CERTIFICATION QUESTIONS & ANSWERS 2026/2027,100% CORRECT
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Question 1
Which of the following is the primary purpose of Medicare Part A?
A. Cover outpatient prescription drugs
B. Cover inpatient hospital care and skilled nursing facilities
C. Provide vision and dental benefits
D. Cover routine wellness exams
Correct Answer: B
Rationale: Medicare Part A primarily covers inpatient hospital services, skilled
nursing facility care, hospice, and some home health services.
Reference: CMS Medicare Overview, 2025.
Question 2
A Medicare Advantage (Part C) plan must provide all services covered under
which part of Original Medicare?
A. Part A only
B. Part B only
C. Parts A and B
D. Part D
Correct Answer: C
Rationale: Medicare Advantage plans cover all Part A and Part B services and may
offer additional benefits.
Reference: CMS Medicare Advantage Guidelines, 2025.
,Question 3
Which statement about Medigap (Supplement) plans is correct?
A. They are available to anyone under 65
B. They cover deductibles, coinsurance, and copayments not covered by Original
Medicare
C. They replace Medicare Part D coverage
D. They provide vision, dental, and hearing as mandatory benefits
Correct Answer: B
Rationale: Medigap plans help cover out-of-pocket costs associated with Original
Medicare.
Reference: CMS Medigap Policies, 2025.
Question 4
Which program is designed to prevent fraud, waste, and abuse in Medicare?
A. CMS Fraud Prevention Unit
B. Medicare Compliance Program
C. Medicare Fraud & Abuse Prevention Program
D. Social Security Office
Correct Answer: C
Rationale: CMS oversees programs to detect and prevent fraud, waste, and abuse
in Medicare services.
Reference: CMS Compliance Program Guidelines, 2025.
Question 5
Which of the following is an example of an annual wellness benefit under
Medicare?
A. Knee replacement surgery
B. Personalized prevention plan including screenings and risk assessment
C. Inpatient hospital stay
D. Prescription drugs for chronic disease
,Correct Answer: B
Rationale: Medicare covers annual wellness visits to create personalized
prevention plans but does not cover surgeries or drugs under this benefit.
Reference: CMS Annual Wellness Visit Guidelines, 2025.
Question 6
Which Medicare Part is optional and helps pay for prescription drugs?
A. Part A
B. Part B
C. Part C
D. Part D
Correct Answer: D
Rationale: Medicare Part D provides coverage for prescription medications and is
voluntary.
Reference: CMS Medicare Part D Overview, 2025.
Question 7
What is the primary difference between Original Medicare and Medicare
Advantage?
A. Original Medicare includes all prescription drug coverage
B. Medicare Advantage is offered by private insurers and may include extra
benefits
C. Original Medicare has lower premiums than Medicare Advantage
D. Medicare Advantage does not cover hospital care
Correct Answer: B
Rationale: Medicare Advantage plans are offered by private companies and may
include vision, dental, or wellness benefits beyond Original Medicare.
Reference: CMS Medicare Advantage Guidelines, 2025.
Question 8
Which action is required to enroll in a Medicare Part D plan?
, A. Contact a private insurer or enroll online during enrollment periods
B. Automatically assigned at age 65
C. Only through employer-sponsored insurance
D. Enrollment is not necessary; coverage is automatic
Correct Answer: A
Rationale: Enrollment in Part D requires active selection during designated
enrollment periods, either online, via mail, or with a private insurer.
Reference: CMS Medicare Part D Enrollment, 2025.
Question 9
Which service is covered under Medicare Part B?
A. Inpatient hospitalization
B. Doctor visits, outpatient care, and preventive services
C. Prescription drugs
D. Dental and vision
Correct Answer: B
Rationale: Part B covers medically necessary services like doctor visits, outpatient
care, and preventive services.
Reference: CMS Medicare Part B Overview, 2025.
Question 10
During the Medicare Annual Enrollment Period, beneficiaries can:
A. Enroll in, change, or drop a Medicare Advantage or Part D plan
B. Change their Part A coverage
C. Change their Social Security retirement benefits
D. Apply for Medicaid
Correct Answer: A
Rationale: The Annual Enrollment Period allows beneficiaries to make changes to
their Medicare Advantage and Part D coverage.
Reference: CMS Annual Enrollment Period Guide, 2025.