Medicare Part D Certification Exam Practice
Study Guide — Exam Questions with Correct
Answers (VerifiedAnswers) Plus Rationales
2026 Q&A Instant Download PDF
Practice Exam
1. What is the primary purpose of Medicare Part D?
A. To cover inpatient hospital services
B. To cover physician and outpatient medical services
C. To provide Medicare prescription drug coverage
D. To cover long-term custodial care
Rationale: Medicare Part D is the Medicare prescription drug
benefit. It provides coverage for eligible outpatient prescription
drugs through private Medicare drug plans, including stand-
alone Prescription Drug Plans (PDPs) and Medicare Advantage
plans that include prescription drug coverage (MA-PDs). Part A
primarily addresses inpatient hospital-related services, while
Part B generally covers physician and outpatient medical
services.
,2. Which type of organization generally offers a stand-alone
Medicare Prescription Drug Plan (PDP)?
A. A state Medicaid agency
B. A private Medicare-approved prescription drug plan
sponsor
C. A hospital operating under Medicare Part A
D. The Social Security Administration directly
Rationale: Stand-alone PDPs are offered by private
organizations that have contracts with Medicare to provide
prescription drug coverage. Medicare beneficiaries can
generally obtain a PDP when they have Medicare Part A and/or
Part B and meet applicable enrollment requirements. Medicare
itself establishes program requirements and contracts with
sponsors but does not operate as the direct insurer for
individual PDP coverage.
3. Which Medicare coverage combination normally includes
Part D drug coverage within the same Medicare plan?
A. Original Medicare alone
B. Medicare Part B alone
C. A Medicare Advantage plan that includes prescription drug
coverage (MA-PD)
D. Medicare Supplement Insurance alone
,Rationale: Many Medicare Advantage plans combine Part A and
Part B coverage and may include Part D prescription drug
coverage. When an MA plan includes Part D, it is commonly
referred to as an MA-PD. Original Medicare by itself does not
include routine outpatient prescription drug coverage, and
Medigap policies generally do not provide current outpatient
prescription drug coverage.
4. What is the maximum standard Part D deductible for 2026?
A. $500
B. $550
C. $615
D. $750
Rationale: For 2026, no Medicare drug plan may have a
deductible greater than $615. A particular plan may have a
lower deductible or no deductible, depending on its benefit
design. The deductible is the amount the enrollee may have to
pay for covered Part D drugs before the plan begins paying
under the plan's subsequent coverage stage.
5. What is the annual Part D out-of-pocket threshold for
covered prescription drugs in 2026?
, A. $1,500
B. $2,000
C. $2,100
D. $2,500
Rationale: Beginning in 2025, the Part D benefit eliminated the
former coverage-gap structure and established an annual out-
of-pocket limit. For 2026, that threshold is $2,100. Once an
enrollee reaches the applicable annual out-of-pocket threshold
for covered Part D drugs, the enrollee generally has no further
cost sharing for covered Part D drugs for the remainder of the
calendar year.
6. Which coverage phase follows the deductible phase under
the 2026 standard Part D benefit structure?
A. Coverage-gap phase
B. Catastrophic phase
C. Initial coverage phase
D. Medicaid phase
Rationale: The 2026 standard Part D benefit has three
sequential phases: deductible, initial coverage, and catastrophic
coverage. The former coverage-gap or “donut hole” phase was
eliminated beginning in 2025. After satisfying any applicable
deductible, an enrollee generally enters the initial coverage
Study Guide — Exam Questions with Correct
Answers (VerifiedAnswers) Plus Rationales
2026 Q&A Instant Download PDF
Practice Exam
1. What is the primary purpose of Medicare Part D?
A. To cover inpatient hospital services
B. To cover physician and outpatient medical services
C. To provide Medicare prescription drug coverage
D. To cover long-term custodial care
Rationale: Medicare Part D is the Medicare prescription drug
benefit. It provides coverage for eligible outpatient prescription
drugs through private Medicare drug plans, including stand-
alone Prescription Drug Plans (PDPs) and Medicare Advantage
plans that include prescription drug coverage (MA-PDs). Part A
primarily addresses inpatient hospital-related services, while
Part B generally covers physician and outpatient medical
services.
,2. Which type of organization generally offers a stand-alone
Medicare Prescription Drug Plan (PDP)?
A. A state Medicaid agency
B. A private Medicare-approved prescription drug plan
sponsor
C. A hospital operating under Medicare Part A
D. The Social Security Administration directly
Rationale: Stand-alone PDPs are offered by private
organizations that have contracts with Medicare to provide
prescription drug coverage. Medicare beneficiaries can
generally obtain a PDP when they have Medicare Part A and/or
Part B and meet applicable enrollment requirements. Medicare
itself establishes program requirements and contracts with
sponsors but does not operate as the direct insurer for
individual PDP coverage.
3. Which Medicare coverage combination normally includes
Part D drug coverage within the same Medicare plan?
A. Original Medicare alone
B. Medicare Part B alone
C. A Medicare Advantage plan that includes prescription drug
coverage (MA-PD)
D. Medicare Supplement Insurance alone
,Rationale: Many Medicare Advantage plans combine Part A and
Part B coverage and may include Part D prescription drug
coverage. When an MA plan includes Part D, it is commonly
referred to as an MA-PD. Original Medicare by itself does not
include routine outpatient prescription drug coverage, and
Medigap policies generally do not provide current outpatient
prescription drug coverage.
4. What is the maximum standard Part D deductible for 2026?
A. $500
B. $550
C. $615
D. $750
Rationale: For 2026, no Medicare drug plan may have a
deductible greater than $615. A particular plan may have a
lower deductible or no deductible, depending on its benefit
design. The deductible is the amount the enrollee may have to
pay for covered Part D drugs before the plan begins paying
under the plan's subsequent coverage stage.
5. What is the annual Part D out-of-pocket threshold for
covered prescription drugs in 2026?
, A. $1,500
B. $2,000
C. $2,100
D. $2,500
Rationale: Beginning in 2025, the Part D benefit eliminated the
former coverage-gap structure and established an annual out-
of-pocket limit. For 2026, that threshold is $2,100. Once an
enrollee reaches the applicable annual out-of-pocket threshold
for covered Part D drugs, the enrollee generally has no further
cost sharing for covered Part D drugs for the remainder of the
calendar year.
6. Which coverage phase follows the deductible phase under
the 2026 standard Part D benefit structure?
A. Coverage-gap phase
B. Catastrophic phase
C. Initial coverage phase
D. Medicaid phase
Rationale: The 2026 standard Part D benefit has three
sequential phases: deductible, initial coverage, and catastrophic
coverage. The former coverage-gap or “donut hole” phase was
eliminated beginning in 2025. After satisfying any applicable
deductible, an enrollee generally enters the initial coverage
