2027 AHIP Final Exam Medicare
Certification
150 Questions with NGN Formats &
Detailed Rationales Actual Questions &
Answers | Guarantee Pass
Exam AHIP Medicare Certification Final Exam 2027
Format Multiple Choice, SATA, Ordered Response, Matrix/Grid,
Cloze
Difficulty Mixed (Easy, Moderate, Hard)
Topics Covered Part A, Part B, Part C (Medicare Advantage), Part
D (Prescription Drugs),
Medigap, Enrollment Periods, Costs & Penalties, COB, FWA
Questions 150
Updated For 2027 AHIP Medicare Certification Test Plan
, 2027 AHIP Medicare Certification Final Exam | 150 Questions with NGN Formats
Question
1
[Multiple Choice]
Medicare Part A: Hospital Insurance
A Medicare beneficiary is admitted to the hospital for a scheduled knee replacement
surgery. The stay lasts 4 days. How does Medicare Part A cover this inpatient stay?
A. The beneficiary pays a per-day copayment for each of the 4 days
B. Medicare Part A covers the full cost after a one-time deductible per
benefit period
C. The beneficiary is responsible for 20 percent of the total hospital charges
D. Medicare Part A does not cover scheduled surgeries; only emergency
admissions are covered
Correct Answer: B
Rationale
:
Medicare Part A covers inpatient hospital stays after the beneficiary meets the
annual Part A deductible, which is $1,732 per benefit period for 2026. During days 1
through 60 of a benefit period, the beneficiary has already met the deductible and owes
no additional daily coinsurance. The 20 percent coinsurance rule applies to
Medicare Part B services, not Part A inpatient care. Scheduled surgeries are indeed
covered as long as they are medically necessary and performed in a Medicare-
approved facility.
Question
2
[Multiple Choice]
Medicare Part A: Hospital Insurance
Mrs. Johnson has been in the hospital for 72 days during her current benefit period. If
she requires an additional 20 days of inpatient care, what will her cost-sharing
responsibility be for those additional days?
A. No additional cost beyond the deductible already paid for this benefit period
B. $433 per day for days 73 through 90
2
, 2027 AHIP Medicare Certification Final Exam | 150 Questions with NGN Formats
C. $866 per day for each day beyond day 60
D. The full cost of care since she has exceeded the 90-day lifetime maximum
Correct Answer: B
Rationale
:
For days 61 through 90 of a Medicare benefit period, the beneficiary is responsible
for a daily coinsurance amount of $433 in 2026. Mrs. Johnson has already used 72
days, so the next 18 days (days 73 through 90) will each cost her $433. Days beyond
90 would require the use of lifetime reserve days, which carry a higher coinsurance
of $866 per day. Medicare does not have a 90-day lifetime maximum; it has 60
lifetime reserve days total across all benefit periods.
Question 3
[Multiple Choice]
Medicare Part A: Hospital Insurance
Mr. Davis is discharged from the hospital after a 10-day stay and is transferred directly
to a skilled nursing facility (SNF) for rehabilitation. Which of the following correctly
describes Medicare Part A SNF coverage?
A. Medicare covers 100 days of SNF care with no cost to the beneficiary
B. Medicare covers up to 100 days of SNF care per benefit period if
preceded by a qualifying hospital stay
C. Medicare covers unlimited SNF days as long as the patient continues to
improve
3
, 2027 AHIP Medicare Certification Final Exam | 150 Questions with NGN Formats
D. Medicare Part A does not cover any skilled nursing facility stays under any
circumstances
Correct Answer: B
Rationale:
Medicare Part A covers up to 100 days of SNF care per benefit period, but the
patient must have a qualifying 3-day inpatient hospital stay prior to admission and
require skilled nursing or rehabilitative services. For days 1 through 20, Medicare pays
the full cost. For days 21 through 100, the beneficiary pays a daily coinsurance of
$192.80 in 2026. Coverage beyond 100 days is not available under Medicare Part A
unless a new benefit period begins with another qualifying hospital stay.
Question 4
[Multiple Choice]
Medicare Part A: Hospital Insurance
Which of the following services is covered under Medicare Part A hospice benefit?
A. Curative treatment aimed at reversing the terminal illness
B. Room and board in a skilled nursing facility during hospice care
C. Pain management and symptom relief for a terminally ill beneficiary
with a life expectancy of 6 months or less
D. Prescription drugs for conditions unrelated to the terminal diagnosis
Correct Answer: C
Rationale:
The Medicare Part A hospice benefit covers palliative care, including pain
management and symptom relief, for beneficiaries certified as terminally ill with a life
expectancy of six months or less. The hospice benefit does not cover curative
treatments aimed at the terminal illness, though beneficiaries may continue to receive
covered Medicare services for unrelated conditions. Room and board in a SNF is
generally not covered under the hospice benefit, and prescription drugs for conditions
unrelated to the terminal diagnosis are covered under Part D, not the hospice benefit.
4
Certification
150 Questions with NGN Formats &
Detailed Rationales Actual Questions &
Answers | Guarantee Pass
Exam AHIP Medicare Certification Final Exam 2027
Format Multiple Choice, SATA, Ordered Response, Matrix/Grid,
Cloze
Difficulty Mixed (Easy, Moderate, Hard)
Topics Covered Part A, Part B, Part C (Medicare Advantage), Part
D (Prescription Drugs),
Medigap, Enrollment Periods, Costs & Penalties, COB, FWA
Questions 150
Updated For 2027 AHIP Medicare Certification Test Plan
, 2027 AHIP Medicare Certification Final Exam | 150 Questions with NGN Formats
Question
1
[Multiple Choice]
Medicare Part A: Hospital Insurance
A Medicare beneficiary is admitted to the hospital for a scheduled knee replacement
surgery. The stay lasts 4 days. How does Medicare Part A cover this inpatient stay?
A. The beneficiary pays a per-day copayment for each of the 4 days
B. Medicare Part A covers the full cost after a one-time deductible per
benefit period
C. The beneficiary is responsible for 20 percent of the total hospital charges
D. Medicare Part A does not cover scheduled surgeries; only emergency
admissions are covered
Correct Answer: B
Rationale
:
Medicare Part A covers inpatient hospital stays after the beneficiary meets the
annual Part A deductible, which is $1,732 per benefit period for 2026. During days 1
through 60 of a benefit period, the beneficiary has already met the deductible and owes
no additional daily coinsurance. The 20 percent coinsurance rule applies to
Medicare Part B services, not Part A inpatient care. Scheduled surgeries are indeed
covered as long as they are medically necessary and performed in a Medicare-
approved facility.
Question
2
[Multiple Choice]
Medicare Part A: Hospital Insurance
Mrs. Johnson has been in the hospital for 72 days during her current benefit period. If
she requires an additional 20 days of inpatient care, what will her cost-sharing
responsibility be for those additional days?
A. No additional cost beyond the deductible already paid for this benefit period
B. $433 per day for days 73 through 90
2
, 2027 AHIP Medicare Certification Final Exam | 150 Questions with NGN Formats
C. $866 per day for each day beyond day 60
D. The full cost of care since she has exceeded the 90-day lifetime maximum
Correct Answer: B
Rationale
:
For days 61 through 90 of a Medicare benefit period, the beneficiary is responsible
for a daily coinsurance amount of $433 in 2026. Mrs. Johnson has already used 72
days, so the next 18 days (days 73 through 90) will each cost her $433. Days beyond
90 would require the use of lifetime reserve days, which carry a higher coinsurance
of $866 per day. Medicare does not have a 90-day lifetime maximum; it has 60
lifetime reserve days total across all benefit periods.
Question 3
[Multiple Choice]
Medicare Part A: Hospital Insurance
Mr. Davis is discharged from the hospital after a 10-day stay and is transferred directly
to a skilled nursing facility (SNF) for rehabilitation. Which of the following correctly
describes Medicare Part A SNF coverage?
A. Medicare covers 100 days of SNF care with no cost to the beneficiary
B. Medicare covers up to 100 days of SNF care per benefit period if
preceded by a qualifying hospital stay
C. Medicare covers unlimited SNF days as long as the patient continues to
improve
3
, 2027 AHIP Medicare Certification Final Exam | 150 Questions with NGN Formats
D. Medicare Part A does not cover any skilled nursing facility stays under any
circumstances
Correct Answer: B
Rationale:
Medicare Part A covers up to 100 days of SNF care per benefit period, but the
patient must have a qualifying 3-day inpatient hospital stay prior to admission and
require skilled nursing or rehabilitative services. For days 1 through 20, Medicare pays
the full cost. For days 21 through 100, the beneficiary pays a daily coinsurance of
$192.80 in 2026. Coverage beyond 100 days is not available under Medicare Part A
unless a new benefit period begins with another qualifying hospital stay.
Question 4
[Multiple Choice]
Medicare Part A: Hospital Insurance
Which of the following services is covered under Medicare Part A hospice benefit?
A. Curative treatment aimed at reversing the terminal illness
B. Room and board in a skilled nursing facility during hospice care
C. Pain management and symptom relief for a terminally ill beneficiary
with a life expectancy of 6 months or less
D. Prescription drugs for conditions unrelated to the terminal diagnosis
Correct Answer: C
Rationale:
The Medicare Part A hospice benefit covers palliative care, including pain
management and symptom relief, for beneficiaries certified as terminally ill with a life
expectancy of six months or less. The hospice benefit does not cover curative
treatments aimed at the terminal illness, though beneficiaries may continue to receive
covered Medicare services for unrelated conditions. Room and board in a SNF is
generally not covered under the hospice benefit, and prescription drugs for conditions
unrelated to the terminal diagnosis are covered under Part D, not the hospice benefit.
4
