Social Insurance — practice questions

4.6% of the exam ≈6 real questions 9 free questions here

Medicare Parts A, B, C and D, Medicaid and Social Security disability: about 6 of the 130 scored questions.

Where people lose points

• Part A skilled nursing needs a 3-day inpatient stay; days 1-20 are paid in full.
• The 60 lifetime reserve days are never replenished.
• Social Security disability has a 5-month waiting period.
• Medicaid is need-based and run by the states; Medicare is federal and age or disability based.

Questions and answers, explained

All 9 questions above, with the correct answer and why it is correct. Everything here is on social insurance.

1. Medicare Part A primarily provides coverage for which of the following?

   • APhysician office visits and outpatient diagnostic tests
   • BInpatient hospital careCorrect
   • COutpatient prescription drugs
   • DRoutine dental and vision care

   Why: Part A is the hospital insurance portion of Medicare: it covers inpatient hospital care, skilled nursing facility care after a qualifying stay, hospice care, and certain home health care. Physician and outpatient services fall under Part B, and outpatient prescription drugs fall under Part D.

   Reference Texas outline #124401, general section VII (Social insurance)

2. 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 Texas outline #124401, general section VII (Social insurance)

3. To qualify for Social Security disability income benefits, a covered worker must meet which definition of disability?

   • AUnable to perform the main duties of his or her own regular occupation for a period of 90 days or more
   • BUnable to work at any job at all for at least 90 consecutive days
   • CSuffering any injury that reduces his or her earnings by 20% or more
   • DUnable to engage in any substantial gainful activity, expected to last 12 months or end in deathCorrect

   Why: Social Security uses the strictest common definition of disability: the inability to engage in any substantial gainful activity due to an impairment expected to last at least 12 months or result in death, plus a 5-month waiting period before benefits begin. The 'own occupation' standard in option A is a definition found in private disability income policies, not Social Security.

   Reference Texas outline #124401, general section VII (Social insurance)

4. 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 Texas outline #124401, general section VII (Social insurance)

5. 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 Texas outline #124401, general section VII (Social insurance)

6. 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 Texas outline #124401, general section VII (Social insurance)

7. 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 Texas outline #124401, general section VII (Social insurance)

8. A Medicare beneficiary may incur a Part D late enrollment penalty after going without Part D or other creditable prescription drug coverage for a continuous period of at least

   • A31 days
   • B63 daysCorrect
   • C6 months
   • D12 months

   Why: The Part D penalty is triggered by 63 or more continuous days without creditable drug coverage after the initial enrollment period, and it equals 1% of the national base beneficiary premium for each full uncovered month, added to the premium for as long as the person has Part D. The 12-month figure belongs to the Part B penalty, which counts only full 12-month periods and adds 10% for each one.

   Reference Texas outline #124401, general section VII (Social insurance)

9. A fully insured worker becomes disabled on March 15 and meets Social Security's definition of disability. Assuming the claim is approved, for which month is the FIRST Social Security disability benefit payable?

   • AMarch
   • BApril
   • CSeptemberCorrect
   • DMarch of the following year

   Why: Social Security imposes a five-month waiting period, counted in full calendar months beginning with the first full month after onset — April through August — so the first payable month is the sixth full month, September. Choice B ignores the waiting period entirely; the separate 24-month rule determines when the disabled worker becomes entitled to Medicare, not when cash benefits start.

   Reference Texas outline #124401, general section VII (Social insurance)

Drill other domains

• Types of Life Policies and Annuities (11.5%)
• Life Policy Riders, Provisions, Options and Exclusions (11.5%)
• Life Application, Underwriting and Policy Delivery (9.2%)
• Retirement and Other Life Insurance Concepts (6.2%)
• Types of Health Policies (12.3%)
• Health Policy Provisions, Clauses and Riders (11.5%)

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