100+ Free NABIP Medicare Practice Questions

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Question 1

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Which part of Original Medicare covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health services?

Part A

Part B

Part C

Part D

to track

2026 Statistics

Key Facts: NABIP Medicare Exam

90%

Passing Score

NABIP MMACR PY2026

Allowed Attempts

vs AHIP's 3

$75-125

Exam Fee

Member / non-member

$2,000

Part D OOP Cap

IRA, effective 2025+

CE Credits Included

No extra charge

51+

Carriers Accepting

PY2026

NABIP MMACR launched its PY2026 course on June 23, 2025 and is accepted by 51+ Medicare Advantage carriers as an alternative to AHIP. The exam requires 90% to pass with 6 attempts allowed (more lenient than AHIP's 3). Cost is ~$75 for NABIP members or ~$125 for non-members, with 8 CE credits included at no extra charge. NABIP places stronger emphasis on benefits-broker context and employer group Medicare interaction than AHIP.

Sample NABIP Medicare Practice Questions

Try these sample questions to test your NABIP Medicare exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Which part of Original Medicare covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health services?

A.Part A

B.Part B

C.Part C

D.Part D

Explanation: Part A is hospital insurance and covers inpatient stays, skilled nursing facility (SNF) care after a qualifying hospital stay, hospice, and some home health. Part B covers outpatient and physician services. Part C is Medicare Advantage. Part D is prescription drugs.

2A beneficiary turning 65 has worked and paid Medicare taxes for 42 quarters. What will their 2026 Part A premium be?

A.$0 (premium-free Part A)

B.$285 per month

C.$518 per month

D.Equal to the Part B premium

Explanation: A person who has 40 or more quarters of Medicare-covered employment qualifies for premium-free Part A. With 42 quarters, this beneficiary owes nothing for Part A. Those with 30-39 quarters pay a reduced premium ($285 in 2026); fewer than 30 quarters pay the full premium ($518 in 2026).

3What is the standard Part B monthly premium for 2026?

A.$164.90

B.$174.70

C.$185.00

D.$206.50

Explanation: The standard Part B premium for 2026 is $185.00 per month for beneficiaries with income at or below the IRMAA threshold. Higher-income beneficiaries pay an Income-Related Monthly Adjustment Amount (IRMAA) on top of the standard premium.

4Which of the following individuals is NOT automatically eligible for Medicare regardless of age?

A.A 45-year-old who has received Social Security Disability Insurance for 24 months

B.A 30-year-old diagnosed with End-Stage Renal Disease (ESRD) requiring dialysis

C.A 50-year-old diagnosed with Amyotrophic Lateral Sclerosis (ALS / Lou Gehrig's disease)

D.A 60-year-old who is a permanent legal resident with 5 years of US residency

Explanation: Medicare eligibility under 65 requires 24 months of SSDI receipt, ESRD, or ALS (which qualifies the same month SSDI begins). A 60-year-old legal resident is not yet eligible — they must turn 65 AND meet the 5-year residency requirement (if not a citizen or qualifying worker).

5A client diagnosed with ALS is approved for Social Security Disability Insurance. When does Medicare coverage begin?

A.Immediately, the same month SSDI payments begin

B.After a 5-month waiting period from SSDI approval

C.After 24 months of SSDI payments

D.Only when the client turns 65

Explanation: ALS (Lou Gehrig's disease) is a special case. Medicare begins the same month SSDI starts — there is no 24-month waiting period. ESRD also bypasses the 24-month rule but with its own coverage start rules. All other SSDI recipients must wait 24 months.

6What is the Part A inpatient hospital deductible per benefit period in 2026?

A.$240

B.$1,632

C.$1,676

D.$408 per day

Explanation: The 2026 Part A inpatient hospital deductible is $1,676 per benefit period. A new benefit period starts after 60 consecutive days out of the hospital or SNF, meaning a beneficiary may pay this deductible more than once in a year.

7After meeting the Part B annual deductible, what does Original Medicare typically pay for covered Part B services?

A.100% of the Medicare-approved amount

B.80% of the Medicare-approved amount

C.70% of billed charges

D.A fixed copay determined by the provider

Explanation: Once the Part B annual deductible ($257 in 2026) is met, Original Medicare pays 80% of the Medicare-approved amount for most outpatient services. The beneficiary is responsible for the remaining 20% coinsurance. There is no annual out-of-pocket maximum in Original Medicare — Medigap or MA plans address this gap.

8Which of the following best describes Medigap (Medicare Supplement) policies?

A.Insurance sold by private companies that pays after Original Medicare to cover deductibles, coinsurance, and copays

B.A bundled MA plan replacement for Parts A and B

C.Government-issued coverage for low-income beneficiaries

D.A standalone prescription drug plan

Explanation: Medigap policies are sold by private insurers and pay after Original Medicare to cover the cost-sharing gaps (deductibles, coinsurance, copays). Medigap works with Original Medicare, not Medicare Advantage — a beneficiary cannot have both an MA plan and a Medigap policy at the same time.

9Which Medigap plans are NOT available to people who became newly eligible for Medicare on or after January 1, 2020?

A.Plans G and N

B.Plans C and F

C.Plans A and B

D.Plans K and L

Explanation: Plans C and F (which cover the Part B deductible) are no longer sold to people who became newly eligible for Medicare on or after January 1, 2020 (MACRA rule). People already eligible before that date can still buy or keep them. Plan G has become the most popular alternative for new enrollees.

10A client has employer group health coverage through her active employment at a 25-employee company and is turning 65. Which payer is primary?

A.Medicare is always primary at age 65

B.The employer group health plan is primary

C.Medicare is primary because the employer has fewer than 100 employees

D.Whichever plan the client enrolled in first

Explanation: When an employer has 20 or more employees, federal Medicare Secondary Payer (MSP) rules make the active-employment group health plan primary and Medicare secondary. With 25 employees the GHP is primary. For employers with fewer than 20 employees, Medicare is primary at age 65. NABIP brokers must counsel group clients on this distinction.

About the NABIP Medicare Exam

The NABIP Medicare, Medicare Advantage, and Compliance Requirements (MMACR) certification is the AHIP alternative for selling Medicare Advantage and Part D plans. Issued annually by NABIP (formerly NAHU), it covers Original Medicare, MA plan types, Part D under the Inflation Reduction Act, CMS marketing rules, and fraud, waste, and abuse. Our free practice bank includes 100 questions covering all six modules of the real 50-question exam.

Questions

50 scored questions

Time Limit

2 hours

Passing Score

90%

Exam Fee

$75-125 (National Association of Benefits and Insurance Professionals (NABIP))

NABIP Medicare Exam Content Outline

20%

Medicare Basics

Original Medicare Parts A and B, 2026 premiums and deductibles, eligibility (age 65, ESRD, ALS, SSDI), Medigap, and coordination with employer group health plans

15%

Eligibility and Enrollment Periods

IEP, ICEP, AEP (Oct 15-Dec 7), MA OEP (Jan 1-Mar 31), SEPs (5-star, LIS, dual-eligible quarterly), and late enrollment penalty rules

20%

Medicare Advantage Plans

HMO, PPO, PFFS, MSA, and Special Needs Plans (C-SNP, D-SNP, I-SNP), MOOP limits, supplemental benefits, employer group waiver plans (EGWP)

15%

Part D Prescription Drug Plans

PDP formularies, Inflation Reduction Act $2,000 annual OOP cap for 2026, Medicare Prescription Payment Plan (M3P), LIS / Extra Help qualification

20%

Marketing and Compliance

CMS Medicare Communications & Marketing Guidelines (MCMG), 48-hour Scope of Appointment rule, TPMO disclosure, prohibited cold calling, generic TV ad rules

10%

Fraud, Waste, Abuse, and General Compliance

FWA definitions, False Claims Act, Anti-Kickback Statute, Stark Law, mandatory FWA training, HIPAA privacy and security, Part D-specific FWA scenarios

How to Pass the NABIP Medicare Exam

What You Need to Know

Passing score: 90%
Exam length: 50 questions
Time limit: 2 hours
Exam fee: $75-125

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

NABIP Medicare Study Tips from Top Performers

1Memorize the 2026 dollar figures cold: Part D $2,000 OOP cap (IRA), Part B premium $185 standard, Part A inpatient deductible $1,676, AEP Oct 15-Dec 7, MA OEP Jan 1-Mar 31

2Master the Scope of Appointment 48-hour rule and the difference between SOA scenarios that require advance documentation versus walk-in exemptions

3Know all SNP types and triggers: C-SNP (chronic condition), D-SNP (dual-eligible Medicare/Medicaid), I-SNP (institutionalized) — and the dual-eligible quarterly SEP changes

4Understand the difference between FWA categories: fraud (intentional), waste (overuse), abuse (incorrect billing) — and which laws apply (False Claims Act, Anti-Kickback, Stark)

5If you are a benefits broker, study the employer group Medicare crossover content carefully — NABIP tests this more deeply than AHIP because of its EGWP and group benefits focus

Frequently Asked Questions

Do I need to retake NABIP Medicare every year?

Yes. NABIP MMACR must be completed annually for each upcoming Medicare plan year. The PY2026 course launched June 23, 2025. Carriers will not allow you to sell that plan year's MA or Part D products until your current-year certification is on file.

What is the difference between NABIP and AHIP for Medicare certification?

Both certify agents to sell Medicare Advantage and Part D plans and require a 90% passing score. AHIP is more widely accepted (most major carriers require it). NABIP allows 6 attempts versus AHIP's 3, costs $75-125 versus AHIP's ~$175, and includes 8 CE credits at no extra charge. As of PY2026, 51+ carriers accept NABIP, but most agents complete both for broader contracting.

How many attempts do I get to pass the NABIP exam?

NABIP MMACR allows 6 attempts to pass per plan year — twice as many as AHIP's 3 attempts. There is no additional fee for retakes within the same enrollment, but each attempt requires you to complete the certification training.

Does the NABIP Medicare certification include CE credits?

Yes. NABIP MMACR includes 8 hours of continuing education credits at no additional charge. CE credits apply in most states toward life and health insurance license renewal — verify acceptance with your state department of insurance.

Why do carriers require Medicare certification at all?

CMS rules require any agent who markets or sells Medicare Advantage or Part D plans to complete annual training on Medicare program basics, plan rules, and CMS marketing requirements. NABIP MMACR and AHIP are the two CMS-recognized industry training programs that satisfy this requirement.

What topics does the NABIP Medicare exam cover?

Six modules: Medicare basics (20%), eligibility and enrollment periods (15%), MA plans including SNPs (20%), Part D PDPs and the Inflation Reduction Act (15%), CMS marketing and compliance (20%), and fraud, waste, and abuse plus general compliance (10%). NABIP places more emphasis than AHIP on benefits-broker context and employer group Medicare.