AHIP MEDICARE CERTIFICATION
2025/2026 ALIGNED PRACTICE BANK
100 Original Multiple-Choice Questions
Correct Answers in Bold | Rationales Under Each Question
2025/2026 Alignment
Coverage includes .
Medicare Parts A-D, Medicare Advantage, Part D, eligibility and election periods, SNPs, plan
documents, marketing and communications, agent responsibilities, privacy, fraud/waste/abuse,
beneficiary decision-making, and 2026 CMS enrollment and training updates.
AHIP Medicare 2025/2026 - 100 Original Practice Questions | Educational Use
,Medicare Fundamentals
1. Which part of Original Medicare primarily covers inpatient hospital care?
A. Part A
B. Part B
C. Part C
D. Part D
Correct Answer: A. Part A
Rationale: Part A primarily covers inpatient hospital, skilled nursing facility, hospice, and certain home health
services, subject to Medicare rules.
2. Which part of Original Medicare primarily covers physician services and outpatient care?
A. Part A
B. Part B
C. Part C
D. Part D
Correct Answer: B. Part B
Rationale: Part B generally covers physician services, outpatient care, preventive services, durable medical
equipment, and other medically necessary services.
3. Medicare Advantage is also known as
A. Part A
B. Part B
C. Part C
D. Part D
Correct Answer: C. Part C
Rationale: Part C is Medicare Advantage, through which private plans contract with Medicare to provide
Medicare-covered benefits.
4. Medicare prescription drug coverage is generally provided through
AHIP Medicare 2025/2026 - 100 Original Practice Questions | Educational Use
, A. Part A only
B. Part B only
C. Part D
D. Medigap only
Correct Answer: C. Part D
Rationale: Part D provides outpatient prescription drug coverage through private plans approved by
Medicare.
5. To enroll in a Medicare Advantage plan, an individual generally must have
A. Part A only
B. Part B only
C. Medicare Part A and Part B
D. Medicaid only
Correct Answer: C. Medicare Part A and Part B
Rationale: CMS states that enrollment in a Medicare health plan generally requires both Part A and Part B,
residence in the service area, and lawful presence/citizenship requirements.
6. Which statement best distinguishes Original Medicare from Medicare Advantage?
A. They are identical delivery systems
B. Original Medicare is administered by the federal Medicare program, while MA benefits are delivered
through private Medicare-contracted plans
C. Medicare Advantage is Medicaid
D. Original Medicare never allows supplemental coverage
Correct Answer: B. Original Medicare is administered by the federal Medicare program, while MA
benefits are delivered through private Medicare-contracted plans
Rationale: Original Medicare is the federal fee-for-service program; Medicare Advantage plans are private
plans contracted with Medicare.
7. A Medicare beneficiary may obtain outpatient drug coverage under Original Medicare by enrolling in
A. a stand-alone Part D prescription drug plan
AHIP Medicare 2025/2026 - 100 Original Practice Questions | Educational Use
, B. Part A only
C. a dental-only policy
D. workers' compensation
Correct Answer: A. a stand-alone Part D prescription drug plan
Rationale: A beneficiary using Original Medicare may add a stand-alone PDP for Part D coverage.
8. Which program is designed to help cover certain costs that Original Medicare does not pay?
A. Medigap
B. Part D formulary
C. Medicaid managed care only
D. COBRA only
Correct Answer: A. Medigap
Rationale: Medigap policies are standardized Medicare Supplement insurance policies designed to help pay
certain Original Medicare cost-sharing amounts.
9. A Medicare Advantage Prescription Drug plan combines
A. Medicaid and workers' compensation
B. Medicare Advantage medical coverage with Part D drug coverage
C. Part A with Medigap only
D. Dental and vision only
Correct Answer: B. Medicare Advantage medical coverage with Part D drug coverage
Rationale: An MA-PD plan provides Medicare Advantage benefits and includes Part D prescription drug
coverage.
10. Which entity administers the federal Medicare program?
A. CDC
B. Centers for Medicare & Medicaid Services (CMS)
C. FDA only
D. Department of Labor only
AHIP Medicare 2025/2026 - 100 Original Practice Questions | Educational Use
2025/2026 ALIGNED PRACTICE BANK
100 Original Multiple-Choice Questions
Correct Answers in Bold | Rationales Under Each Question
2025/2026 Alignment
Coverage includes .
Medicare Parts A-D, Medicare Advantage, Part D, eligibility and election periods, SNPs, plan
documents, marketing and communications, agent responsibilities, privacy, fraud/waste/abuse,
beneficiary decision-making, and 2026 CMS enrollment and training updates.
AHIP Medicare 2025/2026 - 100 Original Practice Questions | Educational Use
,Medicare Fundamentals
1. Which part of Original Medicare primarily covers inpatient hospital care?
A. Part A
B. Part B
C. Part C
D. Part D
Correct Answer: A. Part A
Rationale: Part A primarily covers inpatient hospital, skilled nursing facility, hospice, and certain home health
services, subject to Medicare rules.
2. Which part of Original Medicare primarily covers physician services and outpatient care?
A. Part A
B. Part B
C. Part C
D. Part D
Correct Answer: B. Part B
Rationale: Part B generally covers physician services, outpatient care, preventive services, durable medical
equipment, and other medically necessary services.
3. Medicare Advantage is also known as
A. Part A
B. Part B
C. Part C
D. Part D
Correct Answer: C. Part C
Rationale: Part C is Medicare Advantage, through which private plans contract with Medicare to provide
Medicare-covered benefits.
4. Medicare prescription drug coverage is generally provided through
AHIP Medicare 2025/2026 - 100 Original Practice Questions | Educational Use
, A. Part A only
B. Part B only
C. Part D
D. Medigap only
Correct Answer: C. Part D
Rationale: Part D provides outpatient prescription drug coverage through private plans approved by
Medicare.
5. To enroll in a Medicare Advantage plan, an individual generally must have
A. Part A only
B. Part B only
C. Medicare Part A and Part B
D. Medicaid only
Correct Answer: C. Medicare Part A and Part B
Rationale: CMS states that enrollment in a Medicare health plan generally requires both Part A and Part B,
residence in the service area, and lawful presence/citizenship requirements.
6. Which statement best distinguishes Original Medicare from Medicare Advantage?
A. They are identical delivery systems
B. Original Medicare is administered by the federal Medicare program, while MA benefits are delivered
through private Medicare-contracted plans
C. Medicare Advantage is Medicaid
D. Original Medicare never allows supplemental coverage
Correct Answer: B. Original Medicare is administered by the federal Medicare program, while MA
benefits are delivered through private Medicare-contracted plans
Rationale: Original Medicare is the federal fee-for-service program; Medicare Advantage plans are private
plans contracted with Medicare.
7. A Medicare beneficiary may obtain outpatient drug coverage under Original Medicare by enrolling in
A. a stand-alone Part D prescription drug plan
AHIP Medicare 2025/2026 - 100 Original Practice Questions | Educational Use
, B. Part A only
C. a dental-only policy
D. workers' compensation
Correct Answer: A. a stand-alone Part D prescription drug plan
Rationale: A beneficiary using Original Medicare may add a stand-alone PDP for Part D coverage.
8. Which program is designed to help cover certain costs that Original Medicare does not pay?
A. Medigap
B. Part D formulary
C. Medicaid managed care only
D. COBRA only
Correct Answer: A. Medigap
Rationale: Medigap policies are standardized Medicare Supplement insurance policies designed to help pay
certain Original Medicare cost-sharing amounts.
9. A Medicare Advantage Prescription Drug plan combines
A. Medicaid and workers' compensation
B. Medicare Advantage medical coverage with Part D drug coverage
C. Part A with Medigap only
D. Dental and vision only
Correct Answer: B. Medicare Advantage medical coverage with Part D drug coverage
Rationale: An MA-PD plan provides Medicare Advantage benefits and includes Part D prescription drug
coverage.
10. Which entity administers the federal Medicare program?
A. CDC
B. Centers for Medicare & Medicaid Services (CMS)
C. FDA only
D. Department of Labor only
AHIP Medicare 2025/2026 - 100 Original Practice Questions | Educational Use
