AHIP FINAL EXAM WITH COMPLETE REAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS
WITH RATIONALES / ALREADY GRADED A+
(MOST RECENT!!)
MODULE 1: MEDICARE BASICS (PARTS A, B, C, D) – QUESTIONS 1-40
QUESTION 1
Mrs. Chen is 67 and has Parts A and B. She asks if she needs Part D.
A) Part D is optional with no penalties.
B) Part D is mandatory for all beneficiaries.
C) Part D is optional, but if she delays without creditable coverage, she faces
a Late Enrollment Penalty (1% of the national base premium per month).
D) Part D is only available to MA enrollees.
Correct Answer: C
Rationale: Part D is voluntary, but delaying without creditable coverage triggers
a Late Enrollment Penalty (LEP) of 1% of the national base beneficiary premium
for each full month without coverage. A is false (penalties exist). B is false
(not mandatory). D is false (PDPs available to Original Medicare beneficiaries).
QUESTION 2
Mr. Kowalski turns 65 next month and has large employer group coverage (20+
employees).
Must he enroll in Part A?
A) Must enroll immediately to avoid penalties.
B) Can delay Part A without penalty.
C) Part A is always free, so enroll anyway.
D) Cannot delay Part A under any circumstances.
Correct Answer: B
Rationale: With large employer coverage (20+ employees), he can delay Part A
without penalty under Medicare Secondary Payer (MSP) rules. A is wrong. C is
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,wrong because Part A isn't free for everyone (requires 40+ quarters). D is false.
QUESTION 3
Which service is covered under Medicare Part A?
A) Annual wellness visit.
B) Outpatient surgery.
C) Inpatient hospital stay.
D) Routine eye exam.
Correct Answer: C
Rationale: Part A covers inpatient hospital, SNF, hospice, and some home health.
A and B are Part B services. D is not covered by Original Medicare.
QUESTION 4
Medicare Part B covers which of the following?
A) Prescription drugs taken at home.
B) Inpatient psychiatric care.
C) Physician services and outpatient care.
D) Long-term custodial nursing home care.
Correct Answer: C
Rationale: Part B covers physician visits, outpatient services, DME, and
preventive services. A is Part D. B is Part A (inpatient). D is not covered
(Medicare does not cover custodial care).
QUESTION 5
What is the primary difference between Part A and Part B premiums?
A) Part A always has a premium; Part B is free.
B) Part B always has a premium; Part A may be free with 40+ quarters of work.
C) Both parts have the same monthly premium.
D) Neither part requires a premium for low-income beneficiaries.
Correct Answer: B
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,Rationale: Part A is premium-free with 40+ work credits (10 years). Part B always
requires a premium (income-adjusted with IRMAA). A is reversed. C is false.
D is false (low-income may get help via MSPs, but not automatic).
QUESTION 6
What is the Medicare Initial Enrollment Period (IEP)?
A) 7 months: 3 months before 65th birthday, birth month, and 3 months after.
B) 6 months starting on the 65th birthday.
C) 12 months once in a lifetime.
D) 3 months when applying for Social Security.
Correct Answer: A
Rationale: The IEP is a 7-month window: 3 months before, the birth month, and
3 months after. B, C, and D give incorrect durations.
QUESTION 7
Mr. Tanaka has Parts A and B and wants to enroll in an MA plan. What must he
do?
A) Drop Part B permanently.
B) Enroll in a separate Part D plan.
C) Continue paying his Part B premium and enroll in the MA plan.
D) Disenroll from Medicare entirely.
Correct Answer: C
Rationale: To join an MA plan, he must keep Part B and pay its premium. A is
wrong (he keeps B). B is wrong (MA may include drug coverage as MAPD).
D is wrong (he remains in Medicare, just chooses a private delivery option).
QUESTION 8
Which is NOT covered by Original Medicare (Parts A and B)?
A) Inpatient hospital care.
B) Physician visits.
C) Routine dental care (cleanings, fillings, dentures).
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, D) Home health care under certain conditions.
Correct Answer: C
Rationale: Original Medicare does not cover routine dental, dentures, or most
dental procedures. A, B, and D are covered. Part B covers limited dental only
when integral to a covered medical procedure.
QUESTION 9
What is Medicare Part C?
A) Prescription drug coverage.
B) Medicare Advantage plans offered by private companies.
C) Supplemental Medigap coverage.
D) Long-term care insurance.
Correct Answer: B
Rationale: Part C (Medicare Advantage) is an alternative to Original Medicare
offered by private insurers approved by CMS. A is Part D. C is Medigap (not a
"part" of Medicare). D is not Medicare.
QUESTION 10
What is the "donut hole" in Medicare Part D?
A) The coverage gap where beneficiaries pay a higher share of drug costs.
B) The deductible period at the start of each year.
C) The catastrophic coverage phase.
D) The initial coverage period.
Correct Answer: A
Rationale: The Coverage Gap (donut hole) is the phase after the Initial Coverage
Limit where the beneficiary pays a larger share. Under the Inflation Reduction Act,
starting 2025, the gap is effectively eliminated by the $2,000 out-of-pocket cap.
B is the deductible. C is catastrophic. D is the initial coverage phase.
QUESTION 11
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QUESTIONS AND CORRECT VERIFIED ANSWERS
WITH RATIONALES / ALREADY GRADED A+
(MOST RECENT!!)
MODULE 1: MEDICARE BASICS (PARTS A, B, C, D) – QUESTIONS 1-40
QUESTION 1
Mrs. Chen is 67 and has Parts A and B. She asks if she needs Part D.
A) Part D is optional with no penalties.
B) Part D is mandatory for all beneficiaries.
C) Part D is optional, but if she delays without creditable coverage, she faces
a Late Enrollment Penalty (1% of the national base premium per month).
D) Part D is only available to MA enrollees.
Correct Answer: C
Rationale: Part D is voluntary, but delaying without creditable coverage triggers
a Late Enrollment Penalty (LEP) of 1% of the national base beneficiary premium
for each full month without coverage. A is false (penalties exist). B is false
(not mandatory). D is false (PDPs available to Original Medicare beneficiaries).
QUESTION 2
Mr. Kowalski turns 65 next month and has large employer group coverage (20+
employees).
Must he enroll in Part A?
A) Must enroll immediately to avoid penalties.
B) Can delay Part A without penalty.
C) Part A is always free, so enroll anyway.
D) Cannot delay Part A under any circumstances.
Correct Answer: B
Rationale: With large employer coverage (20+ employees), he can delay Part A
without penalty under Medicare Secondary Payer (MSP) rules. A is wrong. C is
1
,wrong because Part A isn't free for everyone (requires 40+ quarters). D is false.
QUESTION 3
Which service is covered under Medicare Part A?
A) Annual wellness visit.
B) Outpatient surgery.
C) Inpatient hospital stay.
D) Routine eye exam.
Correct Answer: C
Rationale: Part A covers inpatient hospital, SNF, hospice, and some home health.
A and B are Part B services. D is not covered by Original Medicare.
QUESTION 4
Medicare Part B covers which of the following?
A) Prescription drugs taken at home.
B) Inpatient psychiatric care.
C) Physician services and outpatient care.
D) Long-term custodial nursing home care.
Correct Answer: C
Rationale: Part B covers physician visits, outpatient services, DME, and
preventive services. A is Part D. B is Part A (inpatient). D is not covered
(Medicare does not cover custodial care).
QUESTION 5
What is the primary difference between Part A and Part B premiums?
A) Part A always has a premium; Part B is free.
B) Part B always has a premium; Part A may be free with 40+ quarters of work.
C) Both parts have the same monthly premium.
D) Neither part requires a premium for low-income beneficiaries.
Correct Answer: B
2
,Rationale: Part A is premium-free with 40+ work credits (10 years). Part B always
requires a premium (income-adjusted with IRMAA). A is reversed. C is false.
D is false (low-income may get help via MSPs, but not automatic).
QUESTION 6
What is the Medicare Initial Enrollment Period (IEP)?
A) 7 months: 3 months before 65th birthday, birth month, and 3 months after.
B) 6 months starting on the 65th birthday.
C) 12 months once in a lifetime.
D) 3 months when applying for Social Security.
Correct Answer: A
Rationale: The IEP is a 7-month window: 3 months before, the birth month, and
3 months after. B, C, and D give incorrect durations.
QUESTION 7
Mr. Tanaka has Parts A and B and wants to enroll in an MA plan. What must he
do?
A) Drop Part B permanently.
B) Enroll in a separate Part D plan.
C) Continue paying his Part B premium and enroll in the MA plan.
D) Disenroll from Medicare entirely.
Correct Answer: C
Rationale: To join an MA plan, he must keep Part B and pay its premium. A is
wrong (he keeps B). B is wrong (MA may include drug coverage as MAPD).
D is wrong (he remains in Medicare, just chooses a private delivery option).
QUESTION 8
Which is NOT covered by Original Medicare (Parts A and B)?
A) Inpatient hospital care.
B) Physician visits.
C) Routine dental care (cleanings, fillings, dentures).
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, D) Home health care under certain conditions.
Correct Answer: C
Rationale: Original Medicare does not cover routine dental, dentures, or most
dental procedures. A, B, and D are covered. Part B covers limited dental only
when integral to a covered medical procedure.
QUESTION 9
What is Medicare Part C?
A) Prescription drug coverage.
B) Medicare Advantage plans offered by private companies.
C) Supplemental Medigap coverage.
D) Long-term care insurance.
Correct Answer: B
Rationale: Part C (Medicare Advantage) is an alternative to Original Medicare
offered by private insurers approved by CMS. A is Part D. C is Medigap (not a
"part" of Medicare). D is not Medicare.
QUESTION 10
What is the "donut hole" in Medicare Part D?
A) The coverage gap where beneficiaries pay a higher share of drug costs.
B) The deductible period at the start of each year.
C) The catastrophic coverage phase.
D) The initial coverage period.
Correct Answer: A
Rationale: The Coverage Gap (donut hole) is the phase after the Initial Coverage
Limit where the beneficiary pays a larger share. Under the Inflation Reduction Act,
starting 2025, the gap is effectively eliminated by the $2,000 out-of-pocket cap.
B is the deductible. C is catastrophic. D is the initial coverage phase.
QUESTION 11
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