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Examen

Medicare Certification Exam 2025–2026 | 250 Questions & Answers

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Prepare with the Medicare Certification Exam 2025–2026, featuring 250 accurate real exam questions and verified correct answers. Updated for the latest exam cycle, this trusted study resource ensures thorough preparation, accuracy, and exam success. Ideal for nursing and healthcare professionals. Available now on Stuvia with guaranteed satisfaction.

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Medicare Certification
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Institución
Medicare certification
Grado
Medicare certification

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Subido en
18 de septiembre de 2025
Número de páginas
33
Escrito en
2025/2026
Tipo
Examen
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Medicare Certification Exam 2025–
2026 Accurate Real Exam 250
Questions and Verified Correct
Answers
Medicare part A is what? - answer>>>Hospital insurance




What does part A cover? - answer>>>Part A covers hospital stays, including Mental hospitals,
skilled Nursing Facility care, if such care is indicated after at least three days in the hospital,
hospice care, (end of life hospital, but home hospice is included), some home health care
(Extension of hospital care in a cheaper form), blood, religious non-medical care, because some
people will not go into the hospital for religious reasons.




What is included in part A inpatient care? - answer>>>A semi-private room, general nursing,
meals, treatment drugs, other hospital services and supplies



What is a benefit period? - answer>>>The time period which is triggered the first day a
beneficiary enters the hospital and becomes responsible for the part A deductible, is measured
starting the day of discharge and ends when they have not received hospital care, or Medicare-
covered skilled care in a skilled nursing facility for 60 days in a row from the date of discharge..




Can an individual get part A if they have not worked 40 quarters in the United States? -
answer>>>Yes, those who have worked at least 30 quarters can get Part A at a reduced out of
pocket premium, which was $226/month in 2016. Those who have worked less then 30
quarters can get part A at full premium, which in 2016 was $411 per month.




Is there a late enrollment fee for Medicare part A? - answer>>>Yes, if a beneficiary is eligible
for part A and does not take it, then if they elect to take part A coverage any time in the future,
they may be assesed a late enrollment penalty of 10% per year for every full 12 month period
that the beneficiary did not have part A coverage.




What are the fees for a hospital stay under Part A coverage in 2016 - answer>>>Days 1-60
are covered by the deductible of $1288, Days 61-90 are covered at $322 per day, Days 91-
150 are lifetime reserve days and are $644 per day.

,What happens after all hospital inpatient lifetime reserve days have been used? -
answer>>>After all lifetime reserve days have been used, all days of a hospital stay after day
90 which are in the same benefit period are not covered.




What are the fees under part A for a stay in a mental health facility - answer>>>In 2016, Days
1-60 are covered by the deductible of $1288, Days 61-90 are covered at $322 per day, Days
91-190 are lifetime reserve days and are $644 per day.




What are the fees under part A for a stay in a skilled nursing facility? - answer>>>The patient
must stay 3 days in-hospital, and be certified by a physician to be admitted to a SNF, which
means that in 2016 the patient will owe the Part A deductible of $1288 for days 1-20. There are
no other charges for days 1-20. Days 21-100 are covered at $161 per day. All days after 100 in
the same benefit period are not covered.




What is Medicare part B? - answer>>>Part B is called Medical insurance, and covers providers
that are oriented towards out-patient care.



As a general rule, all services and supplies that are covered under part B must be what? -
answer>>>Medically necessary




How does a beneficiary enroll in part B? - answer>>>In general, part B enrollment is
automatic, and occurs at the same time part A enrollment takes place. If a beneficiary wants
to delay their part B enrollment, they must notify Social Security.




Is there a late enrollment penalty for part B? - answer>>>Yes. Although enrollment in part B is
voluntary, the beneficiary is required to have some form of credible coverage, and if they
cannot produce evidence of this credible coverage at the time of enrollment into part B, they
may be assessed a late enrollment penalty of 10% of the premium per each 12 month time
period in which they could have had part B and did not.




Is there any assistance available for the Part B Premium? - answer>>>Yes, if the beneficiary is
low income, they may be eligible for premium assistance. Refer the client to the state medicaid
system.



2|Page

,Is there an income-related extra burden associated with the Part B Premium? - answer>>>Yes,
its called IRMAA which stands for Income Related Monthly Adjustment Amount. Basically, the
higher the income, the higher the premium.




For 2016, what is the Part B Deductible? - answer>>>For 2017, the deductible is $183



Is accupuncture covered under Medicare? - answer>>>No, Medicare does not cover
accupuncture




Is cosmetic surgery covered under Medicare? - answer>>>No, cosmetic surgery is not covered




Are hearing aids and exams for hearing aids covered under Medicare? - answer>>>No, hearing
aids are not covered




Is Long Term Care covered under Medicare? - answer>>>No, LTC is not covered, although
many people think that it is.




Are preventative dental care and dentures covered under Medicare? - answer>>>No, dental
care is not covered




Is routine foot care covered under Medicare? - answer>>>No, but diabetics enjoy limited foot
benefits



Are travel vaccinations covered under Medicare? - answer>>>No, travel vaccinations are not
covered




Are eye glasses covered under Medicare? - answer>>>In most cases eyeglasses are not



Are clinical laboratory services covered under Medicare? - answer>>>Yes, clinical lab services
are covered


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, Is home health part time skilled nursing care covered under Medicare? - answer>>>Yes, part
time skilled nursing care is covered at 100% under the following conditions.

It is recommended by a physician.

It is provided by a Medicare authorized provider
The patient is homebound.
It includes skilled nursing, occupational therapy, language pathology, or physical therapy




Are home health aide services covered under Medicare? - answer>>>Yes home health aide
services are covered on a limited basis



Are emergency room services covered under Medicare? - answer>>>Yes, this is a right




Are kidney dialysis services and supplies covered under Medicare? - answer>>>Yes, dialysis is
covered




Are medical nutritional services covered under Medicare? - answer>>>Yes, for people with
diabeties or kidney disease




Are foot exams covered under Medicare? - answer>>>Yes, for people with diabeties



Are second surgical opinions covered under Medicare? - answer>>>Yes, second opinions are
covered



Are outpatient prescription drugs covered under Medicare? - answer>>>Yes on a very limited
basis, usually administered in the doctors office




What is an MAO? - answer>>>It is a Medicare Advantage Organization, usually but not
necessarily a private insurance company, which has contracted with the Federal government to
administer Medicare parts A and B benefits.




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