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AHIP Final Exam Actual Exam 2026/2027 |
Complete Medicare Certification Test Bank with
Verified Questions & Correct Answers | Updated
for Current CMS Guidelines | A+ Graded
SECTION 1: MEDICARE FUNDAMENTALS (Questions 1-20)
Q1: Mrs. Garcia turns 65 on June 15, 2026. She is currently covered under her employer's group
health plan and plans to continue working. What is her Initial Enrollment Period (IEP) for
Medicare?
A. January 1, 2026 to December 31, 2026
B. March 1, 2026 to September 1, 2026
C. March 1, 2026 to August 31, 2026
D. March 1, 2026 to August 31, 2026 [CORRECT]
Correct Answer: D
Rationale: The Initial Enrollment Period (IEP) is the 7-month period that begins 3 months
before the month of turning 65, includes the birth month, and ends 3 months after the birth
month. For a June 15 birthday, this is March 1 - August 31, 2026. Option A is 12 months, too
long. Options B and C have incorrect end dates (September 1 vs. August 31).
Q2: Mr. Thompson is 68 years old and delayed Part B enrollment because he had employer
coverage. He retired on March 1, 2026. When does his Special Enrollment Period (SEP) for Part
B begin and end?
A. March 1, 2026 to September 1, 2026
B. March 1, 2026 to September 30, 2026
C. April 1, 2026 to September 30, 2026
D. Anytime during the General Enrollment Period [CORRECT]
Correct Answer: B
Rationale: The SEP for Part B begins the month employment ends or coverage ends (whichever
is first) and lasts for 8 months. Since Mr. Thompson retired March 1, 2026, his SEP runs March 1
,2
- September 30, 2026. Option A has the wrong end date. Option C incorrectly delays the start.
Option D is incorrect because SEP and GEP are different enrollment periods.
Q3: Which of the following services is NOT covered under Medicare Part A?
A. Inpatient hospital stays
B. Skilled nursing facility care
C. Routine dental care [CORRECT]
D. Hospice care
Correct Answer: C
Rationale: Medicare Part A covers inpatient hospital stays, skilled nursing facility care
(following a 3-day hospital stay), hospice care, and limited home health care. Routine dental care
is not covered under Original Medicare (Parts A or B) and would require a Medicare Advantage
plan or separate dental insurance.
Q4: Mrs. Johnson is enrolled in Medicare Part B. What is the standard monthly premium for Part
B in 2026, and how is it typically paid?
A. $174.70, automatically deducted from Social Security benefits [CORRECT]
B. $185.50, billed quarterly to the beneficiary
C. $174.70, billed annually
D. $164.90, paid through state Medicaid programs
Correct Answer: A
Rationale: For 2026, the standard Part B premium is $174.70 per month (subject to annual
adjustments). Most beneficiaries have this premium automatically deducted from their Social
Security retirement benefits. Those not receiving Social Security receive a quarterly bill. Option
D reflects outdated 2024 rates.
Q5: What is the Medicare Part A deductible for hospital stays in 2026?
A. $1,632 per benefit period
B. $1,676 per benefit period
C. $1,676 per calendar year
D. $1,676 per benefit period [CORRECT]
Correct Answer: D
Rationale: The 2026 Part A hospital deductible is $1,676 per benefit period (not per calendar
year). A benefit period begins the day a patient is admitted and ends when they haven't received
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inpatient care for 60 consecutive days. The patient may pay multiple deductibles in one year if
readmitted after 60 days.
Q6: Mr. Chen is turning 65 in August 2026. He is not collecting Social Security yet. How must
he enroll in Medicare Part A and Part B?
A. Automatic enrollment 3 months before his birthday
B. He must actively enroll through Social Security Administration [CORRECT]
C. Enrollment happens automatically when he files taxes
D. He can enroll anytime during his birthday month only
Correct Answer: B
Rationale: Individuals not receiving Social Security benefits must actively enroll in Medicare
through the Social Security Administration (online, by phone, or in person). Automatic
enrollment only applies to those already receiving Social Security retirement or Railroad
Retirement benefits. Missing the IEP can result in lifetime late enrollment penalties.
Q7: Which statement about the Medicare Part D late enrollment penalty (LEP) is correct?
A. The penalty is 1% of the national base beneficiary premium for each full month without
creditable coverage
B. The penalty is permanent and added to the monthly premium for as long as the beneficiary has
Part D
C. The penalty is calculated using 1% of the national base beneficiary premium multiplied by the
number of full months without creditable coverage
D. All of the above [CORRECT]
Correct Answer: D
Rationale: The Part D LEP is 1% of the national base beneficiary premium (approximately
$34.70 in 2026) for each full month without creditable prescription drug coverage, calculated
when the beneficiary finally enrolls. This penalty is permanent and added to the monthly
premium for as long as the beneficiary maintains Part D coverage.
Q8: Mrs. Williams has Medicare Parts A and B. She wants to add prescription drug coverage.
When can she enroll in a standalone Part D plan?
A. Only during her Initial Enrollment Period
B. During the Annual Election Period (October 15 - December 7) [CORRECT]
C. Only during the Medicare Advantage Open Enrollment Period
D. Anytime with a 30-day waiting period
AHIP Final Exam Actual Exam 2026/2027 |
Complete Medicare Certification Test Bank with
Verified Questions & Correct Answers | Updated
for Current CMS Guidelines | A+ Graded
SECTION 1: MEDICARE FUNDAMENTALS (Questions 1-20)
Q1: Mrs. Garcia turns 65 on June 15, 2026. She is currently covered under her employer's group
health plan and plans to continue working. What is her Initial Enrollment Period (IEP) for
Medicare?
A. January 1, 2026 to December 31, 2026
B. March 1, 2026 to September 1, 2026
C. March 1, 2026 to August 31, 2026
D. March 1, 2026 to August 31, 2026 [CORRECT]
Correct Answer: D
Rationale: The Initial Enrollment Period (IEP) is the 7-month period that begins 3 months
before the month of turning 65, includes the birth month, and ends 3 months after the birth
month. For a June 15 birthday, this is March 1 - August 31, 2026. Option A is 12 months, too
long. Options B and C have incorrect end dates (September 1 vs. August 31).
Q2: Mr. Thompson is 68 years old and delayed Part B enrollment because he had employer
coverage. He retired on March 1, 2026. When does his Special Enrollment Period (SEP) for Part
B begin and end?
A. March 1, 2026 to September 1, 2026
B. March 1, 2026 to September 30, 2026
C. April 1, 2026 to September 30, 2026
D. Anytime during the General Enrollment Period [CORRECT]
Correct Answer: B
Rationale: The SEP for Part B begins the month employment ends or coverage ends (whichever
is first) and lasts for 8 months. Since Mr. Thompson retired March 1, 2026, his SEP runs March 1
,2
- September 30, 2026. Option A has the wrong end date. Option C incorrectly delays the start.
Option D is incorrect because SEP and GEP are different enrollment periods.
Q3: Which of the following services is NOT covered under Medicare Part A?
A. Inpatient hospital stays
B. Skilled nursing facility care
C. Routine dental care [CORRECT]
D. Hospice care
Correct Answer: C
Rationale: Medicare Part A covers inpatient hospital stays, skilled nursing facility care
(following a 3-day hospital stay), hospice care, and limited home health care. Routine dental care
is not covered under Original Medicare (Parts A or B) and would require a Medicare Advantage
plan or separate dental insurance.
Q4: Mrs. Johnson is enrolled in Medicare Part B. What is the standard monthly premium for Part
B in 2026, and how is it typically paid?
A. $174.70, automatically deducted from Social Security benefits [CORRECT]
B. $185.50, billed quarterly to the beneficiary
C. $174.70, billed annually
D. $164.90, paid through state Medicaid programs
Correct Answer: A
Rationale: For 2026, the standard Part B premium is $174.70 per month (subject to annual
adjustments). Most beneficiaries have this premium automatically deducted from their Social
Security retirement benefits. Those not receiving Social Security receive a quarterly bill. Option
D reflects outdated 2024 rates.
Q5: What is the Medicare Part A deductible for hospital stays in 2026?
A. $1,632 per benefit period
B. $1,676 per benefit period
C. $1,676 per calendar year
D. $1,676 per benefit period [CORRECT]
Correct Answer: D
Rationale: The 2026 Part A hospital deductible is $1,676 per benefit period (not per calendar
year). A benefit period begins the day a patient is admitted and ends when they haven't received
, 3
inpatient care for 60 consecutive days. The patient may pay multiple deductibles in one year if
readmitted after 60 days.
Q6: Mr. Chen is turning 65 in August 2026. He is not collecting Social Security yet. How must
he enroll in Medicare Part A and Part B?
A. Automatic enrollment 3 months before his birthday
B. He must actively enroll through Social Security Administration [CORRECT]
C. Enrollment happens automatically when he files taxes
D. He can enroll anytime during his birthday month only
Correct Answer: B
Rationale: Individuals not receiving Social Security benefits must actively enroll in Medicare
through the Social Security Administration (online, by phone, or in person). Automatic
enrollment only applies to those already receiving Social Security retirement or Railroad
Retirement benefits. Missing the IEP can result in lifetime late enrollment penalties.
Q7: Which statement about the Medicare Part D late enrollment penalty (LEP) is correct?
A. The penalty is 1% of the national base beneficiary premium for each full month without
creditable coverage
B. The penalty is permanent and added to the monthly premium for as long as the beneficiary has
Part D
C. The penalty is calculated using 1% of the national base beneficiary premium multiplied by the
number of full months without creditable coverage
D. All of the above [CORRECT]
Correct Answer: D
Rationale: The Part D LEP is 1% of the national base beneficiary premium (approximately
$34.70 in 2026) for each full month without creditable prescription drug coverage, calculated
when the beneficiary finally enrolls. This penalty is permanent and added to the monthly
premium for as long as the beneficiary maintains Part D coverage.
Q8: Mrs. Williams has Medicare Parts A and B. She wants to add prescription drug coverage.
When can she enroll in a standalone Part D plan?
A. Only during her Initial Enrollment Period
B. During the Annual Election Period (October 15 - December 7) [CORRECT]
C. Only during the Medicare Advantage Open Enrollment Period
D. Anytime with a 30-day waiting period
