2026 AHIP
CERTIFICATION EXAM
Actual Questions and Answers
What’s Inside?
Actual AHIP 2026 Certification Exam questions with verified
and explained answers
Fully aligned with the latest CMS & AHIP training modules
Detailed coverage of all exam sections,
Each question includes rationales and key references to reinforce
understanding
Content designed to mirror the official AHIP
testing environment
Downloaded by harun mburu ()
,**1. Edward suffered from serious kidney disease. As a result, Edward
became eligible for Medicare coverage due to end-stage renal disease
(ESRD). A close relative donated their kidney and Edward
successfully underwent transplant surgery 12 months ago. Edward is
now age 50 and asks you if his Medicare coverage will continue, what
should you say?**
A. His Medicare coverage will end 12 months after transplant surgery,
regardless of his age.
B. His Medicare coverage will continue as long as he receives follow-up
care for the transplant.
C. His Medicare coverage will end 36 months after the transplant unless he
otherwise qualifies.
D. His Medicare coverage ends immediately after transplant surgery.
**Correct Answer: C. His Medicare coverage will end 36 months after
the transplant unless he otherwise qualifies.**
**Expert Rationale:** For individuals eligible for Medicare due to ESRD,
coverage ends 36 months after a successful kidney transplant unless they
qualify for Medicare due to age or disability. Edward’s coverage will
continue for 3 years post-transplant unless he turns 65 or qualifies for
disability.
---
**2. Ms. Henderson believes that she will qualify for Medicare
Coverage when she turns 65, without paying any premiums, because
Downloaded by harun mburu ()
,she has been working for 40 years and paying Medicare taxes. What
should you tell her?**
A. She is not eligible for any Medicare coverage.
B. She will receive Medicare Part A without premiums, but must pay
premiums for Part B.
C. She will not need to pay any premiums for Part A or Part B.
D. She is only eligible for Medicare Part B.
**Correct Answer: B. She will receive Medicare Part A without
premiums, but must pay premiums for Part B.**
**Expert Rationale:** Individuals with sufficient work credits (generally 40
quarters) receive premium-free Part A at age 65. However, Part B requires
a monthly premium, which is income-adjusted. This often causes
confusion, but Part B premiums are always required unless she qualifies for
Medicaid or other coverage.
---
**3. Ms. Lewis has aggressive cancer and would like to know if
Medicare will cover hospice services in case she needs them. What
should you tell her?**
A. Hospice is not covered under Original Medicare.
B. Hospice is covered under Medicare Part A.
C. Hospice is covered under Medicare Part B.
Downloaded by harun mburu ()
, D. Hospice*is*only*covered*if*she*has*a*Medicare*Advantage*plan.
**Correct*Answer:*B.*Hospice*is*covered*under*Medicare*Part*A.**
**Expert*Rationale:***Hospice*care*is*a*benefit*under*Part*A*of*Medicare,*a
vailable*to*terminally*ill*individuals*who*elect*to*focus*on*comfort*care*rather*
than*curative*treatment.*Coverage*includes*pain*relief,*symptom*managem
ent,*and*support*services.
---
**4.*Mr.*Capadona*would*like*to*purchase*a*Medicare*Advantage*(MA)*pl
an*and*a*Medigap*plan*to*pick*up*costs*not*covered*by*that*plan.
What*should*you*tell*him?**
A. He*can*enroll*in*both*MA*and*Medigap*plans.
B. Medigap*can*only*be*used*with*Original*Medicare,*not*MA*plans.
C. Medigap*will*cover*costs*not*included*by*MA*plans.
D. He*does*not*need*any*plan.
**Correct*Answer:*B.*Medigap*can*only*be*used*with*Original*Medicare
,*not*MA*plans.**
**Expert*Rationale:***Federal*law*prohibits*the*sale*of*Medigap*policies*to*in
dividuals*enrolled*in*Medicare*Advantage,*since*Medigap*supplements*only*
Original*Medicare*(Part*A*and*Part*B),*not*Medicare*Advantage*plans.
Downloaded*by*harun*mburu*(
CERTIFICATION EXAM
Actual Questions and Answers
What’s Inside?
Actual AHIP 2026 Certification Exam questions with verified
and explained answers
Fully aligned with the latest CMS & AHIP training modules
Detailed coverage of all exam sections,
Each question includes rationales and key references to reinforce
understanding
Content designed to mirror the official AHIP
testing environment
Downloaded by harun mburu ()
,**1. Edward suffered from serious kidney disease. As a result, Edward
became eligible for Medicare coverage due to end-stage renal disease
(ESRD). A close relative donated their kidney and Edward
successfully underwent transplant surgery 12 months ago. Edward is
now age 50 and asks you if his Medicare coverage will continue, what
should you say?**
A. His Medicare coverage will end 12 months after transplant surgery,
regardless of his age.
B. His Medicare coverage will continue as long as he receives follow-up
care for the transplant.
C. His Medicare coverage will end 36 months after the transplant unless he
otherwise qualifies.
D. His Medicare coverage ends immediately after transplant surgery.
**Correct Answer: C. His Medicare coverage will end 36 months after
the transplant unless he otherwise qualifies.**
**Expert Rationale:** For individuals eligible for Medicare due to ESRD,
coverage ends 36 months after a successful kidney transplant unless they
qualify for Medicare due to age or disability. Edward’s coverage will
continue for 3 years post-transplant unless he turns 65 or qualifies for
disability.
---
**2. Ms. Henderson believes that she will qualify for Medicare
Coverage when she turns 65, without paying any premiums, because
Downloaded by harun mburu ()
,she has been working for 40 years and paying Medicare taxes. What
should you tell her?**
A. She is not eligible for any Medicare coverage.
B. She will receive Medicare Part A without premiums, but must pay
premiums for Part B.
C. She will not need to pay any premiums for Part A or Part B.
D. She is only eligible for Medicare Part B.
**Correct Answer: B. She will receive Medicare Part A without
premiums, but must pay premiums for Part B.**
**Expert Rationale:** Individuals with sufficient work credits (generally 40
quarters) receive premium-free Part A at age 65. However, Part B requires
a monthly premium, which is income-adjusted. This often causes
confusion, but Part B premiums are always required unless she qualifies for
Medicaid or other coverage.
---
**3. Ms. Lewis has aggressive cancer and would like to know if
Medicare will cover hospice services in case she needs them. What
should you tell her?**
A. Hospice is not covered under Original Medicare.
B. Hospice is covered under Medicare Part A.
C. Hospice is covered under Medicare Part B.
Downloaded by harun mburu ()
, D. Hospice*is*only*covered*if*she*has*a*Medicare*Advantage*plan.
**Correct*Answer:*B.*Hospice*is*covered*under*Medicare*Part*A.**
**Expert*Rationale:***Hospice*care*is*a*benefit*under*Part*A*of*Medicare,*a
vailable*to*terminally*ill*individuals*who*elect*to*focus*on*comfort*care*rather*
than*curative*treatment.*Coverage*includes*pain*relief,*symptom*managem
ent,*and*support*services.
---
**4.*Mr.*Capadona*would*like*to*purchase*a*Medicare*Advantage*(MA)*pl
an*and*a*Medigap*plan*to*pick*up*costs*not*covered*by*that*plan.
What*should*you*tell*him?**
A. He*can*enroll*in*both*MA*and*Medigap*plans.
B. Medigap*can*only*be*used*with*Original*Medicare,*not*MA*plans.
C. Medigap*will*cover*costs*not*included*by*MA*plans.
D. He*does*not*need*any*plan.
**Correct*Answer:*B.*Medigap*can*only*be*used*with*Original*Medicare
,*not*MA*plans.**
**Expert*Rationale:***Federal*law*prohibits*the*sale*of*Medigap*policies*to*in
dividuals*enrolled*in*Medicare*Advantage,*since*Medigap*supplements*only*
Original*Medicare*(Part*A*and*Part*B),*not*Medicare*Advantage*plans.
Downloaded*by*harun*mburu*(
