AHIP Final Exam 2026/2027 |
Complete Test Questions with
Verified Correct Answers | Fully
Graded A+ Success Guide
Course
AHIP MEDICARE CERTIFICATION
1. Which Medicare part primarily covers inpatient hospital services?
A. Part A
B. Part B
C. Part C
D. Part D
Answer: A
Rationale: Medicare Part A covers inpatient hospital care, skilled nursing facility care (under
qualifying conditions), hospice, and limited home health services.
2. Medicare Part B generally covers:
A. Prescription drugs only
B. Physician services and outpatient care
C. Long-term custodial nursing home care
D. Dental insurance
Answer: B
Rationale: Part B covers physician visits, preventive care, outpatient services, laboratory testing,
durable medical equipment, and many other medically necessary services.
3. Medicare Advantage plans are also known as:
A. Medigap
B. Medicare Part C
C. Medicaid Expansion
,D. CHIP
Answer: B
Rationale: Medicare Advantage (Part C) combines Part A and Part B benefits through private
insurance companies approved by Medicare.
4. Medicare Part D primarily provides coverage for:
A. Hospital stays
B. Prescription medications
C. Hospice care
D. Skilled nursing facility services
Answer: B
Rationale: Part D helps beneficiaries pay for outpatient prescription medications.
5. Which individual is generally eligible for Medicare based on age?
A. 55 years old
B. 60 years old
C. 65 years old
D. 70 years old
Answer: C
Rationale: Most individuals become eligible for Medicare at age 65 if they meet residency or
work history requirements.
6. What is the Initial Enrollment Period (IEP)?
A. A 3-month enrollment window
B. A 7-month period surrounding a person's 65th birthday
C. Annual enrollment every January
D. Open enrollment for all beneficiaries
,Answer: B
Rationale: The IEP includes the three months before, the birthday month, and the three months
after turning 65.
7. Which statement about Medicare Advantage is correct?
A. It replaces Original Medicare benefits while providing at least the same coverage required by
Medicare.
B. It eliminates all out-of-pocket costs.
C. It never requires provider networks.
D. It excludes preventive services.
Answer: A
Rationale: Medicare Advantage plans must provide at least the same Medicare-covered services
as Original Medicare, although costs and provider networks may differ.
8. What is a formulary?
A. A provider directory
B. A list of covered prescription drugs
C. A hospital network
D. A Medicare application
Answer: B
Rationale: Each Part D plan maintains a formulary listing covered medications.
9. Which Medicare program helps pay Medicare premiums and cost-sharing for eligible low-
income beneficiaries?
A. Medigap
B. Medicare Savings Programs
C. COBRA
, D. TRICARE
Answer: B
Rationale: Medicare Savings Programs assist qualified beneficiaries with Medicare costs.
10. Extra Help primarily assists beneficiaries with:
A. Hospital deductibles
B. Prescription drug costs
C. Vision coverage only
D. Dental benefits only
Answer: B
Rationale: The Extra Help (Low-Income Subsidy) program reduces Part D premiums and
prescription drug expenses for eligible individuals.
11. Which organization administers Medicare?
A. Internal Revenue Service
B. Centers for Medicare & Medicaid Services (CMS)
C. Department of Labor
D. Social Security Administration exclusively
Answer: B
Rationale: CMS oversees Medicare and Medicaid programs.
12. Which enrollment period allows beneficiaries to change Medicare Advantage or Part D
plans each fall?
A. Initial Enrollment Period
B. Annual Enrollment Period (AEP)
C. Special Enrollment Period only
D. General Enrollment Period
Complete Test Questions with
Verified Correct Answers | Fully
Graded A+ Success Guide
Course
AHIP MEDICARE CERTIFICATION
1. Which Medicare part primarily covers inpatient hospital services?
A. Part A
B. Part B
C. Part C
D. Part D
Answer: A
Rationale: Medicare Part A covers inpatient hospital care, skilled nursing facility care (under
qualifying conditions), hospice, and limited home health services.
2. Medicare Part B generally covers:
A. Prescription drugs only
B. Physician services and outpatient care
C. Long-term custodial nursing home care
D. Dental insurance
Answer: B
Rationale: Part B covers physician visits, preventive care, outpatient services, laboratory testing,
durable medical equipment, and many other medically necessary services.
3. Medicare Advantage plans are also known as:
A. Medigap
B. Medicare Part C
C. Medicaid Expansion
,D. CHIP
Answer: B
Rationale: Medicare Advantage (Part C) combines Part A and Part B benefits through private
insurance companies approved by Medicare.
4. Medicare Part D primarily provides coverage for:
A. Hospital stays
B. Prescription medications
C. Hospice care
D. Skilled nursing facility services
Answer: B
Rationale: Part D helps beneficiaries pay for outpatient prescription medications.
5. Which individual is generally eligible for Medicare based on age?
A. 55 years old
B. 60 years old
C. 65 years old
D. 70 years old
Answer: C
Rationale: Most individuals become eligible for Medicare at age 65 if they meet residency or
work history requirements.
6. What is the Initial Enrollment Period (IEP)?
A. A 3-month enrollment window
B. A 7-month period surrounding a person's 65th birthday
C. Annual enrollment every January
D. Open enrollment for all beneficiaries
,Answer: B
Rationale: The IEP includes the three months before, the birthday month, and the three months
after turning 65.
7. Which statement about Medicare Advantage is correct?
A. It replaces Original Medicare benefits while providing at least the same coverage required by
Medicare.
B. It eliminates all out-of-pocket costs.
C. It never requires provider networks.
D. It excludes preventive services.
Answer: A
Rationale: Medicare Advantage plans must provide at least the same Medicare-covered services
as Original Medicare, although costs and provider networks may differ.
8. What is a formulary?
A. A provider directory
B. A list of covered prescription drugs
C. A hospital network
D. A Medicare application
Answer: B
Rationale: Each Part D plan maintains a formulary listing covered medications.
9. Which Medicare program helps pay Medicare premiums and cost-sharing for eligible low-
income beneficiaries?
A. Medigap
B. Medicare Savings Programs
C. COBRA
, D. TRICARE
Answer: B
Rationale: Medicare Savings Programs assist qualified beneficiaries with Medicare costs.
10. Extra Help primarily assists beneficiaries with:
A. Hospital deductibles
B. Prescription drug costs
C. Vision coverage only
D. Dental benefits only
Answer: B
Rationale: The Extra Help (Low-Income Subsidy) program reduces Part D premiums and
prescription drug expenses for eligible individuals.
11. Which organization administers Medicare?
A. Internal Revenue Service
B. Centers for Medicare & Medicaid Services (CMS)
C. Department of Labor
D. Social Security Administration exclusively
Answer: B
Rationale: CMS oversees Medicare and Medicaid programs.
12. Which enrollment period allows beneficiaries to change Medicare Advantage or Part D
plans each fall?
A. Initial Enrollment Period
B. Annual Enrollment Period (AEP)
C. Special Enrollment Period only
D. General Enrollment Period
