18 Free California Medicare & Senior Health Practice Questions (2026)
How to Use This Senior Health Question Set
Senior Health Products is the largest single block on the health side of the California Life, Accident and Health exam. The CDI License Examination Objectives give it 15 of the 75 Accident & Health questions — more than individual medical expense (14), group (8) or PPACA (8), and almost four times the weight of Disability Income or Long-Term Care at 4 each.
It is also the block where generic national material leaves the most gaps. Medicare enrollment windows and penalties are federal, but California adds its own layer: a 30-day free look on Medicare Supplement policies, HICAP as the state's counseling program, and the Insurance Code's duty of honesty, good faith and fair dealing toward people aged 65 and over.
These 18 questions come from chapter 7 of LanePrep's California Life & Health quiz bank and follow the three ways the exam approaches the topic: how Medicare Parts A, B and D work and what enrolling late costs; who qualifies before 65 and how Medicare Advantage and Part D plans interact; and the Medicare Supplement, counseling and marketing rules that apply in California.
Work them before you read the answer. Every question has the explanation folded underneath it. Guessing and then reading is worth more than reading and then agreeing.
Practice Questions 1-6: Medicare Parts A, B and D — Eligibility, Enrollment and Penalties
The exam likes numbers here, and the numbers are different for each part: the quarters of coverage that decide whether Part A is premium-free, the seven-month initial enrollment period, the eight-month special enrollment window after employer coverage ends, the 10% Part B penalty per 12-month period and the 1% per month Part D penalty. The last question separates what Part A pays from what Part B pays inside the same hospital stay.
Question 1 (Chapter 7)
A California resident is 65 years old and has worked for 35 quarters in jobs covered by Social Security. What is their status regarding Medicare Part A premiums?
- A) They must pay the full Part A premium because they have fewer than 40 credits.
- B) They qualify for premium-free Part A because they have at least 30 credits.
- C) They are ineligible for Part A until they reach 40 credits.
- D) They must pay a reduced premium for Part A.
Show answer & explanation
Answer: D
Medicare Part A is premium-free for those with 40 quarters of coverage. For those with 30-39 credits, the premium is reduced; for those with 0-29, the premium is higher.
Question 2 (Chapter 7)
A client is 65 years old and is still working. They are covered by their employer's group health plan. When does their Initial Enrollment Period (IEP) for Medicare Part B begin?
- A) Only during the General Enrollment Period (January 1 to March 31).
- B) The day they retire.
- C) Three months before they turn 65, the month they turn 65, and three months after.
- D) They do not have an IEP because they are working.
Show answer & explanation
Answer: C
The Initial Enrollment Period (IEP) for Medicare is a 7-month window surrounding an individual's 65th birthday, regardless of employment status.
Question 3 (Chapter 7)
An insurance agent is discussing Medicare Part B with a client who is turning 65. The client is currently covered by a large group employer plan (200 employees) and asks if they must enroll in Part B immediately to avoid a penalty. What should the agent advise?
- A) They can delay Part B enrollment without penalty as long as they are covered by an employer plan and enroll within 8 months of losing that coverage.
- B) They must enroll in Part B within 7 months of turning 65 to avoid a permanent penalty.
- C) They must enroll in Part B immediately, as employer plans are always secondary to Medicare.
- D) They are exempt from Part B enrollment requirements for life because they have group coverage.
Show answer & explanation
Answer: A
Under the Special Enrollment Period (SEP) rules, individuals covered by an active employer plan (for groups of 20+) can delay Part B without penalty. They have an 8-month window to enroll after the employment or coverage ends.
Question 4 (Chapter 7)
A client is 65 years old and has never had health insurance. They enroll in Medicare Part B during the General Enrollment Period. What is the penalty?
- A) 10% of the premium for every 12-month period they could have been enrolled but were not.
- B) A flat fee of $500.
- C) A 5% penalty for each year they were uninsured.
- D) No penalty, as they are over 65.
Show answer & explanation
Answer: A
The Part B late enrollment penalty is 10% of the premium for each 12-month period the individual was eligible but not enrolled. Option C and D are incorrect.
Question 5 (Chapter 7)
A client is 65 years old and has been enrolled in Medicare Part B for 3 years, but never enrolled in Part D. They now decide to enroll in a stand-alone Part D plan. What is the penalty they will likely face?
- A) A lifetime penalty of 10% per year.
- B) A 1% monthly penalty for every month they were eligible but did not have creditable coverage.
- C) A one-time flat fee of $500.
- D) No penalty, as Part D is voluntary.
Show answer & explanation
Answer: B
The Part D late enrollment penalty is 1% of the 'national base beneficiary premium' for every month the individual went without creditable coverage after their initial enrollment period.
Question 6 (Chapter 7)
A Medicare Part B beneficiary is hospitalized. Which part of Medicare covers the physician's fees for services rendered during the hospital stay?
- A) Part A.
- B) Part B.
- C) Part C.
- D) Part D.
Show answer & explanation
Answer: B
Medicare Part A covers inpatient hospital facility costs, while Part B covers physician and surgeon charges, even when performed in a hospital setting. This is a common point of confusion on the exam.
Get the 25-question sample set by email
Want a full-exam practice set to study offline? Drop your email — we'll send 25 questions across every content area, each with the answer and explanation.
No spam. Just the questions and one optional follow-up.
Practice Questions 7-12: Medicare Before 65, Medicare Advantage and Part D Plans
Two of these questions test eligibility before age 65 — end-stage renal disease and ALS — and the rest test how the pieces interact: what enrolling in a Medicare Advantage drug plan does to a stand-alone Part D plan, what a stand-alone Part D plan does to a Medicare Advantage plan, why a Health Savings Account stops accepting contributions once any part of Medicare begins, and what became of the Part D coverage gap.
Question 7 (Chapter 7)
An agent is helping a client who is 64 years old and has End-Stage Renal Disease (ESRD). Are they eligible for Medicare?
- A) No, they must wait until age 65.
- B) Yes, Medicare is available to individuals of any age with ESRD requiring dialysis or a transplant.
- C) Yes, but only after 24 months of disability benefits.
- D) No, ESRD is not a qualifying condition for Medicare.
Show answer & explanation
Answer: B
Medicare is available to individuals of any age who have permanent kidney failure (ESRD) requiring dialysis or a kidney transplant.
Question 8 (Chapter 7)
A 64-year-old individual with ALS (Lou Gehrig's disease) is applying for Medicare. What is their eligibility status?
- A) They must wait until age 65 to qualify for Medicare Part A.
- B) They are eligible for Medicare immediately upon receiving Social Security Disability Insurance (SSDI) benefits, regardless of age.
- C) They are only eligible for Medicare Part B once they reach age 65.
- D) They must have at least 40 quarters of Social Security coverage to qualify before age 65.
Show answer & explanation
Answer: B
Individuals with ALS (Amyotrophic Lateral Sclerosis) are eligible for Medicare immediately upon qualifying for SSDI, waiving the standard 24-month waiting period that applies to other disabilities. Option A is wrong because ALS provides an exception to the age 65 requirement.
Question 9 (Chapter 7)
A Medicare beneficiary is enrolled in a stand-alone Prescription Drug Plan (PDP). They decide to enroll in a Medicare Advantage Prescription Drug (MAPD) plan. What happens to their previous PDP enrollment?
- A) The PDP enrollment is automatically terminated upon enrollment in the MAPD plan.
- B) The PDP enrollment remains active, and the client will have dual coverage.
- C) The client must manually cancel the PDP before the MAPD enrollment can be processed.
- D) The client will be penalized for having two drug plans.
Show answer & explanation
Answer: A
Enrolling in a Medicare Advantage plan that includes prescription drug coverage (MAPD) automatically terminates enrollment in a stand-alone Medicare Part D plan.
Question 10 (Chapter 7)
A client is enrolled in a Medicare Advantage (Part C) plan. They decide to purchase a stand-alone Medicare Part D Prescription Drug Plan (PDP) to get better drug coverage. What is the immediate effect of this action?
- A) The Medicare Advantage plan will be automatically terminated.
- B) The client will be covered by both plans simultaneously.
- C) The Part D plan will be rejected by the carrier.
- D) The client will be placed in a dual-eligibility status.
Show answer & explanation
Answer: A
Enrolling in a stand-alone Part D plan automatically disenrolls the individual from their Medicare Advantage plan, as Part C plans usually include prescription drug coverage.
Question 11 (Chapter 7)
An agent is assisting a client who is turning 65. The client is currently enrolled in a high-deductible health plan (HDHP) with a Health Savings Account (HSA). The client is enrolling in Medicare Part A. What should the agent advise regarding the HSA?
- A) The client can continue making contributions to the HSA as long as they have Part A.
- B) The client must close the HSA immediately upon turning 65.
- C) The client must stop making contributions to the HSA once they are enrolled in any part of Medicare, as Medicare enrollment is considered 'other coverage'.
- D) The client can continue contributions if they are also enrolled in a Medicare Advantage plan.
Show answer & explanation
Answer: C
Once an individual is enrolled in Medicare (even just Part A), they are no longer eligible to contribute to an HSA because Medicare is considered 'other coverage' that is not an HDHP. They can keep the funds already in the account, but cannot add more. Options A, B, and D are incorrect interpretations of IRS/Medicare coordination rules.
Question 12 (Chapter 7)
An agent is preparing a presentation for a senior client regarding Medicare Part D. The client asks about the 'coverage gap' (donut hole) they have heard about. What should the agent explain?
- A) The coverage gap was eliminated in 2025; Part D now caps annual out-of-pocket spending on covered drugs ($2,100 in 2026), after which catastrophic coverage pays in full.
- B) It is the period between age 65 and the month the client enrolls in Part D.
- C) It is the time while a Part D application is waiting to be approved.
- D) It is the deductible phase at the beginning of each plan year.
Show answer & explanation
Answer: A
The 'coverage gap' was a phase of Part D in which enrollees once paid a larger share of their drug costs after reaching the initial coverage limit. Since 2025 that gap no longer exists: Part D has a deductible, an initial coverage phase, and an annual out-of-pocket cap ($2,100 in 2026); once the cap is reached, the enrollee pays nothing more for covered drugs for the rest of the year.
Practice Questions 13-18: Medicare Supplement, HICAP and California Marketing Rules
Medicare Supplement policies are standardized, and California layers its own rules on top: a 30-day free look, and a prohibition on selling a Medigap policy to anyone enrolled in a Medicare Advantage plan. The remaining questions cover HICAP, the Scope of Appointment form, and what an agent may and may not say about a Medicare Advantage plan's relationship to the federal government.
Question 13 (Chapter 7)
Which of the following is a core benefit that must be included in every standardized Medicare Supplement (Medigap) plan?
- A) Part A coinsurance for hospital costs up to an additional 365 days after Medicare benefits are exhausted.
- B) Coverage for outpatient prescription drugs.
- C) The Part B deductible.
- D) Coverage for vision and dental services.
Show answer & explanation
Answer: A
Plan A (the core plan) includes basic benefits such as Part A coinsurance and the cost of an additional 365 days of inpatient hospital care after Medicare benefits are exhausted.
Question 14 (Chapter 7)
An insurance agent is meeting with a 70-year-old client who currently has a Medicare Advantage (Part C) plan. The client wants to purchase a Medicare Supplement (Medigap) policy to cover the out-of-pocket costs of their Advantage plan. How should the agent advise the client?
- A) The agent can sell the client a Plan G Medigap policy to coordinate with their Advantage plan.
- B) The agent can sell the Medigap policy, but only if the client pays an additional premium for the coordination of benefits.
- C) The agent can sell the Medigap policy, but the client must drop their Part D coverage first.
- D) The agent must inform the client that it is illegal to sell a Medigap policy to someone who already has a Medicare Advantage plan.
Show answer & explanation
Answer: D
Under California law and federal rules, a Medicare Supplement policy cannot be sold to an individual who is enrolled in a Medicare Advantage plan. Medigap policies are designed to supplement Original Medicare, not Medicare Advantage.
Question 15 (Chapter 7)
Under California law, what is the 'free look' period for a Medicare Supplement policy?
- A) 10 days
- B) 20 days
- C) 30 days
- D) 45 days
Show answer & explanation
Answer: C
Medicare Supplement policies in California must provide a 30-day free look period, allowing the policyholder to return the policy for a full refund of premiums paid.
Question 16 (Chapter 7)
Which entity is responsible for providing free, unbiased counseling to California seniors regarding Medicare, Medicare Supplement, and Long-Term Care insurance?
- A) The California Department of Insurance (CDI).
- B) The Centers for Medicare & Medicaid Services (CMS).
- C) The Health Insurance Counseling and Advocacy Program (HICAP).
- D) The Social Security Administration (SSA).
Show answer & explanation
Answer: C
HICAP is a federally mandated, state-funded program that provides free, objective information and counseling to seniors about Medicare and related health insurance products.
Question 17 (Chapter 7)
An agent is marketing a Medicare Advantage plan. During the appointment, the agent asks the client to sign a document that outlines what products will be discussed. What is this document called?
- A) Statement of Understanding
- B) Permission to Contact (PTC)
- C) Scope of Appointment (SOA)
- D) Marketing Compliance Disclosure
Show answer & explanation
Answer: C
The Scope of Appointment (SOA) form is required by CMS to ensure the client agrees to the specific types of products the agent will discuss during the appointment.
Question 18 (Chapter 7)
A licensed agent is conducting a marketing event for Medicare Advantage plans. During the presentation, the agent mentions that the plan is 'endorsed by Medicare.' According to CMS marketing compliance rules, what is the status of this statement?
- A) This is a violation of CMS marketing rules because private plans are not endorsed by the federal government.
- B) This is acceptable as long as the agent provides a disclaimer.
- C) This is permitted if the plan has a 5-star rating from CMS.
- D) This is allowed only if the agent is a captive agent for that specific carrier.
Show answer & explanation
Answer: A
CMS strictly prohibits agents from claiming that a specific Medicare Advantage plan is endorsed or recommended by Medicare or any other government agency.
The Senior Health Mistakes That Cost Marks
Treating Medigap and Medicare Advantage as a pair. They are mutually exclusive. A client in a Medicare Advantage plan cannot be sold a Medicare Supplement policy, and the exam asks the question from several directions — as advice, as application handling, and as a compliance obligation.
Mixing up the two late-enrollment penalties. Part B is 10% of the premium for each full 12-month period without enrollment; Part D is 1% of the national base beneficiary premium for each month without creditable coverage. Different base, different period.
Assuming everyone with Part A has it for free. Premium-free Part A needs 40 quarters of coverage. Thirty to 39 credits means a reduced premium; fewer than 30 means a higher one.
Answering the coverage gap question from old notes. Since 2025 there is no Part D coverage gap. There is an annual out-of-pocket cap on covered drugs, after which catastrophic coverage pays in full.
Putting the hospital physician on Part A. Part A pays the inpatient facility; Part B pays the physician and surgeon charges, even during an inpatient stay.
Chapter 7 of the LanePrep California course covers group health, PPACA, senior health products and the California rules common to both lines as an audio lesson. Chapters 1 and 9 are free, no signup. For a sample across the whole exam, the 25-question set covers every content area; for the individual life contract and riders, see the policy provisions set.
Question counts and content weighting come from the California Department of Insurance License Examination Objectives (effective January 1, 2026). Read October 2026.
Free: 25 California L&H practice questions
Liked this article? Get 25 exam-style questions emailed to you — with full answer explanations, no credit card. Closest thing to studying offline.
No spam. Just the questions and one optional follow-up.
Study this topic with LanePrep
Listen to these audio chapters on your commute — no screen required.
Related Articles
How to Pass the California Life & Health Exam on Your First Try (2026)
8 min read
$360 in Fees: California Life & Health License Cost 2026
7 min read
25 Free California Life & Health Exam Practice Questions (2026)
18 min read
18 Free California Life Insurance Policy Provisions Practice Questions (2026)
14 min read