C
is Medicare Advantage, while Part D provides outpatient prescription drug coverage.
2. Maria is enrolled in Original Medicare and wants insurance designed to help pay some deductibles,
coinsurance, and other cost-sharing left by Original Medicare. Which product is she describing?
A. A stand-alone Part D plan
B. A Chronic Condition Special Needs Plan
C. A Medicare Supplement (Medigap) policy
D. A Medicare Advantage Medical Savings Account
Answer: C — A Medicare Supplement (Medigap) policy
Rationale: Medigap is supplemental insurance that works with Original Medicare to help with certain
beneficiary cost-sharing. It is not prescription drug coverage and is not a Medicare Advantage plan.
3. Leon wants one private-plan package that replaces the way he receives Part A and Part B benefits and
also includes prescription drug coverage. Which option most directly fits that preference?
A. Original Medicare plus Medigap only
B. An MA-PD plan
C. A stand-alone PDP only
D. Part A only
Answer: B — An MA-PD plan
Rationale: An MA-PD combines Medicare Advantage medical coverage with Part D prescription drug
coverage. Original Medicare plus Medigap does not itself include Part D.
4. A prospect asks whether a Medicare Advantage plan is simply an optional dental rider added to
Original Medicare. What is the most accurate response?
A. Yes; MA only changes prescription drug coverage
B. No; MA is available only to people with Medicaid
C. Yes; all MA plans are dental riders
D. No; MA is an alternative way to receive Medicare-covered Part A and Part B benefits through a private plan
Answer: D — No; MA is an alternative way to receive Medicare-covered Part A and Part B benefits through a
private plan
Rationale: Medicare Advantage is a private-plan alternative for receiving Medicare-covered Part A and Part
B services. Some plans may include supplemental benefits, but the plan is not merely a dental or vision rider.
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, ORIGINAL 2024 MEDICARE CERTIFICATION PRACTICE ASSESSMENT
5. A beneficiary values having an annual ceiling on out-of-pocket spending for Medicare-covered Part A
and Part B services. Which general distinction is most relevant?
A. Part D establishes the medical maximum out-of-pocket limit
B. Medicare Advantage plans include a maximum out-of-pocket limit for covered Part A and B services
C. Medigap policies never reduce cost sharing
D. Original Medicare has a built-in annual maximum for all Part A and B cost sharing
Answer: B — Medicare Advantage plans include a maximum out-of-pocket limit for covered Part A and B
services
Rationale: Medicare Advantage plans have a maximum out-of-pocket limit for covered Part A and Part B
services. Original Medicare by itself does not have the same annual medical out-of-pocket cap.
6. DeShawn wants a plan specifically designed for people who meet defined special-needs criteria.
Which category should an agent investigate first?
A. Original Medicare Part B
B. SNP
C. Medigap
D. PDP
Answer: B — SNP
Rationale: Special Needs Plans (SNPs) are Medicare Advantage plan types designed for defined eligible
populations, such as certain chronic conditions, institutional status, or dual eligibility.
7. A client has both Medicare and Medicaid and asks about a Medicare Advantage plan tailored to people
with both forms of coverage. Which plan type is most directly relevant?
A. I-SNP
B. C-SNP
C. D-SNP
D. MSA
Answer: C — D-SNP
Rationale: A Dual-Eligible Special Needs Plan (D-SNP) is designed for people who meet the plan's Medicare
and Medicaid eligibility requirements.
8. A beneficiary lives in an institution and meets the plan's institutional eligibility rules. Which Medicare
Advantage category is designed around that status?
A. D-SNP
B. I-SNP
C. PFFS
D. C-SNP
Answer: B — I-SNP
Rationale: Institutional Special Needs Plans (I-SNPs) serve people who meet qualifying institutional criteria.
Eligibility must be maintained according to the plan's rules.
9. A beneficiary with a qualifying severe or disabling chronic condition wants a plan structured for that
condition. Which plan type is most relevant?
A. I-SNP
B. Medigap
C. Cost Plan
D. C-SNP
3
AHIP-STYLE 2024
Medicare Certification
Practice Final
90 Original Scenario-Based Questions • Answer & Rationale Immediately Below Every Question
Medicare Basics • MA & Part D • Enrollment • Marketing • Compliance • FWA
1
, ORIGINAL 2024 MEDICARE CERTIFICATION PRACTICE ASSESSMENT
Section I - Medicare Foundations & Plan Types
1. A beneficiary says, “I want hospital and physician coverage from the federal Original Medicare
program, and I will decide separately whether I need drug coverage.” Which pairing correctly identifies
the two core Original Medicare components?
A. Part A and Part B
B. Part B and Part C
C. Part A and Part D
D. Part C and Part D
Answer: A — Part A and Part B
Rationale: Original Medicare is built from Part A (hospital insurance) and Part B (medical insurance). Part C
is Medicare Advantage, while Part D provides outpatient prescription drug coverage.
2. Maria is enrolled in Original Medicare and wants insurance designed to help pay some deductibles,
coinsurance, and other cost-sharing left by Original Medicare. Which product is she describing?
A. A stand-alone Part D plan
B. A Chronic Condition Special Needs Plan
C. A Medicare Supplement (Medigap) policy
D. A Medicare Advantage Medical Savings Account
Answer: C — A Medicare Supplement (Medigap) policy
Rationale: Medigap is supplemental insurance that works with Original Medicare to help with certain
beneficiary cost-sharing. It is not prescription drug coverage and is not a Medicare Advantage plan.
3. Leon wants one private-plan package that replaces the way he receives Part A and Part B benefits and
also includes prescription drug coverage. Which option most directly fits that preference?
A. Original Medicare plus Medigap only
B. An MA-PD plan
C. A stand-alone PDP only
D. Part A only
Answer: B — An MA-PD plan
Rationale: An MA-PD combines Medicare Advantage medical coverage with Part D prescription drug
coverage. Original Medicare plus Medigap does not itself include Part D.
4. A prospect asks whether a Medicare Advantage plan is simply an optional dental rider added to
Original Medicare. What is the most accurate response?
A. Yes; MA only changes prescription drug coverage
B. No; MA is available only to people with Medicaid
C. Yes; all MA plans are dental riders
D. No; MA is an alternative way to receive Medicare-covered Part A and Part B benefits through a private plan
Answer: D — No; MA is an alternative way to receive Medicare-covered Part A and Part B benefits through a
private plan
Rationale: Medicare Advantage is a private-plan alternative for receiving Medicare-covered Part A and Part
B services. Some plans may include supplemental benefits, but the plan is not merely a dental or vision rider.
2
, ORIGINAL 2024 MEDICARE CERTIFICATION PRACTICE ASSESSMENT
5. A beneficiary values having an annual ceiling on out-of-pocket spending for Medicare-covered Part A
and Part B services. Which general distinction is most relevant?
A. Part D establishes the medical maximum out-of-pocket limit
B. Medicare Advantage plans include a maximum out-of-pocket limit for covered Part A and B services
C. Medigap policies never reduce cost sharing
D. Original Medicare has a built-in annual maximum for all Part A and B cost sharing
Answer: B — Medicare Advantage plans include a maximum out-of-pocket limit for covered Part A and B
services
Rationale: Medicare Advantage plans have a maximum out-of-pocket limit for covered Part A and Part B
services. Original Medicare by itself does not have the same annual medical out-of-pocket cap.
6. DeShawn wants a plan specifically designed for people who meet defined special-needs criteria.
Which category should an agent investigate first?
A. Original Medicare Part B
B. SNP
C. Medigap
D. PDP
Answer: B — SNP
Rationale: Special Needs Plans (SNPs) are Medicare Advantage plan types designed for defined eligible
populations, such as certain chronic conditions, institutional status, or dual eligibility.
7. A client has both Medicare and Medicaid and asks about a Medicare Advantage plan tailored to people
with both forms of coverage. Which plan type is most directly relevant?
A. I-SNP
B. C-SNP
C. D-SNP
D. MSA
Answer: C — D-SNP
Rationale: A Dual-Eligible Special Needs Plan (D-SNP) is designed for people who meet the plan's Medicare
and Medicaid eligibility requirements.
8. A beneficiary lives in an institution and meets the plan's institutional eligibility rules. Which Medicare
Advantage category is designed around that status?
A. D-SNP
B. I-SNP
C. PFFS
D. C-SNP
Answer: B — I-SNP
Rationale: Institutional Special Needs Plans (I-SNPs) serve people who meet qualifying institutional criteria.
Eligibility must be maintained according to the plan's rules.
9. A beneficiary with a qualifying severe or disabling chronic condition wants a plan structured for that
condition. Which plan type is most relevant?
A. I-SNP
B. Medigap
C. Cost Plan
D. C-SNP
3
