AHIP Medicare Certification Final
Exam 200+ Practice Questions
with Correct Answers & Rationales
🏥AHIP Medicare Certification Final Exam
✅ Practice Questions with Answers & Rationales
1. Medicare Part A primarily covers:
A. Physician services
B. Hospital inpatient care
C. Prescription drugs
D. Dental
✅ Answer: B
Rationale: Part A = inpatient hospital, skilled nursing, hospice.
2. Medicare Part B includes:
A. Inpatient care
B. Outpatient services
C. Long-term care
D. Dental
✅ Answer: B
Rationale: Covers doctor visits, outpatient care, preventive services.
3. Medicare Advantage (Part C) plans are:
A. Government-run
B. Private plans approved by CMS
,C. Medicaid programs
D. Drug-only plans
✅ Answer: B
Rationale: Offered by private insurers but regulated by CMS.
4. Medicare Part D covers:
A. Hospital stays
B. Prescription drugs
C. Surgery
D. Vision
✅ Answer: B
5. A premium is:
A. Deductible
B. Monthly payment
C. Copayment
D. Coinsurance
✅ Answer: B
6. Deductible means:
A. Monthly fee
B. Amount paid before coverage begins
C. Fixed fee
D. Percentage
✅ Answer: B
7. Coinsurance is:
A. Fixed amount
B. Percentage of cost
,C. Monthly payment
D. Annual fee
✅ Answer: B
8. A formulary is:
A. Plan
B. Drug list
C. Provider network
D. Policy
✅ Answer: B
9. Generic drugs are:
A. More expensive
B. Lower-cost equivalents
C. Unsafe
D. Experimental
✅ Answer: B
10. HMO plans require:
A. No referrals
B. PCP referrals
C. No network
D. Cash
✅ Answer: B
11. PPO plans allow:
A. No providers
B. Out-of-network care
C. No flexibility
D. No coverage
, ✅ Answer: B
12. Emergency care is covered:
A. Only in-network
B. Anywhere
C. Only hospital
D. Only PCP
✅ Answer: B
13. AEP occurs:
A. Jan–Mar
B. Oct 15–Dec 7
C. Apr–Jun
D. Anytime
✅ Answer: B
14. MA-OEP occurs:
A. Jan 1–Mar 31
B. Oct–Dec
C. Apr–Jun
D. Anytime
✅ Answer: A
15. SEP is triggered by:
A. Routine
B. Life events
C. Monthly
D. Payment
✅ Answer: B
Exam 200+ Practice Questions
with Correct Answers & Rationales
🏥AHIP Medicare Certification Final Exam
✅ Practice Questions with Answers & Rationales
1. Medicare Part A primarily covers:
A. Physician services
B. Hospital inpatient care
C. Prescription drugs
D. Dental
✅ Answer: B
Rationale: Part A = inpatient hospital, skilled nursing, hospice.
2. Medicare Part B includes:
A. Inpatient care
B. Outpatient services
C. Long-term care
D. Dental
✅ Answer: B
Rationale: Covers doctor visits, outpatient care, preventive services.
3. Medicare Advantage (Part C) plans are:
A. Government-run
B. Private plans approved by CMS
,C. Medicaid programs
D. Drug-only plans
✅ Answer: B
Rationale: Offered by private insurers but regulated by CMS.
4. Medicare Part D covers:
A. Hospital stays
B. Prescription drugs
C. Surgery
D. Vision
✅ Answer: B
5. A premium is:
A. Deductible
B. Monthly payment
C. Copayment
D. Coinsurance
✅ Answer: B
6. Deductible means:
A. Monthly fee
B. Amount paid before coverage begins
C. Fixed fee
D. Percentage
✅ Answer: B
7. Coinsurance is:
A. Fixed amount
B. Percentage of cost
,C. Monthly payment
D. Annual fee
✅ Answer: B
8. A formulary is:
A. Plan
B. Drug list
C. Provider network
D. Policy
✅ Answer: B
9. Generic drugs are:
A. More expensive
B. Lower-cost equivalents
C. Unsafe
D. Experimental
✅ Answer: B
10. HMO plans require:
A. No referrals
B. PCP referrals
C. No network
D. Cash
✅ Answer: B
11. PPO plans allow:
A. No providers
B. Out-of-network care
C. No flexibility
D. No coverage
, ✅ Answer: B
12. Emergency care is covered:
A. Only in-network
B. Anywhere
C. Only hospital
D. Only PCP
✅ Answer: B
13. AEP occurs:
A. Jan–Mar
B. Oct 15–Dec 7
C. Apr–Jun
D. Anytime
✅ Answer: B
14. MA-OEP occurs:
A. Jan 1–Mar 31
B. Oct–Dec
C. Apr–Jun
D. Anytime
✅ Answer: A
15. SEP is triggered by:
A. Routine
B. Life events
C. Monthly
D. Payment
✅ Answer: B
