Which group of services is covered under Medicare Part A?
Physician office visits, outpatient diagnostic labs, and durable medical equipment
Outpatient prescription drugs picked up at a retail pharmacy
Extra benefits such as routine dental and vision added by private plans
Inpatient hospital stays, post-hospital skilled nursing facility care, home health services, and hospice care
Question 2 of 40
Which statement accurately describes Medicare Part B?
It is voluntary supplementary medical insurance requiring a monthly premium, with a penalty structure for those who enroll late
It is premium-free for everyone who is entitled to Part A
It is available only to beneficiaries who first join a Medicare Advantage plan
It pays hospital and skilled nursing facility charges after a per-benefit-period deductible
Question 3 of 40
What must be true before a beneficiary can join a Medicare Advantage (Part C) plan?
The beneficiary must already be enrolled in a standalone Part D prescription drug plan
The beneficiary must be entitled to Part A and enrolled in Part B
The beneficiary must show proof of creditable employer group drug coverage
The beneficiary must give up entitlement to Part A hospital insurance
Question 4 of 40
Which statement correctly describes Medicare Part D?
It is automatic and premium-free for everyone who turns 65
The government pays pharmacies directly on a fee-for-service basis
It is a voluntary benefit delivered only through private plans that contract with Medicare, either as a standalone drug plan or as the drug portion of a Medicare Advantage plan
It covers only drugs administered to a patient during an inpatient hospital stay
Question 5 of 40
A 67-year-old client wants to stay in Original Medicare so she can use any provider that accepts Medicare, but she also takes several maintenance medications she buys at a pharmacy. Which arrangement fits her stated goals?
Enroll in a Medicare Advantage plan with bundled drug coverage
Rely on Parts A and B, which already pay for outpatient prescription drugs
Keep Parts A and B and add a standalone Part D prescription drug plan
Drop Part B and enroll in Part C, which is the only route to drug coverage
Question 6 of 40
Parts A and B together are commonly called "Original Medicare." What distinguishes that arrangement from Part C?
Parts A and B are the only parts of Medicare that ever require a premium
Parts A and B include outpatient prescription drug coverage, so no separate plan is ever needed
Parts A and B are administered by private organizations under contract with Medicare
Under Parts A and B the government pays providers directly on a fee-for-service basis, while Part C routes the same benefits through a private plan
Question 7 of 40
Under the Social Security Act, which of the following describes a group extended Medicare entitlement in addition to people age 65 who are entitled to Social Security or Railroad Retirement benefits?
Anyone who has maintained individual health insurance coverage for at least five years
People who have received Social Security disability benefits for the required waiting period
Any resident under age 65 whose household income falls below the federal poverty level
Anyone diagnosed with a chronic condition before age 65, regardless of benefit status
Question 8 of 40
A beneficiary enrolls in a Medicare Advantage plan that includes prescription drug coverage (an MA-PD). Which statement best describes his resulting coverage?
He remains a Medicare beneficiary; the plan delivers his Part A and Part B benefits plus his Part D drug coverage and must furnish at least what Original Medicare provides
He has left the Medicare program and now holds ordinary private major medical insurance
The plan may furnish fewer benefits than Original Medicare in exchange for a lower premium
He must still purchase a separate standalone Part D plan to obtain drug coverage
Question 9 of 40
Alma is discharged after an inpatient hospital stay and transferred to a skilled nursing facility for post-hospital rehabilitation. Which part of Medicare is the hospital insurance benefit that pays for this kind of facility-based care?
Part B, supplementary medical insurance
Part D, the prescription drug benefit
Part A, hospital insurance
Part C, Medicare Advantage, which is a separate list of institutional benefits
Question 10 of 40
Which statement accurately describes Medicare Part B?
It is furnished automatically and premium-free to everyone entitled to Part A.
It is the outpatient prescription drug benefit, purchased from private drug plans.
It is voluntary supplementary medical insurance: the eligible person enrolls during a designated enrollment period, pays a monthly premium, and faces a late-enrollment penalty for waiting.
It is available only to beneficiaries who first join a private managed-care plan.
Question 11 of 40
A 66-year-old prospect wants to join a Medicare Advantage plan. What must be true about her Medicare status before she can enroll?
She must be entitled to Part A and enrolled in Part B.
She must first be enrolled in a standalone Part D prescription drug plan.
She must have declined Part B so the private plan can replace it.
She must have exhausted her available Part A inpatient benefit days.
Question 12 of 40
How is Medicare Part D prescription drug coverage delivered to beneficiaries?
Directly by the federal government, which pays pharmacies on a fee-for-service basis.
Only through private plans that contract with Medicare — either a standalone drug plan added to Original Medicare or the drug portion of a Medicare Advantage plan.
Automatically to everyone entitled to Part A, with no separate election or premium.
Only through Medicare Advantage plans; it is unavailable to people who keep Original Medicare.
Question 13 of 40
Ruben is 67, has Parts A and B, and wants to keep seeing any doctor he likes on a fee-for-service basis rather than joining a network plan. He takes four maintenance medications from a retail pharmacy and has no other drug coverage. What best fits his stated wishes?
Add a standalone Part D prescription drug plan to his Original Medicare coverage.
Join an MA-PD plan, because drug coverage can only be obtained through Part C.
Do nothing, because Part B already covers retail outpatient prescription drugs.
Do nothing, because Part A covers self-administered drugs purchased at a pharmacy.
Question 14 of 40
A client tells you, "I just have Original Medicare." What does that statement mean?
She is enrolled in a Medicare Advantage plan that includes extra benefits.
She has Part A plus a standalone Part D drug plan, with no medical coverage.
She has Part C coverage with prescription drugs bundled in.
She has Parts A and B, under which the government pays providers directly on a fee-for-service basis.
Question 15 of 40
Most people become entitled to Medicare at age 65 when they are entitled to Social Security or Railroad Retirement benefits. Which additional group does the statute also extend Medicare entitlement to?
Any U.S. resident under 65 who has been declined for individual health coverage.
Anyone who has paid Medicare taxes for at least one calendar quarter, at any age.
Anyone who needs long-term custodial nursing home care, at any age.
People who have received Social Security disability benefits for the required waiting period, and people with end-stage renal disease who need dialysis or a kidney transplant.
Question 16 of 40
A Medicare Advantage plan advertises a dental allowance and a fitness benefit. A prospect asks whether joining means trading away his hospital and physician coverage to get those extras. What is the accurate response?
Yes — the plan substitutes its extra benefits for hospital coverage, and Part A entitlement ends on enrollment.
No — the plan must furnish at least the benefits available under Original Medicare; extras are added on top, and he remains a Medicare beneficiary with the plan simply delivering the coverage.
Partly — Medicare Advantage plans deliver only Part B services, while Part A stays with the government on a fee-for-service basis.
Yes, if he signs a written waiver exchanging his Part A benefits for the plan's supplemental benefits.
Question 17 of 40
Which of the following services is furnished under Medicare Part A?
Post-hospital care in a skilled nursing facility
Routine physician office visits
Outpatient prescription drugs filled at a retail pharmacy
Durable medical equipment used in the home
Question 18 of 40
Which statement best describes Medicare Part B?
It is mandatory hospital insurance that requires no premium from any beneficiary.
It is a drug benefit available only through private plans that contract with Medicare.
It is the program under which private organizations deliver hospital and medical benefits through managed care.
It is voluntary supplementary medical insurance covering physician and outpatient services, financed in part by a monthly premium, with a penalty for late enrollment.
Question 19 of 40
A 66-year-old client wants to leave fee-for-service Medicare and join a Medicare Advantage plan. What must be true for her to enroll in the Part C plan?
She must first enroll in a standalone Part D prescription drug plan.
She must decline Part A so that the private plan can replace it.
She must have creditable employer group coverage in addition to Medicare.
She must be entitled to Part A and enrolled in Part B.
Question 20 of 40
Which statement about Medicare Part D is accurate?
It is automatic for everyone entitled to Part A and requires no election.
Medicare pays pharmacies directly on a fee-for-service basis, as it does under Parts A and B.
It is a voluntary outpatient prescription drug benefit delivered only through private plans that contract with Medicare.
It replaces Part B for beneficiaries who need only outpatient services.
Question 21 of 40
An agent tells a client that under "Original Medicare" the government pays providers directly on a fee-for-service basis. Which parts is the agent describing?
Part A only
Parts A and B
Parts B and D
Parts C and D
Question 22 of 40
A carrier's brochure describes one of its products as an "MA-PD" plan. What does that tell an agent about the product?
It is a Medicare Advantage plan that delivers Part A and Part B benefits and also includes prescription drug coverage.
It is a standalone prescription drug plan added to Original Medicare.
It is a policy that supplements Original Medicare's deductibles and coinsurance only.
It is a Medicare Advantage plan that furnishes Part B benefits only, leaving hospital care to Part A fee-for-service.
Question 23 of 40
Apart from reaching age 65 with entitlement to Social Security or Railroad Retirement benefits, which of the following describes a group the statute extends Medicare to?
Anyone age 60 or older who has retired from covered employment
A person who has received Social Security disability benefits for the required waiting period
Any lawful resident whose household income falls below the federal poverty level
A person age 55 or older who is covered by an employer group health plan
Question 24 of 40
A client asks why she received Part A without paying a monthly premium but must pay one for Part B. What is the best explanation?
Part A benefits cost the program less than Part B benefits, so no premium is needed.
Part A premiums are always waived for anyone age 65 or older, regardless of work history.
Part A entitlement is generally earned through work in Medicare-taxed employment, while Part B is voluntary supplementary insurance that an enrollee elects and pays a monthly premium for.
Part B is administered by private insurers, which set and collect the premium themselves.
Question 25 of 40
A Medicare beneficiary is admitted to the hospital, then transferred to a skilled nursing facility for post-hospital rehabilitation. Which part of Medicare is the hospital insurance benefit that covers this type of institutional and facility-based care?
Part B
Part A
Part C
Part D
Question 26 of 40
A 67-year-old client asks you to enroll her in a Medicare Advantage (Part C) plan. What must be true about her Medicare status before she can join?
She must be entitled to Part A and enrolled in Part B
She must be enrolled in a standalone Part D prescription drug plan first
She must have declined Part A so that the private plan replaces it
She must be entitled to Part A only; Part B enrollment is not permitted with Part C
Question 27 of 40
Which statement correctly describes Medicare Part D?
It is a voluntary outpatient prescription drug benefit delivered only through private plans that contract with Medicare
It is a mandatory drug benefit administered directly by the federal government on a fee-for-service basis
It covers drugs administered during an inpatient hospital stay and is included in the Part A premium
It is available only to beneficiaries who have declined Part B coverage
Question 28 of 40
A client turning 65 asks why he is being billed a monthly premium for the part of Medicare that pays his doctor visits, lab work, and durable medical equipment. Which statement best explains the design of that part?
Part A is hospital insurance, and everyone pays a monthly premium for it based on income
Part C requires a premium because the private plan replaces his Medicare entitlement
Part B is voluntary supplementary medical insurance, so an eligible person enrolls during a designated enrollment period and pays a monthly premium
Part D charges the premium because outpatient physician services are treated as drug benefits
Question 29 of 40
A client who is relocating from Texas to another state asks whether her Medicare hospital and medical benefits will change when she moves. What is the most accurate response?
Yes — each state's insurance department sets its own Medicare benefit package
Yes — Part A benefits are federal but Part B benefits are set state by state
No — Medicare is a federal program created by Title XVIII of the Social Security Act, so its benefit structure is the same in every state
No — but only because she is enrolled in Original Medicare; Part A and Part B benefits differ by state for Medicare Advantage enrollees
Question 30 of 40
Apart from reaching age 65 with entitlement to Social Security or Railroad Retirement benefits, which of the following describes a group to whom the statute extends Medicare?
Any person who purchases a Medicare Supplement policy from a licensed producer
Any person age 60 or older who is no longer working full time
Any person whose household income falls below the federal poverty level, at any age
A person with end-stage renal disease who needs dialysis or a kidney transplant
Question 31 of 40
A client is enrolled in Original Medicare — Part A and Part B — and takes several maintenance medications he fills at a retail pharmacy. He does not want to leave Original Medicare. What is the appropriate way to obtain Medicare prescription drug coverage?
Nothing is needed; outpatient drugs are already covered under his Part B benefits
He must first buy into Part A by paying a premium, which then activates drug coverage
He must enroll in a Medicare Advantage plan, because Part D exists only inside Part C
He can enroll in a standalone Part D prescription drug plan offered by a private company that contracts with Medicare
Question 32 of 40
Two clients compare their Medicare bills. One pays no monthly premium for Part A; the other is told she must pay a premium to obtain Part A. Which explanation is correct?
Part A is always premium-free; the second client is being quoted a Part B premium by mistake
Most people receive Part A without a monthly premium because entitlement is built on work in Medicare-taxed employment, and those who do not qualify that way may be allowed to buy in by paying a premium
Part A premiums depend on which state the beneficiary lives in and are set by the state insurance department
Part A is premium-free only for beneficiaries who also enroll in a Part C plan
Question 33 of 40
A client is discharged from a three-day inpatient hospital stay and moves into a skilled nursing facility for post-hospital rehabilitation. Later, when her illness becomes terminal, she elects hospice care. Which part of Medicare is the source of coverage for this institutional and facility-based care?
Part D
Part B
Part A
Part C, because facility care is never covered by Original Medicare
Question 34 of 40
Which statement best describes Medicare Part B?
It is mandatory for everyone entitled to Part A and is financed entirely by payroll taxes.
It is the hospital insurance benefit and pays inpatient facility charges in full after one deductible.
It is voluntary supplementary medical insurance covering physician and outpatient services, requiring a monthly premium and subject to a late-enrollment penalty structure.
It is a private prescription drug benefit sold only by insurers that contract with Medicare.
Question 35 of 40
A 67-year-old prospect asks you to enroll him in a Medicare Advantage (Part C) plan. Before he can join, what must be true of his Medicare status?
He must be entitled to Part A and enrolled in Part B.
He must be entitled to Part A only; Part B enrollment is not relevant to Part C.
He must first enroll in a standalone Part D plan.
He must drop Part A and Part B, because Part C replaces entitlement to them.
Question 36 of 40
A Medicare Advantage plan's marketing piece states that the plan covers less than Original Medicare in exchange for a lower premium. Why is that claim inconsistent with how Part C is structured?
Part C plans may not charge premiums of any kind, so any trade-off for a lower premium is impossible.
A Part C plan must furnish at least the benefits available under Original Medicare, and many add extra benefits rather than subtract them.
Part C plans are administered directly by the federal government on a fee-for-service basis and have no benefit design of their own.
Part C plans may reduce Part A benefits but never Part B benefits.
Question 37 of 40
A client stays in Original Medicare (Parts A and B) but wants coverage for her outpatient prescription drugs. What is the appropriate route?
Enroll in a standalone Part D prescription drug plan offered by a private organization that contracts with Medicare.
Do nothing, because Part B automatically includes all outpatient prescription drugs.
Buy drug coverage directly from the federal government, which administers the Part D benefit itself.
Add drug coverage to Part A, since drugs are treated as a hospital benefit.
Question 38 of 40
A 42-year-old client has end-stage renal disease and requires regular dialysis. He assumes he cannot have Medicare because he is not 65. How should you respond?
He is correct; Medicare entitlement begins only at age 65 for everyone.
He is correct unless he moves to a state that has extended Medicare to younger residents.
He could qualify, but only by first purchasing a Medicare Advantage plan on his own.
He may be entitled to Medicare, because the statute extends the program to people with end-stage renal disease who need dialysis or a kidney transplant.
Question 39 of 40
Two clients compare notes: one pays no monthly premium for Part A, the other must pay one. What best explains the difference?
Part A premiums are waived only for beneficiaries who also enroll in a Part C plan.
Premium-free Part A rests on entitlement built through work in Medicare-taxed employment; a person who does not qualify that way may be permitted to buy in by paying a premium.
Part A is always premium-free, so the second client is actually describing the Part D premium.
Part A premiums depend on whether the beneficiary has satisfied the Part B late-enrollment penalty.
Question 40 of 40
A Texas client who is enrolled in Original Medicare is relocating to another state and asks whether her Medicare benefits will shrink after the move. Which response is accurate?
Part A benefits follow her, but Part B benefits are set state by state.
Her benefits depend on whether the new state has adopted Title XVIII.
She must re-establish entitlement from the beginning, because Medicare entitlement is granted by each state.
Medicare is a federal program created under Title XVIII of the Social Security Act, so its benefit structure is the same in every state.