AHIP Medicare Certification Examination Questions And Correct Answers (Verified Answers) Plus Rationales 2026 Q&A | Instant Download Pdf

AHIP Medicare Certification
Examination Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant Download
Pdf
1. Which Medicare part primarily provides hospital insurance
coverage?
A. Part B
B. Part D
C. Part C
D. Part A
Answer: D. Part A
Rationale: Medicare Part A is Medicare Hospital Insurance. It
generally helps cover inpatient hospital care, skilled nursing facility
care following a qualifying hospitalization, hospice care, and certain
home health services. Part B primarily covers physician and outpatient
services, Part C refers to Medicare Advantage, and Part D provides
prescription drug coverage.
2. Which Medicare part primarily covers physician services,
outpatient medical services, and many preventive services?
A. Part B
B. Part A
C. Part C
D. Part D

,Answer: A. Part B
Rationale: Medicare Part B is Medical Insurance. It generally covers
medically necessary physician services, outpatient care, durable
medical equipment, preventive services, and other covered medical
services. Beneficiaries generally pay a monthly Part B premium and
applicable deductibles and coinsurance.
3. What is Medicare Part C?
A. Medicare prescription drug coverage
B. Medicare Advantage
C. Medicare hospital insurance
D. Medicare Supplement insurance
Answer: B. Medicare Advantage
Rationale: Medicare Part C is Medicare Advantage. Medicare
Advantage plans are offered by Medicare-approved private
organizations and provide Medicare-covered Part A and Part B
benefits through the plan, except hospice care, which remains covered
under Original Medicare. Many Medicare Advantage plans also
include Part D prescription drug coverage.
4. Which Medicare part provides prescription drug coverage through
stand-alone Prescription Drug Plans and Medicare Advantage
Prescription Drug plans?
A. Part A
B. Part B
C. Part D
D. Part C only
Answer: C. Part D

,Rationale: Medicare Part D provides outpatient prescription drug
coverage. Beneficiaries may obtain Part D through a stand-alone
Prescription Drug Plan when appropriate or through a Medicare
Advantage Prescription Drug plan. Part D plans use formularies and
defined cost-sharing structures to administer covered prescription
drugs.
5. Which statement best describes Original Medicare?
A. It is available only through HMOs.
B. It automatically includes prescription drug coverage.
C. It requires beneficiaries to use only one private plan network.
D. It consists primarily of Medicare Part A and Part B administered
by the federal Medicare program.
Answer: D. It consists primarily of Medicare Part A and Part B
administered by the federal Medicare program.
Rationale: Original Medicare is the traditional Medicare program
consisting of Part A and Part B. Beneficiaries may generally use
Medicare-participating providers nationwide. Original Medicare does
not automatically include Part D prescription drug coverage, and
beneficiaries may purchase a separate Part D plan when eligible.
6. A beneficiary enrolled in Original Medicare wants prescription
drug coverage. Which option may provide that coverage?
A. A stand-alone Medicare Part D Prescription Drug Plan
B. A Medigap policy
C. A Medicare Supplement Plan without Part D
D. Part A alone
Answer: A. A stand-alone Medicare Part D Prescription Drug Plan

, Rationale: A beneficiary who remains in Original Medicare may
generally obtain prescription drug coverage through a stand-alone
Part D plan if eligible. Medigap policies generally do not provide
current outpatient prescription drug coverage. Medicare Part A and
Part B also do not constitute comprehensive outpatient prescription
drug coverage.
7. Which type of insurance is designed to help pay certain Medicare
cost-sharing amounts associated with Original Medicare?
A. Part D
B. Medicare Advantage
C. Medigap
D. Medicaid only
Answer: C. Medigap
Rationale: Medigap, also called Medicare Supplement Insurance, is
private insurance designed to supplement Original Medicare.
Depending on the standardized plan selected and applicable rules,
Medigap may help pay certain deductibles, coinsurance, and
copayments. Medigap generally does not replace Medicare or function
as Medicare Advantage.
8. Which statement about Medicare Advantage is generally correct?
A. Medicare Advantage beneficiaries always receive care only from
federal Medicare facilities.
B. Medicare Advantage automatically replaces Medicare eligibility.
C. Medicare Advantage is a Medigap policy.
D. Medicare Advantage plans are offered by Medicare-approved
private organizations and provide covered Part A and Part B
benefits through the plan.