Social Insurance — practice questions

4% of the exam ≈6 real questions 10 free questions here

Medicare Parts A through D, Medicaid, and Social Security disability — about 6 scored questions. Small domain, entirely memorization, and free points if you drill it.

Where people lose points

• Part A is inpatient hospital and premium-free for most; Part B is outpatient and always has a premium.
• Part C is Medicare Advantage (a delivery method), Part D is prescription drugs.
• Social Security disability has a five-month waiting period and uses a strict any-occupation definition.
• Medicaid is need-based and state-administered; Medicare is age- or disability-based and federal.

Questions and answers, explained

All 8 questions above, with the correct answer and why it is correct. Everything here is on social insurance.

1. Medicare Part D provides which of the following benefits?

   • ACoverage of Medicare's deductibles and coinsurance
   • BInpatient psychiatric hospital care
   • COutpatient prescription drug coverage through private plansCorrect
   • DCustodial long-term nursing home care

   Why: Part D is optional prescription drug coverage sold through private insurers approved by Medicare. Covering Medicare's deductibles and coinsurance is the role of a Medicare Supplement (Medigap) policy, and custodial nursing home care is not covered by Medicare at all.

   Reference Outline VII (Social Insurance): Medicare Part D

2. Ana is an inpatient in an acute care hospital for 95 consecutive days in a single benefit period. She has never used a lifetime reserve day before. How many lifetime reserve days does she have remaining after this stay?

   • A55Correct
   • B60
   • C30
   • D0

   Why: Part A covers days 1–60 after the deductible and days 61–90 with a daily coinsurance; days 91 and beyond draw on lifetime reserve days, so days 91–95 consume 5 of her 60, leaving 55. Choice B assumes reserve days are not touched until later or that they reset each benefit period — in fact the 60 days are a once-in-a-lifetime pool that is never replenished.

   Reference Outline VII (Social Insurance): Medicare Part A — lifetime reserve days

3. In 2026, after a qualifying hospital stay, Beatriz spends 62 days in a Medicare-certified skilled nursing facility within one benefit period. The 2026 Part A skilled nursing daily coinsurance is $217. What is her total skilled nursing coinsurance for the stay?

   • A$0
   • B$4,340
   • C$9,114Correct
   • D$13,454

   Why: Part A pays the full cost of the first 20 skilled nursing days in a benefit period, so only days 21 through 62 — 42 days — carry coinsurance: 42 × $217 = $9,114. Choice D incorrectly charges coinsurance for all 62 days and ignores the 20 days Medicare covers in full; after day 100 the beneficiary would pay the entire cost.

   Reference Outline VII (Social Insurance): Medicare Part A — skilled nursing facility cost sharing (CMS CY 2026 amounts)

4. Carmen kept working past 65 and stayed on her employer's group health plan, delaying Part B. Her employment ends April 30. To enroll in Part B without a late enrollment penalty, she may use a special enrollment period lasting

   • A3 months
   • B6 months
   • C8 monthsCorrect
   • D12 months

   Why: A person covered by a group health plan based on current employment receives an 8-month special enrollment period beginning the month after employment or the group coverage ends, whichever comes first, and enrolling within it avoids the Part B late enrollment penalty. The 6-month figure is the Medicare supplement open enrollment period, a different window; note also that COBRA and retiree coverage are not 'current employment' coverage, so relying on them can still trigger the penalty.

   Reference Outline VII (Social Insurance): Medicare enrollment periods — Part B special enrollment period

5. A client enrolled in a Medicare Advantage plan asks his agent to sell him a Medicare supplement policy to 'fill the gaps' in the Advantage plan. The agent should explain that

   • Aa Medigap policy will pay the Advantage plan's copayments, coinsurance, and deductibles
   • Bhe may keep both policies, but the Medigap policy will pay only as secondary to the Advantage plan
   • Cfederal law requires a Medigap policy whenever a client is enrolled in Part C
   • Dit is an illegal sale unless he is leaving the Advantage plan and returning to Original MedicareCorrect

   Why: Medicare supplement policies are built to pay the deductibles and coinsurance of Original Medicare, so they pay essentially nothing for a Medicare Advantage enrollee, and federal law makes it unlawful to knowingly sell one to a person in an MA plan unless that coverage is ending. Choice B is wrong because Medigap does not coordinate with Part C at all — it is not a secondary payer to an Advantage plan.

   Reference Outline VII (Social Insurance): Medicare Part C vs. Medicare supplement; Social Security Act s. 1882(d)(3)(A)

6. Under the 2026 Medicare Part D benefit design, what happens once a beneficiary's out-of-pocket spending on covered drugs reaches the annual cap of $2,100?

   • AThe beneficiary enters a coverage gap and pays 25% of the cost of covered drugs
   • BThe plan stops paying until the beneficiary satisfies a second annual deductible
   • CThe beneficiary pays nothing more for covered Part D drugs for the rest of the calendar yearCorrect
   • DThe beneficiary must switch to a Medicare Advantage plan with drug coverage

   Why: Part D now has three stages — deductible, initial coverage, and catastrophic — and reaching the annual out-of-pocket cap ($2,100 in 2026) moves the beneficiary into catastrophic coverage, where cost sharing on covered Part D drugs is $0 for the remainder of the year. Choice A describes the old 'donut hole' coverage gap, which was eliminated when the redesign took effect in 2025 and is the most common outdated answer.

   Reference Outline VII (Social Insurance): Medicare Part D — coverage stages (CMS CY 2026 Part D redesign)

7. A 72-year-old widow is enrolled in both Medicare and Medicaid and is hospitalized. Which statement correctly describes how the two programs pay?

   • AMedicaid pays first as primary, and Medicare then pays whatever balance remains
   • BThe two programs each pay 50% of the covered hospital bill after her deductible
   • CMedicare pays first, and Medicaid may then cover Medicare's cost sharing as payer of last resortCorrect
   • DEnrolling in Medicaid automatically terminates her Medicare Part A and Part B coverage

   Why: For dual eligibles, Medicare is the primary payer and Medicaid is the payer of last resort, picking up Medicare cost sharing and, for those who qualify, services Medicare does not cover at all — most importantly custodial nursing home care. Choice A reverses the order: Medicaid pays only after every other available source of coverage, public or private, has paid.

   Reference Outline VII (Social Insurance): Medicaid and Medicare coordination — dual eligibles

8. A 52-year-old has been receiving Social Security disability benefits. Which statement about her Medicare eligibility is TRUE?

   • AShe is not eligible for Medicare until she reaches age 65
   • BMedicare begins the same month her disability benefits begin, with no waiting period
   • CShe must exhaust her Medicaid benefits before Medicare coverage will begin
   • DShe becomes entitled to Medicare after 24 months of disability benefits, and ALS waives that waitCorrect

   Why: Disabled workers under 65 generally become entitled to Medicare after 24 months of entitlement to Social Security disability benefits; amyotrophic lateral sclerosis (ALS) waives that wait entirely and end-stage renal disease has its own accelerated rule. Choice A is a common misconception — Medicare is available before 65 on the basis of disability, which is precisely why s. 627.6741, F.S., extends a Medicare supplement open enrollment period to Florida Medicare enrollees under 65.

   Reference Outline VII (Social Insurance): Social Security disability and Medicare entitlement; s. 627.6741, F.S.

Topics inside this domain

• Medicare and Medicare supplement rules
• Disability income insurance

Drill other domains

• Types of Life Policies and Features (10%)
• Life Policy Riders, Provisions, Options, and Exclusions (10%)
• Life Application, Underwriting, and Policy Delivery (8%)
• Retirement and Other Life Insurance Concepts (5%)
• Types of Health Policies (11%)
• Health Policy Provisions, Clauses, and Riders (10%)

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