AHIP Medicare Certification Practice
Examination Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant
Download Pdf
1. Which federal health insurance program primarily provides health
coverage for people age 65 and older, as well as certain younger
people with qualifying disabilities or specific conditions?
A. Medicaid
B. Children's Health Insurance Program
C. Medicare
D. Veterans Health Administration
Answer: C. Medicare
Rationale: Medicare is a federal health insurance program that
primarily serves people age 65 and older and also covers certain
younger individuals who qualify because of disability, end-stage renal
disease, or other specified circumstances. Medicaid is a separate
program jointly administered by federal and state governments and is
generally based on financial and other eligibility criteria.
2. Which part of Original Medicare generally helps pay for medically
necessary inpatient hospital services?
A. Medicare Part A
B. Medicare Part B
,C. Medicare Part C
D. Medicare Part D
Answer: A. Medicare Part A
Rationale: Medicare Part A is hospital insurance. It generally helps
cover inpatient hospital care, skilled nursing facility care under
qualifying circumstances, hospice care, and certain home health
services. Part B primarily covers physician and outpatient medical
services.
3. Which Medicare part generally covers physician services,
outpatient care, preventive services, and durable medical
equipment?
A. Part A
B. Part B
C. Part C
D. Part D
Answer: B. Part B
Rationale: Medicare Part B is medical insurance. It generally covers
medically necessary physician and outpatient services, preventive
services, certain ambulance services, durable medical equipment, and
other covered medical services.
4. Medicare Advantage is also known as which of the following?
A. Medicare Part A
B. Medicare Supplement
C. Medicaid
D. Medicare Part C
Answer: D. Medicare Part C
,Rationale: Medicare Advantage is the Medicare program commonly
referred to as Part C. Medicare Advantage plans are offered by
Medicare-approved private organizations and provide Medicare-
covered Part A and Part B benefits, generally through the plan's
network and rules. Many plans also include prescription drug
coverage.
5. Which Medicare part primarily provides outpatient prescription
drug coverage?
A. Part A
B. Part B
C. Part D
D. Part C only
Answer: C. Part D
Rationale: Medicare Part D provides prescription drug coverage
through private Medicare-approved prescription drug plans and
Medicare Advantage plans that include drug coverage. Coverage,
formularies, cost sharing, and pharmacy networks vary by plan.
6. A person who is enrolled in Original Medicare generally receives
Part A and Part B benefits through which entity?
A. A private Medicare Advantage organization
B. The federal Medicare program
C. A Medigap insurer
D. A Part D prescription drug insurer
Answer: B. The federal Medicare program
Rationale: Original Medicare is administered through the federal
Medicare program, with claims generally processed by Medicare
administrative contractors. Private insurers may offer supplemental
, Medigap policies and standalone Part D plans, but those products are
not the same as Original Medicare.
7. Which statement best describes a Medicare Advantage plan?
A. It replaces Medicaid for low-income beneficiaries
B. It is only available to people under age 65
C. It provides only prescription drug coverage
D. It is a Medicare-approved private health plan that provides
Medicare Part A and Part B benefits
Answer: D. It is a Medicare-approved private health plan that provides
Medicare Part A and Part B benefits
Rationale: Medicare Advantage plans are offered by private
organizations approved by Medicare. A beneficiary who enrolls in
Medicare Advantage generally receives covered Part A and Part B
services through the plan rather than through Original Medicare,
subject to the plan's rules.
8. Which type of Medicare coverage is designed to help pay some
Medicare cost-sharing amounts associated with Original Medicare?
A. Medigap
B. Medicaid only
C. Part D
D. Medicare Advantage only
Answer: A. Medigap
Rationale: Medigap policies are private supplemental insurance
policies designed to help cover certain costs that Original Medicare
does not fully pay, depending on the standardized plan selected and
applicable rules. Medigap generally works with Original Medicare and
cannot be used to supplement a Medicare Advantage plan.
Examination Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant
Download Pdf
1. Which federal health insurance program primarily provides health
coverage for people age 65 and older, as well as certain younger
people with qualifying disabilities or specific conditions?
A. Medicaid
B. Children's Health Insurance Program
C. Medicare
D. Veterans Health Administration
Answer: C. Medicare
Rationale: Medicare is a federal health insurance program that
primarily serves people age 65 and older and also covers certain
younger individuals who qualify because of disability, end-stage renal
disease, or other specified circumstances. Medicaid is a separate
program jointly administered by federal and state governments and is
generally based on financial and other eligibility criteria.
2. Which part of Original Medicare generally helps pay for medically
necessary inpatient hospital services?
A. Medicare Part A
B. Medicare Part B
,C. Medicare Part C
D. Medicare Part D
Answer: A. Medicare Part A
Rationale: Medicare Part A is hospital insurance. It generally helps
cover inpatient hospital care, skilled nursing facility care under
qualifying circumstances, hospice care, and certain home health
services. Part B primarily covers physician and outpatient medical
services.
3. Which Medicare part generally covers physician services,
outpatient care, preventive services, and durable medical
equipment?
A. Part A
B. Part B
C. Part C
D. Part D
Answer: B. Part B
Rationale: Medicare Part B is medical insurance. It generally covers
medically necessary physician and outpatient services, preventive
services, certain ambulance services, durable medical equipment, and
other covered medical services.
4. Medicare Advantage is also known as which of the following?
A. Medicare Part A
B. Medicare Supplement
C. Medicaid
D. Medicare Part C
Answer: D. Medicare Part C
,Rationale: Medicare Advantage is the Medicare program commonly
referred to as Part C. Medicare Advantage plans are offered by
Medicare-approved private organizations and provide Medicare-
covered Part A and Part B benefits, generally through the plan's
network and rules. Many plans also include prescription drug
coverage.
5. Which Medicare part primarily provides outpatient prescription
drug coverage?
A. Part A
B. Part B
C. Part D
D. Part C only
Answer: C. Part D
Rationale: Medicare Part D provides prescription drug coverage
through private Medicare-approved prescription drug plans and
Medicare Advantage plans that include drug coverage. Coverage,
formularies, cost sharing, and pharmacy networks vary by plan.
6. A person who is enrolled in Original Medicare generally receives
Part A and Part B benefits through which entity?
A. A private Medicare Advantage organization
B. The federal Medicare program
C. A Medigap insurer
D. A Part D prescription drug insurer
Answer: B. The federal Medicare program
Rationale: Original Medicare is administered through the federal
Medicare program, with claims generally processed by Medicare
administrative contractors. Private insurers may offer supplemental
, Medigap policies and standalone Part D plans, but those products are
not the same as Original Medicare.
7. Which statement best describes a Medicare Advantage plan?
A. It replaces Medicaid for low-income beneficiaries
B. It is only available to people under age 65
C. It provides only prescription drug coverage
D. It is a Medicare-approved private health plan that provides
Medicare Part A and Part B benefits
Answer: D. It is a Medicare-approved private health plan that provides
Medicare Part A and Part B benefits
Rationale: Medicare Advantage plans are offered by private
organizations approved by Medicare. A beneficiary who enrolls in
Medicare Advantage generally receives covered Part A and Part B
services through the plan rather than through Original Medicare,
subject to the plan's rules.
8. Which type of Medicare coverage is designed to help pay some
Medicare cost-sharing amounts associated with Original Medicare?
A. Medigap
B. Medicaid only
C. Part D
D. Medicare Advantage only
Answer: A. Medigap
Rationale: Medigap policies are private supplemental insurance
policies designed to help cover certain costs that Original Medicare
does not fully pay, depending on the standardized plan selected and
applicable rules. Medigap generally works with Original Medicare and
cannot be used to supplement a Medicare Advantage plan.
