AHIP FINAL EXAM 2027
EXAM QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES | LATEST VERSION PDF
EXAM OVERVIEW & KEY FACTS
The AHIP (America's Health Insurance Plans) Final Exam is the annual Medicare
training and certification requirement for licensed insurance agents who wish to sell
Medicare Advantage and Prescription Drug Plans for the upcoming plan year. The exam
covers Medicare basics, compliance rules, and Fraud, Waste, and Abuse (FWA) training .
For 2027 plan year, agents must complete the Medicare + Fraud, Waste, and Abuse
(MFWA) training and achieve 90% or higher on the final exam to pass . You are allowed
up to 3 attempts to pass the exam .
Feature Details
Exam Start
June 22, 2026
Date
Cost $175 (2026 price)
Number of
50
Questions
Time Limit 2 hours
Passing Score 90%
,Feature Details
Attempts
3
Allowed
Medicare Parts A, B, C, D; Enrollment Periods (IEP, AEP, SEP); Marketing and
Key Topic Areas
Communications Rules; Scope of Appointment (SOA); Fraud, Waste, and Abuse (FWA)
Key 2027 Exam Tips:
• Returning agents can skip Modules 1, 2, and 3, but Modules 4 and 5 have timed
slides that cannot be skipped .
• Pay extra attention to less common plan types like Medicare Savings Accounts
(MSAs), Cost Plans, Private Fee-for-Service (PFFS) Plans, and Employer
Group Waiver Plans (EGWPs) .
• Review module quizzes carefully as many final exam questions closely mirror
them .
• Watch for updated Marketing and Communication Rules, especially Scope of
Appointment (SOA) requirements .
SECTION 1: MEDICARE BASICS – PARTS A, B, C, AND D
Question 1:
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from
arthritis through acupuncture. She is concerned about whether or not Medicare will
cover these items and services. What should you tell her?
A) Medicare covers acupuncture, glasses, and dentures
B) Medicare covers acupuncture only
C) Medicare covers glasses and dentures only
D) Medicare does not cover acupuncture, or, in general, glasses or dentures
,Answer: D
Rationale: Original Medicare does not cover acupuncture, or, in general, glasses or
dentures. While some Medicare Advantage plans may offer supplemental benefits that
cover these items, Original Medicare Parts A and B do not cover routine vision, dental, or
acupuncture services.
Question 2:
Mr. Capadona would like to purchase a Medicare Advantage (MA) plan. He is 67 years
old and has been enrolled in Original Medicare Parts A and B. Which enrollment period
is he in if he wants to join an MA plan?
A) Initial Enrollment Period (IEP)
B) Annual Enrollment Period (AEP)
C) Special Enrollment Period (SEP)
D) Medicare Advantage Open Enrollment Period (MA OEP)
Answer: B
Rationale: The Annual Enrollment Period (AEP) runs from October 15 to December 7 each
year. During this period, beneficiaries enrolled in Original Medicare can join a Medicare
Advantage plan or switch plans. Since Mr. Capadona is already enrolled in Parts A and B,
the AEP is the appropriate enrollment period.
Question 3:
Which of the following is true about Medicare Part A?
A) It covers outpatient medical services and doctor visits
B) It covers inpatient hospital care, skilled nursing facility care, hospice, and some home
health services
C) It covers prescription drugs only
D) It covers vision, dental, and hearing services exclusively
Answer: B
Rationale: Medicare Part A is hospital insurance that covers inpatient hospital stays, skilled
nursing facility care, hospice care, and limited home health services. Outpatient services
are covered under Part B, and prescription drugs are covered under Part D.
, Question 4:
What is the standard monthly premium for Medicare Part B for 2026?
A) $0 (premium-free)
B) $174.70 per month
C) $278.50 per month
D) $500.00 per month
Answer: B
Rationale: The standard monthly premium for Medicare Part B is $174.70 for 2026.
Higher-income beneficiaries may pay more due to the Income-Related Monthly
Adjustment Amount (IRMAA).
Question 5:
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full
time, and paid taxes during that entire period. She is concerned that she will not qualify
for coverage under Part A because she was not born in the United States. What should
you tell her?
A) She does not qualify because she is not a natural-born citizen
B) Most individuals who are citizens and over age 65 are covered under Part A by virtue
of having paid Medicare taxes while working
C) She must wait until she is 70 to qualify
D) She must purchase Part A at full cost
Answer: B
Rationale: Most individuals who are citizens and over age 65 are covered under Part A if
they or their spouse paid Medicare taxes for at least 10 years (40 quarters). Birth location
does not determine eligibility; citizenship and tax contributions matter.
Question 6:
Medicare Part B late enrollment penalty is based on:
EXAM QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES | LATEST VERSION PDF
EXAM OVERVIEW & KEY FACTS
The AHIP (America's Health Insurance Plans) Final Exam is the annual Medicare
training and certification requirement for licensed insurance agents who wish to sell
Medicare Advantage and Prescription Drug Plans for the upcoming plan year. The exam
covers Medicare basics, compliance rules, and Fraud, Waste, and Abuse (FWA) training .
For 2027 plan year, agents must complete the Medicare + Fraud, Waste, and Abuse
(MFWA) training and achieve 90% or higher on the final exam to pass . You are allowed
up to 3 attempts to pass the exam .
Feature Details
Exam Start
June 22, 2026
Date
Cost $175 (2026 price)
Number of
50
Questions
Time Limit 2 hours
Passing Score 90%
,Feature Details
Attempts
3
Allowed
Medicare Parts A, B, C, D; Enrollment Periods (IEP, AEP, SEP); Marketing and
Key Topic Areas
Communications Rules; Scope of Appointment (SOA); Fraud, Waste, and Abuse (FWA)
Key 2027 Exam Tips:
• Returning agents can skip Modules 1, 2, and 3, but Modules 4 and 5 have timed
slides that cannot be skipped .
• Pay extra attention to less common plan types like Medicare Savings Accounts
(MSAs), Cost Plans, Private Fee-for-Service (PFFS) Plans, and Employer
Group Waiver Plans (EGWPs) .
• Review module quizzes carefully as many final exam questions closely mirror
them .
• Watch for updated Marketing and Communication Rules, especially Scope of
Appointment (SOA) requirements .
SECTION 1: MEDICARE BASICS – PARTS A, B, C, AND D
Question 1:
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from
arthritis through acupuncture. She is concerned about whether or not Medicare will
cover these items and services. What should you tell her?
A) Medicare covers acupuncture, glasses, and dentures
B) Medicare covers acupuncture only
C) Medicare covers glasses and dentures only
D) Medicare does not cover acupuncture, or, in general, glasses or dentures
,Answer: D
Rationale: Original Medicare does not cover acupuncture, or, in general, glasses or
dentures. While some Medicare Advantage plans may offer supplemental benefits that
cover these items, Original Medicare Parts A and B do not cover routine vision, dental, or
acupuncture services.
Question 2:
Mr. Capadona would like to purchase a Medicare Advantage (MA) plan. He is 67 years
old and has been enrolled in Original Medicare Parts A and B. Which enrollment period
is he in if he wants to join an MA plan?
A) Initial Enrollment Period (IEP)
B) Annual Enrollment Period (AEP)
C) Special Enrollment Period (SEP)
D) Medicare Advantage Open Enrollment Period (MA OEP)
Answer: B
Rationale: The Annual Enrollment Period (AEP) runs from October 15 to December 7 each
year. During this period, beneficiaries enrolled in Original Medicare can join a Medicare
Advantage plan or switch plans. Since Mr. Capadona is already enrolled in Parts A and B,
the AEP is the appropriate enrollment period.
Question 3:
Which of the following is true about Medicare Part A?
A) It covers outpatient medical services and doctor visits
B) It covers inpatient hospital care, skilled nursing facility care, hospice, and some home
health services
C) It covers prescription drugs only
D) It covers vision, dental, and hearing services exclusively
Answer: B
Rationale: Medicare Part A is hospital insurance that covers inpatient hospital stays, skilled
nursing facility care, hospice care, and limited home health services. Outpatient services
are covered under Part B, and prescription drugs are covered under Part D.
, Question 4:
What is the standard monthly premium for Medicare Part B for 2026?
A) $0 (premium-free)
B) $174.70 per month
C) $278.50 per month
D) $500.00 per month
Answer: B
Rationale: The standard monthly premium for Medicare Part B is $174.70 for 2026.
Higher-income beneficiaries may pay more due to the Income-Related Monthly
Adjustment Amount (IRMAA).
Question 5:
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full
time, and paid taxes during that entire period. She is concerned that she will not qualify
for coverage under Part A because she was not born in the United States. What should
you tell her?
A) She does not qualify because she is not a natural-born citizen
B) Most individuals who are citizens and over age 65 are covered under Part A by virtue
of having paid Medicare taxes while working
C) She must wait until she is 70 to qualify
D) She must purchase Part A at full cost
Answer: B
Rationale: Most individuals who are citizens and over age 65 are covered under Part A if
they or their spouse paid Medicare taxes for at least 10 years (40 quarters). Birth location
does not determine eligibility; citizenship and tax contributions matter.
Question 6:
Medicare Part B late enrollment penalty is based on:
