1
AHIP EXAM 2026/2027 | 50 Verified Questions with Correct
Answers | A+ Graded UPDATED | Pass Guaranteed - A+
Graded
SECTION 1: MEDICARE BASICS & ELIGIBILITY (Q1-Q8)
Q1: Mrs. Henderson turns 65 on August 10, 2026. She currently has no other
creditable health coverage. She asks her agent when she can first enroll in Medicare
without penalty. The agent correctly explains that her Initial Enrollment Period (IEP)
is:
A. The single month of August 2026 only
B. A 7-month window that begins May 1, 2026, and ends November 30, 2026
[CORRECT]
C. The General Enrollment Period from January 1 through March 31, 2027
D. The Annual Election Period from October 15 through December 7, 2026
Correct Answer: B
Rationale: CMS establishes the IEP as a 7-month window beginning 3 months before
the month of the beneficiary's 65th birthday, including the birthday month, and
ending 3 months after. Enrolling during this period ensures timely coverage and
avoids lifetime late enrollment penalties. Option A is too narrow, while C and D
describe separate enrollment periods that do not serve as the primary enrollment
window for newly eligible beneficiaries.
Q2: A 52-year-old individual has been receiving Social Security Disability Insurance
(SSDI) for 30 months and has amyotrophic lateral sclerosis (ALS). Regarding Medicare
eligibility, the agent correctly advises that:
A. ALS beneficiaries must wait the full 24 months like all other disability recipients
B. Individuals with ALS are exempt from the 24-month Medicare waiting period and
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are entitled to Part A and Part B immediately upon SSDI entitlement [CORRECT]
C. ALS is not a qualifying disability for Medicare
D. The patient must wait until age 65 to enroll in Medicare
Correct Answer: B
Rationale: Under CMS rules, individuals diagnosed with ALS who are entitled to SSDI
benefits are the only disability category exempt from the standard 24-month waiting
period for Medicare entitlement, receiving immediate Part A and Part B coverage.
Options A and D incorrectly apply standard disability or age-based rules, while C is
factually incorrect.
Q3: A 58-year-old patient with end-stage renal disease (ESRD) has been receiving
dialysis treatments for two months and is scheduled for a kidney transplant in six
weeks. The agent explains that Medicare eligibility based on ESRD:
A. Requires 24 months of dialysis before Medicare begins
B. Begins in the fourth month of dialysis, or earlier if a transplant is scheduled, and
continues for 36 months post-transplant if dialysis is no longer needed [CORRECT]
C. Is only available if the patient also qualifies for Medicaid
D. Is never available to patients under age 65
Correct Answer: B
Rationale: CMS rules provide that ESRD Medicare entitlement generally begins in the
fourth month of dialysis; however, coverage can begin earlier if the beneficiary
undergoes training for self-dialysis or has a scheduled transplant. After a successful
transplant, Medicare continues for 36 months. Options A, C, and D misstate the
ESRD-specific eligibility criteria established by CMS.
Q4: A beneficiary asks her agent to explain the fundamental difference between
Original Medicare and Medicare Advantage (Part C). The agent correctly states that:
A. Original Medicare is sold by private insurance companies, while Medicare
Advantage is administered directly by the federal government
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B. Original Medicare is the traditional fee-for-service program administered by the
federal government, whereas Medicare Advantage is offered by CMS-approved
private insurers that provide Part A and Part B benefits [CORRECT]
C. Medicare Advantage and Medigap are identical products with different names
D. Original Medicare automatically includes prescription drug coverage
Correct Answer: B
Rationale: Original Medicare (Parts A and B) is a federal fee-for-service program,
while Medicare Advantage (Part C) contracts with CMS-approved private insurers to
deliver Medicare benefits, often with additional coverage. Option A reverses the
roles, C confuses MA with Medigap, and D is incorrect because Original Medicare
does not include outpatient prescription drug coverage without a separate Part D
plan.
Q5: A 45-year-old individual has been receiving SSDI payments for 20 months due to
a disabling spinal cord injury. The individual asks when Medicare coverage will begin.
The agent correctly responds:
A. Medicare coverage began immediately when SSDI payments started
B. Medicare coverage will begin after 24 months of SSDI entitlement, with the 24-
month waiting period measured from the first month of SSDI cash benefits
[CORRECT]
C. Medicare is not available to individuals under age 65 regardless of disability status
D. The individual can enroll during the Annual Election Period to avoid the waiting
period
Correct Answer: B
Rationale: CMS regulations require most disabled individuals under age 65 to
complete a 24-month waiting period from the first month of SSDI cash entitlement
before Medicare coverage begins. Option A ignores the waiting period, C is incorrect
because disability is a pathway to Medicare under 65, and D misapplies the AEP,
which does not override the SSDI waiting period.
AHIP EXAM 2026/2027 | 50 Verified Questions with Correct
Answers | A+ Graded UPDATED | Pass Guaranteed - A+
Graded
SECTION 1: MEDICARE BASICS & ELIGIBILITY (Q1-Q8)
Q1: Mrs. Henderson turns 65 on August 10, 2026. She currently has no other
creditable health coverage. She asks her agent when she can first enroll in Medicare
without penalty. The agent correctly explains that her Initial Enrollment Period (IEP)
is:
A. The single month of August 2026 only
B. A 7-month window that begins May 1, 2026, and ends November 30, 2026
[CORRECT]
C. The General Enrollment Period from January 1 through March 31, 2027
D. The Annual Election Period from October 15 through December 7, 2026
Correct Answer: B
Rationale: CMS establishes the IEP as a 7-month window beginning 3 months before
the month of the beneficiary's 65th birthday, including the birthday month, and
ending 3 months after. Enrolling during this period ensures timely coverage and
avoids lifetime late enrollment penalties. Option A is too narrow, while C and D
describe separate enrollment periods that do not serve as the primary enrollment
window for newly eligible beneficiaries.
Q2: A 52-year-old individual has been receiving Social Security Disability Insurance
(SSDI) for 30 months and has amyotrophic lateral sclerosis (ALS). Regarding Medicare
eligibility, the agent correctly advises that:
A. ALS beneficiaries must wait the full 24 months like all other disability recipients
B. Individuals with ALS are exempt from the 24-month Medicare waiting period and
,2
are entitled to Part A and Part B immediately upon SSDI entitlement [CORRECT]
C. ALS is not a qualifying disability for Medicare
D. The patient must wait until age 65 to enroll in Medicare
Correct Answer: B
Rationale: Under CMS rules, individuals diagnosed with ALS who are entitled to SSDI
benefits are the only disability category exempt from the standard 24-month waiting
period for Medicare entitlement, receiving immediate Part A and Part B coverage.
Options A and D incorrectly apply standard disability or age-based rules, while C is
factually incorrect.
Q3: A 58-year-old patient with end-stage renal disease (ESRD) has been receiving
dialysis treatments for two months and is scheduled for a kidney transplant in six
weeks. The agent explains that Medicare eligibility based on ESRD:
A. Requires 24 months of dialysis before Medicare begins
B. Begins in the fourth month of dialysis, or earlier if a transplant is scheduled, and
continues for 36 months post-transplant if dialysis is no longer needed [CORRECT]
C. Is only available if the patient also qualifies for Medicaid
D. Is never available to patients under age 65
Correct Answer: B
Rationale: CMS rules provide that ESRD Medicare entitlement generally begins in the
fourth month of dialysis; however, coverage can begin earlier if the beneficiary
undergoes training for self-dialysis or has a scheduled transplant. After a successful
transplant, Medicare continues for 36 months. Options A, C, and D misstate the
ESRD-specific eligibility criteria established by CMS.
Q4: A beneficiary asks her agent to explain the fundamental difference between
Original Medicare and Medicare Advantage (Part C). The agent correctly states that:
A. Original Medicare is sold by private insurance companies, while Medicare
Advantage is administered directly by the federal government
, 3
B. Original Medicare is the traditional fee-for-service program administered by the
federal government, whereas Medicare Advantage is offered by CMS-approved
private insurers that provide Part A and Part B benefits [CORRECT]
C. Medicare Advantage and Medigap are identical products with different names
D. Original Medicare automatically includes prescription drug coverage
Correct Answer: B
Rationale: Original Medicare (Parts A and B) is a federal fee-for-service program,
while Medicare Advantage (Part C) contracts with CMS-approved private insurers to
deliver Medicare benefits, often with additional coverage. Option A reverses the
roles, C confuses MA with Medigap, and D is incorrect because Original Medicare
does not include outpatient prescription drug coverage without a separate Part D
plan.
Q5: A 45-year-old individual has been receiving SSDI payments for 20 months due to
a disabling spinal cord injury. The individual asks when Medicare coverage will begin.
The agent correctly responds:
A. Medicare coverage began immediately when SSDI payments started
B. Medicare coverage will begin after 24 months of SSDI entitlement, with the 24-
month waiting period measured from the first month of SSDI cash benefits
[CORRECT]
C. Medicare is not available to individuals under age 65 regardless of disability status
D. The individual can enroll during the Annual Election Period to avoid the waiting
period
Correct Answer: B
Rationale: CMS regulations require most disabled individuals under age 65 to
complete a 24-month waiting period from the first month of SSDI cash entitlement
before Medicare coverage begins. Option A ignores the waiting period, C is incorrect
because disability is a pathway to Medicare under 65, and D misapplies the AEP,
which does not override the SSDI waiting period.
