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AHIP 2026 FINAL EXAM ANSWER KEY | 2026/2027
Certification Period | Verified Answers for Medicare
Certification | Pass Guaranteed - A+ Graded
SECTION 1: Medicare Eligibility & Enrollment (Q1-Q20)
Q1: A client turns 65 on March 15, 2026. When does their Initial Enrollment Period
(IEP) for Medicare begin and end?
A. January 1, 2026 through July 31, 2026
B. December 1, 2025 through June 30, 2026
C. January 1, 2026 through September 30, 2026
D. December 1, 2025 through July 31, 2026
B. December 1, 2025 through June 30, 2026 [CORRECT]
Correct Answer: B
Rationale: The IEP is a 7-month window that begins 3 months before the month of the
65th birthday, includes the birthday month, and ends 3 months after. For a March 15
birthday, the IEP runs from December 1, 2025 (3 months before March) through June
30, 2026 (3 months after March). Enrolling during the first 3 months ensures coverage
begins the first day of the birthday month.
Q2: A 62-year-old client has been receiving Social Security Disability Insurance (SSDI)
for 20 months. When will they become eligible for Medicare?
A. Immediately, because they are receiving SSDI
B. After 24 months of SSDI payments
C. At age 65, regardless of SSDI status
D. After 12 months of SSDI payments
B. After 24 months of SSDI payments [CORRECT]
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Correct Answer: B
Rationale: Individuals under age 65 who receive SSDI become eligible for Medicare after
24 months of SSDI payments. The 24-month waiting period begins with the first month
of SSDI entitlement. The two exceptions that bypass the 24-month wait are End-Stage
Renal Disease (ESRD) and Amyotrophic Lateral Sclerosis (ALS), which provide
immediate Medicare eligibility.
Q3: A client is diagnosed with Amyotrophic Lateral Sclerosis (ALS). When does
Medicare eligibility begin?
A. After 24 months of disability payments
B. Immediately upon diagnosis, with no waiting period
C. At age 65
D. After 12 months of treatment
B. Immediately upon diagnosis, with no waiting period [CORRECT]
Correct Answer: B
Rationale: ALS (Lou Gehrig's disease) is one of two conditions that provide immediate
Medicare eligibility without a waiting period. The Social Security Administration
automatically enrolls individuals with ALS in Medicare Part A and Part B the month
disability benefits begin. ESRD is the other condition with special eligibility rules,
though ESRD has a 3-month waiting period in most cases.
Q4: A client with End-Stage Renal Disease (ESRD) begins dialysis. When does Medicare
coverage typically begin?
A. Immediately upon starting dialysis
B. The first day of the fourth month of dialysis
C. After 24 months of dialysis
D. The first day of the month dialysis begins
B. The first day of the fourth month of dialysis [CORRECT]
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Correct Answer: B
Rationale: For most individuals with ESRD, Medicare coverage begins the first day of the
fourth month of dialysis treatments. However, coverage can begin earlier (first month of
dialysis) if the individual participates in a self-dialysis training program or receives a
kidney transplant. Medicare coverage for ESRD continues for 36 months after a
successful kidney transplant.
Q5: A client is a U.S. permanent resident (green card holder) who has lived in the United
States for 3 years. Can they enroll in Medicare?
A. Yes, immediately
B. No, only U.S. citizens can enroll in Medicare
C. Yes, after 5 years of continuous legal residency
D. Only if they are age 65 or older
C. Yes, after 5 years of continuous legal residency [CORRECT]
Correct Answer: C
Rationale: To be eligible for Medicare, a person must be either a U.S. citizen or a legal
permanent resident who has lived in the U.S. continuously for at least 5 years. The client
has only 3 years of residency, so they do not yet qualify. Once they reach 5 years of
continuous legal residency, they may enroll during their IEP if they are also age 65+, or
apply for Medicare based on disability if eligible.
Q6: A client worked and paid Medicare taxes for 35 quarters (8.75 years). What is their
Part A premium status?
A. $0 premium (fully premium-free)
B. Reduced premium of $311/month in 2026
C. Full premium of $565/month in 2026
D. They are not eligible for Part A
B. Reduced premium of $311/month in 2026 [CORRECT]
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Correct Answer: B
Rationale: Most people receive premium-free Part A if they or their spouse worked and
paid Medicare taxes for at least 40 quarters (10 years). Individuals with 30-39 quarters
pay a reduced premium ($311/month in 2026). Those with fewer than 30 quarters pay
the full premium ($565/month in 2026). This client has 35 quarters, so they qualify for
the reduced premium.
Q7: A client turns 65 and is still working with employer group health coverage through
a company with 25 employees. They want to delay Medicare Part B. What should the
agent advise?
A. They must enroll in Part B at 65 regardless of employer coverage
B. They can delay Part B without penalty if the employer has 20+ employees
C. They should enroll in Part B and drop employer coverage immediately
D. They can delay Part B only if the employer has fewer than 20 employees
B. They can delay Part B without penalty if the employer has 20+ employees
[CORRECT]
Correct Answer: B
Rationale: If an employer has 20 or more employees, the group health plan is the
primary payer and Medicare is secondary. The client can delay Part B enrollment
without penalty and enroll later during an 8-month Special Enrollment Period (SEP)
after employment ends or coverage terminates. If the employer had fewer than 20
employees, Medicare would be primary, and the client should generally enroll in Part B
at 65 to avoid gaps in coverage.
Q8: A client delayed Medicare Part B because they had employer coverage. They retire
on June 30, 2026, and their employer coverage ends the same day. When is their Special
Enrollment Period (SEP) for Part B?
AHIP 2026 FINAL EXAM ANSWER KEY | 2026/2027
Certification Period | Verified Answers for Medicare
Certification | Pass Guaranteed - A+ Graded
SECTION 1: Medicare Eligibility & Enrollment (Q1-Q20)
Q1: A client turns 65 on March 15, 2026. When does their Initial Enrollment Period
(IEP) for Medicare begin and end?
A. January 1, 2026 through July 31, 2026
B. December 1, 2025 through June 30, 2026
C. January 1, 2026 through September 30, 2026
D. December 1, 2025 through July 31, 2026
B. December 1, 2025 through June 30, 2026 [CORRECT]
Correct Answer: B
Rationale: The IEP is a 7-month window that begins 3 months before the month of the
65th birthday, includes the birthday month, and ends 3 months after. For a March 15
birthday, the IEP runs from December 1, 2025 (3 months before March) through June
30, 2026 (3 months after March). Enrolling during the first 3 months ensures coverage
begins the first day of the birthday month.
Q2: A 62-year-old client has been receiving Social Security Disability Insurance (SSDI)
for 20 months. When will they become eligible for Medicare?
A. Immediately, because they are receiving SSDI
B. After 24 months of SSDI payments
C. At age 65, regardless of SSDI status
D. After 12 months of SSDI payments
B. After 24 months of SSDI payments [CORRECT]
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Correct Answer: B
Rationale: Individuals under age 65 who receive SSDI become eligible for Medicare after
24 months of SSDI payments. The 24-month waiting period begins with the first month
of SSDI entitlement. The two exceptions that bypass the 24-month wait are End-Stage
Renal Disease (ESRD) and Amyotrophic Lateral Sclerosis (ALS), which provide
immediate Medicare eligibility.
Q3: A client is diagnosed with Amyotrophic Lateral Sclerosis (ALS). When does
Medicare eligibility begin?
A. After 24 months of disability payments
B. Immediately upon diagnosis, with no waiting period
C. At age 65
D. After 12 months of treatment
B. Immediately upon diagnosis, with no waiting period [CORRECT]
Correct Answer: B
Rationale: ALS (Lou Gehrig's disease) is one of two conditions that provide immediate
Medicare eligibility without a waiting period. The Social Security Administration
automatically enrolls individuals with ALS in Medicare Part A and Part B the month
disability benefits begin. ESRD is the other condition with special eligibility rules,
though ESRD has a 3-month waiting period in most cases.
Q4: A client with End-Stage Renal Disease (ESRD) begins dialysis. When does Medicare
coverage typically begin?
A. Immediately upon starting dialysis
B. The first day of the fourth month of dialysis
C. After 24 months of dialysis
D. The first day of the month dialysis begins
B. The first day of the fourth month of dialysis [CORRECT]
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Correct Answer: B
Rationale: For most individuals with ESRD, Medicare coverage begins the first day of the
fourth month of dialysis treatments. However, coverage can begin earlier (first month of
dialysis) if the individual participates in a self-dialysis training program or receives a
kidney transplant. Medicare coverage for ESRD continues for 36 months after a
successful kidney transplant.
Q5: A client is a U.S. permanent resident (green card holder) who has lived in the United
States for 3 years. Can they enroll in Medicare?
A. Yes, immediately
B. No, only U.S. citizens can enroll in Medicare
C. Yes, after 5 years of continuous legal residency
D. Only if they are age 65 or older
C. Yes, after 5 years of continuous legal residency [CORRECT]
Correct Answer: C
Rationale: To be eligible for Medicare, a person must be either a U.S. citizen or a legal
permanent resident who has lived in the U.S. continuously for at least 5 years. The client
has only 3 years of residency, so they do not yet qualify. Once they reach 5 years of
continuous legal residency, they may enroll during their IEP if they are also age 65+, or
apply for Medicare based on disability if eligible.
Q6: A client worked and paid Medicare taxes for 35 quarters (8.75 years). What is their
Part A premium status?
A. $0 premium (fully premium-free)
B. Reduced premium of $311/month in 2026
C. Full premium of $565/month in 2026
D. They are not eligible for Part A
B. Reduced premium of $311/month in 2026 [CORRECT]
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Correct Answer: B
Rationale: Most people receive premium-free Part A if they or their spouse worked and
paid Medicare taxes for at least 40 quarters (10 years). Individuals with 30-39 quarters
pay a reduced premium ($311/month in 2026). Those with fewer than 30 quarters pay
the full premium ($565/month in 2026). This client has 35 quarters, so they qualify for
the reduced premium.
Q7: A client turns 65 and is still working with employer group health coverage through
a company with 25 employees. They want to delay Medicare Part B. What should the
agent advise?
A. They must enroll in Part B at 65 regardless of employer coverage
B. They can delay Part B without penalty if the employer has 20+ employees
C. They should enroll in Part B and drop employer coverage immediately
D. They can delay Part B only if the employer has fewer than 20 employees
B. They can delay Part B without penalty if the employer has 20+ employees
[CORRECT]
Correct Answer: B
Rationale: If an employer has 20 or more employees, the group health plan is the
primary payer and Medicare is secondary. The client can delay Part B enrollment
without penalty and enroll later during an 8-month Special Enrollment Period (SEP)
after employment ends or coverage terminates. If the employer had fewer than 20
employees, Medicare would be primary, and the client should generally enroll in Part B
at 65 to avoid gaps in coverage.
Q8: A client delayed Medicare Part B because they had employer coverage. They retire
on June 30, 2026, and their employer coverage ends the same day. When is their Special
Enrollment Period (SEP) for Part B?
