2026 QUESTION BANK CERTIFIED RESULTS
ANALYSIS SHEET
◉
Answer: The consumer must be in a valid MA election or
disenrollment period.
◉ Which of the following consumers would be eligible for Medicare?
Answer: Consumers age 65 or older, consumers under 65 years of
age with certain disabilities for more than 24 months and
consumers of all ages with ESRD or ALS
◉ Which of the following defines a Medicare Advantage (MA) Plan?
Answer: MA Plans are health plan options approved by Medicare
and offered by private insurance companies.
◉ Janice wants to enroll in a 2021 Medicare Advantage plan. What
eligibility requirements must she meet? (Select the two answers that
apply.)
Answer: Not have End Stage Renal Disease (permanent kidney
failure)Reside in the plan's service area
,◉ What must be explained to consumers enrolling in an HMO
(Health Maintenance Organization) MA Plan? (Select 3)
Answer:
◉ Which of the following are MA Plans that focus on using network
providers to maximize the benefits and reduce out-of-network
expenses?
Answer: HMO, POS, PPO
◉ Which is true about Medicare Supplement Open Enrollment?
Answer: By federal law, Medicare Supplement Open Enrollment is
the first 6 months a consumer is 65 or older and enrolled in
Medicare Part B.
◉ How does the Medicare Advantage Out-of-Pocket (OOP) maximum
work?
Answer: The OOP maximum is a feature that limits the amount of
money a consumer will have to spend on Medicare-covered health
care services each year.
◉ A consumer currently has Original Medicare and is enrolled in a
stand-alone Prescription Drug Plan (PDP). What will happen if the
consumer enrolls in an MA Plan that has integrated prescription
drug coverage?
, Answer: The consumer will be automatically disenrolled from their
stand-alone PDP upon enrollment in the MA Plan that has integrated
prescription drug coverage
◉ A government program, offered only through a private insurance
company or other private company approved by Medicare, that
provides prescription drug coverage describes which of the
following:
Answer: Medicare Parts A and B
◉ Which of the following statements is true about eligibility
requirements for Medicare Prescription Drug Plans?
Answer: A consumer must be entitled to Medicare Part A and/or
enrolled in Medicare Part B
◉ What are two options for Medicare consumers to get Part D
prescription drug coverage (assuming they meet all eligibility
requirements)? (Select 2)
Answer:
◉ Which of the following statements is not true about the Coverage
Gap?
Answer: All members reach the Coverage Gap