AHIP MODULE 1 QUIZ TEST QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
*- Medicare Eligibility Requirements*
*- Part A Hospital Insurance Coverage*
*- Part B Medical Insurance Coverage*
*- Original Medicare vs. Medicare Advantage*
*- Medicare Supplemental (Medigap) Insurance*
*- Enrollment Periods and Timing*
*- Hospice Benefits Under Medicare*
*- Deductibles and Coinsurance Structures*
*- Beneficiary Protections and Rights*
*- Limited Income Assistance Programs*
Introduction
This comprehensive assessment evaluates foundational knowledge of the Medicare program as required for
AHIP Module 1 certification. The exam assesses critical skills including Medicare eligibility determination,
coverage options under Parts A and B, understanding of Original Medicare versus Medicare Advantage
plans, Medigap coverage characteristics, enrollment period requirements, hospice benefit provisions, and
cost-sharing structures including deductibles and coinsurance.
,The assessment consists entirely of multiple-choice questions, many presented as real-world scenarios
requiring professional decision-making. Success requires not only memorization of facts but application of
knowledge to practical situations that insurance agents and healthcare professionals encounter daily.
Emphasis is placed on real-world application, regulatory compliance, ethical professional standards, and the
ability to make sound decisions when guiding beneficiaries through complex Medicare choices.
SECTION ONE: QUESTIONS 1–100
Question 1
Mr. Moy's wife has a Medicare Advantage plan, but he wants to understand what coverage Medicare
Supplemental Insurance provides since his health care needs differ from his wife's. What could you tell Mr.
Moy?
A. Medicare Supplemental Insurance only covers prescription drugs
B. Medicare Supplemental Insurance would help cover his Part A and Part B deductibles or coinsurance in
Original Fee-for-Service Medicare as well as possibly some services Medicare does not cover
C. Medicare Supplemental Insurance replaces all Original Medicare coverage
D. Medicare Supplemental Insurance is only available to beneficiaries under age 65
🟢 Correct answer: B
🔴 RATIONALE: Medicare Supplemental (Medigap) Insurance helps cover Part A and Part B deductibles and
coinsurance in Original FFS Medicare and may cover some services Medicare doesn't cover. It does not replace
Original Medicare or only cover prescription drugs.
,Question 2
Mildred Savage enrolled in Allcare Medicare Advantage plan and recently learned she has inoperable cancer
with a few months to live. She wants hospice care. Her family asks whether hospice benefits will be paid under
the Allcare Medicare Advantage plan. What should you say?
A. Hospice benefits are not available to Medicare Advantage enrollees
B. Mildred must disenroll from Allcare to receive any hospice care
C. Mildred may remain enrolled in Allcare and make a hospice election; hospice benefits will be paid by Original
Medicare under Part A, and Allcare continues paying for non-hospice services
D. Allcare Medicare Advantage plan covers all hospice benefits completely
🟢 Correct answer: C
🔴 RATIONALE: Medicare Advantage enrollees may remain enrolled while electing hospice care. Hospice
benefits are paid by Original Medicare under Part A, and the Medicare Advantage plan continues covering non-
hospice services.
Question 3
Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health with considerable
income and concerns that income will make her unable to qualify for Medicare. What could you tell her?
A. Medicare is only available to individuals with low income
B. Medicare is a program for people age 65 or older and those under 65 with certain disabilities, end-stage renal
disease, and Lou Gehrig's disease, so she will be eligible
C. High income automatically disqualifies individuals from Medicare eligibility
D. Ms. Moore must wait until she reduces her income to qualify for Medicare
, 🟢 Correct answer: B
🔴 RATIONALE: Medicare eligibility is based primarily on age (65+) or specific disabilities (including ESRD
and Lou Gehrig's disease), not income level. Income affects costs but not eligibility.
Question 4
Mrs. Chen will be 65 soon, has been a citizen for 12 years, employed full-time paying taxes throughout. She
worries she won't qualify for Part A because she wasn't born in the United States. What should you tell her?
A. Only U.S.-born citizens qualify for Part A coverage
B. Most individuals who are citizens and age 65 or over are covered under Part A by virtue of having paid
Medicare taxes while working, though some may be covered by paying monthly premiums
C. Mrs. Chen must wait 20 years as a citizen before qualifying for Part A
D. Part A coverage is unavailable to immigrants regardless of tax history
🟢 Correct answer: B
🔴 RATIONALE: Part A coverage is based on citizenship status and Medicare tax payment history, not birth
location. Most citizens 65+ who paid Medicare taxes are covered automatically.
Question 5
What is Part A referred to as in Medicare terminology?
PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
*- Medicare Eligibility Requirements*
*- Part A Hospital Insurance Coverage*
*- Part B Medical Insurance Coverage*
*- Original Medicare vs. Medicare Advantage*
*- Medicare Supplemental (Medigap) Insurance*
*- Enrollment Periods and Timing*
*- Hospice Benefits Under Medicare*
*- Deductibles and Coinsurance Structures*
*- Beneficiary Protections and Rights*
*- Limited Income Assistance Programs*
Introduction
This comprehensive assessment evaluates foundational knowledge of the Medicare program as required for
AHIP Module 1 certification. The exam assesses critical skills including Medicare eligibility determination,
coverage options under Parts A and B, understanding of Original Medicare versus Medicare Advantage
plans, Medigap coverage characteristics, enrollment period requirements, hospice benefit provisions, and
cost-sharing structures including deductibles and coinsurance.
,The assessment consists entirely of multiple-choice questions, many presented as real-world scenarios
requiring professional decision-making. Success requires not only memorization of facts but application of
knowledge to practical situations that insurance agents and healthcare professionals encounter daily.
Emphasis is placed on real-world application, regulatory compliance, ethical professional standards, and the
ability to make sound decisions when guiding beneficiaries through complex Medicare choices.
SECTION ONE: QUESTIONS 1–100
Question 1
Mr. Moy's wife has a Medicare Advantage plan, but he wants to understand what coverage Medicare
Supplemental Insurance provides since his health care needs differ from his wife's. What could you tell Mr.
Moy?
A. Medicare Supplemental Insurance only covers prescription drugs
B. Medicare Supplemental Insurance would help cover his Part A and Part B deductibles or coinsurance in
Original Fee-for-Service Medicare as well as possibly some services Medicare does not cover
C. Medicare Supplemental Insurance replaces all Original Medicare coverage
D. Medicare Supplemental Insurance is only available to beneficiaries under age 65
🟢 Correct answer: B
🔴 RATIONALE: Medicare Supplemental (Medigap) Insurance helps cover Part A and Part B deductibles and
coinsurance in Original FFS Medicare and may cover some services Medicare doesn't cover. It does not replace
Original Medicare or only cover prescription drugs.
,Question 2
Mildred Savage enrolled in Allcare Medicare Advantage plan and recently learned she has inoperable cancer
with a few months to live. She wants hospice care. Her family asks whether hospice benefits will be paid under
the Allcare Medicare Advantage plan. What should you say?
A. Hospice benefits are not available to Medicare Advantage enrollees
B. Mildred must disenroll from Allcare to receive any hospice care
C. Mildred may remain enrolled in Allcare and make a hospice election; hospice benefits will be paid by Original
Medicare under Part A, and Allcare continues paying for non-hospice services
D. Allcare Medicare Advantage plan covers all hospice benefits completely
🟢 Correct answer: C
🔴 RATIONALE: Medicare Advantage enrollees may remain enrolled while electing hospice care. Hospice
benefits are paid by Original Medicare under Part A, and the Medicare Advantage plan continues covering non-
hospice services.
Question 3
Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health with considerable
income and concerns that income will make her unable to qualify for Medicare. What could you tell her?
A. Medicare is only available to individuals with low income
B. Medicare is a program for people age 65 or older and those under 65 with certain disabilities, end-stage renal
disease, and Lou Gehrig's disease, so she will be eligible
C. High income automatically disqualifies individuals from Medicare eligibility
D. Ms. Moore must wait until she reduces her income to qualify for Medicare
, 🟢 Correct answer: B
🔴 RATIONALE: Medicare eligibility is based primarily on age (65+) or specific disabilities (including ESRD
and Lou Gehrig's disease), not income level. Income affects costs but not eligibility.
Question 4
Mrs. Chen will be 65 soon, has been a citizen for 12 years, employed full-time paying taxes throughout. She
worries she won't qualify for Part A because she wasn't born in the United States. What should you tell her?
A. Only U.S.-born citizens qualify for Part A coverage
B. Most individuals who are citizens and age 65 or over are covered under Part A by virtue of having paid
Medicare taxes while working, though some may be covered by paying monthly premiums
C. Mrs. Chen must wait 20 years as a citizen before qualifying for Part A
D. Part A coverage is unavailable to immigrants regardless of tax history
🟢 Correct answer: B
🔴 RATIONALE: Part A coverage is based on citizenship status and Medicare tax payment history, not birth
location. Most citizens 65+ who paid Medicare taxes are covered automatically.
Question 5
What is Part A referred to as in Medicare terminology?
