AHIP 2027 FINAL EXAM – MEDICARE CERTIFICATION –
ACTUAL QUESTIONS & ANSWERS (AHIP) GUARANTEE
PASS
AHIP Medicare Certification Practice Exam
Questions 1–10 (Original)
Question 1
Which part of Medicare primarily covers inpatient hospital care?
A. Part A
B. Part B
C. Part C
D. Part D
Correct Answer: A. Part A
Rationale: Medicare Part A covers inpatient hospital stays, skilled nursing facility care
following a qualifying hospital stay, some home health services, and hospice care.
Question 2
Medicare Part B primarily covers:
A. Prescription drugs
B. Physician services and outpatient medical care
C. Long-term custodial care
D. Routine dental care
Correct Answer: B. Physician services and outpatient medical care
Rationale: Part B covers medically necessary physician services, outpatient care, preventive
services, durable medical equipment, and certain home health services.
Question 3
Which Medicare option is offered through private insurance companies approved by Medicare?
,A. Original Medicare
B. Medicare Advantage (Part C)
C. Medicaid
D. Medigap
Correct Answer: B. Medicare Advantage (Part C)
Rationale: Medicare Advantage plans are administered by private insurers under contract with
Medicare and must provide at least the same Medicare-covered benefits as Original Medicare.
Question 4
A beneficiary wants coverage for outpatient prescription medications. Which Medicare benefit
provides this coverage?
A. Part A
B. Part B
C. Part D
D. Medigap
Correct Answer: C. Part D
Rationale: Medicare Part D helps cover outpatient prescription drugs through private plans
approved by Medicare.
Question 5
Original Medicare consists of:
A. Parts A and B
B. Parts A and D
C. Parts B and C
D. Parts C and D
Correct Answer: A. Parts A and B
Rationale: Original Medicare includes hospital insurance (Part A) and medical insurance (Part
B).
, Question 6
Which statement best describes a Medigap policy?
A. It replaces Medicare.
B. It supplements Original Medicare by helping pay certain out-of-pocket costs.
C. It provides only prescription drug coverage.
D. It is the same as Medicaid.
Correct Answer: B. It supplements Original Medicare by helping pay certain out-of-pocket
costs.
Rationale: Medigap policies help pay deductibles, coinsurance, and copayments not fully
covered by Original Medicare.
Question 7
A beneficiary moves permanently outside the service area of their Medicare Advantage plan.
What may happen?
A. They may qualify for a Special Enrollment Period.
B. They permanently lose Medicare coverage.
C. They must wait five years to enroll again.
D. Nothing changes.
Correct Answer: A. They may qualify for a Special Enrollment Period.
Rationale: Moving outside a plan's service area is generally a qualifying event that allows
beneficiaries to enroll in another Medicare plan.
Question 8
What is the primary purpose of the Medicare Annual Enrollment Period (AEP)?
A. Apply for Social Security benefits
B. Enroll in Medicaid
C. Join, switch, or drop Medicare Advantage or Part D plans
ACTUAL QUESTIONS & ANSWERS (AHIP) GUARANTEE
PASS
AHIP Medicare Certification Practice Exam
Questions 1–10 (Original)
Question 1
Which part of Medicare primarily covers inpatient hospital care?
A. Part A
B. Part B
C. Part C
D. Part D
Correct Answer: A. Part A
Rationale: Medicare Part A covers inpatient hospital stays, skilled nursing facility care
following a qualifying hospital stay, some home health services, and hospice care.
Question 2
Medicare Part B primarily covers:
A. Prescription drugs
B. Physician services and outpatient medical care
C. Long-term custodial care
D. Routine dental care
Correct Answer: B. Physician services and outpatient medical care
Rationale: Part B covers medically necessary physician services, outpatient care, preventive
services, durable medical equipment, and certain home health services.
Question 3
Which Medicare option is offered through private insurance companies approved by Medicare?
,A. Original Medicare
B. Medicare Advantage (Part C)
C. Medicaid
D. Medigap
Correct Answer: B. Medicare Advantage (Part C)
Rationale: Medicare Advantage plans are administered by private insurers under contract with
Medicare and must provide at least the same Medicare-covered benefits as Original Medicare.
Question 4
A beneficiary wants coverage for outpatient prescription medications. Which Medicare benefit
provides this coverage?
A. Part A
B. Part B
C. Part D
D. Medigap
Correct Answer: C. Part D
Rationale: Medicare Part D helps cover outpatient prescription drugs through private plans
approved by Medicare.
Question 5
Original Medicare consists of:
A. Parts A and B
B. Parts A and D
C. Parts B and C
D. Parts C and D
Correct Answer: A. Parts A and B
Rationale: Original Medicare includes hospital insurance (Part A) and medical insurance (Part
B).
, Question 6
Which statement best describes a Medigap policy?
A. It replaces Medicare.
B. It supplements Original Medicare by helping pay certain out-of-pocket costs.
C. It provides only prescription drug coverage.
D. It is the same as Medicaid.
Correct Answer: B. It supplements Original Medicare by helping pay certain out-of-pocket
costs.
Rationale: Medigap policies help pay deductibles, coinsurance, and copayments not fully
covered by Original Medicare.
Question 7
A beneficiary moves permanently outside the service area of their Medicare Advantage plan.
What may happen?
A. They may qualify for a Special Enrollment Period.
B. They permanently lose Medicare coverage.
C. They must wait five years to enroll again.
D. Nothing changes.
Correct Answer: A. They may qualify for a Special Enrollment Period.
Rationale: Moving outside a plan's service area is generally a qualifying event that allows
beneficiaries to enroll in another Medicare plan.
Question 8
What is the primary purpose of the Medicare Annual Enrollment Period (AEP)?
A. Apply for Social Security benefits
B. Enroll in Medicaid
C. Join, switch, or drop Medicare Advantage or Part D plans
