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AHIP Medicare Certification – Expanded Study Guide & Original
Q&A Bank (Questions 101–250)
Section 1: Medicare Basics and Eligibility (Questions 101–120)
101. A 64-year-old individual is approaching Medicare
eligibility. Which of the following statements is accurate
regarding automatic enrollment?
A. Individuals already receiving Social Security retirement
benefits are automatically enrolled in Medicare Parts A and
B when they turn 65
B. Everyone must apply for Medicare in person
C. Automatic enrollment occurs only for Part D
D. No one is automatically enrolled
Answer: A
Rationale: Individuals receiving Social Security or Railroad
Retirement Board benefits for at least 4 months before
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turning 65 are automatically enrolled in Medicare Parts A
and B starting the first day of the month they turn 65.
102. A beneficiary who is automatically enrolled in Medicare
Part B but does not want it can:
A. Decline Part B coverage by following the instructions on
the Medicare card
B. Do nothing; it is mandatory
C. Only decline if they have no other insurance
D. Decline only during AEP
Answer: A
Rationale: Beneficiaries who are automatically enrolled can
decline Part B by following the instructions provided with
their Medicare card if they have other creditable coverage.
103. Which of the following individuals is eligible for
Medicare based solely on age?
A. A 65-year-old U.S. citizen or permanent legal resident
who has lived in the U.S. for at least 5 continuous years
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B. A 60-year-old with a disability
C. A 55-year-old with ESRD
D. A 70-year-old non-resident
Answer: A
Rationale: Medicare eligibility based on age requires the
individual to be 65 or older and a U.S. citizen or legal
resident for 5+ years.
104. A beneficiary is eligible for Medicare due to End-Stage
Renal Disease (ESRD). When does their coverage begin?
A. Typically the first day of the month of their first dialysis
treatment, or earlier under certain circumstances
B. 24 months after diagnosis
C. Only at age 65
D. Immediately upon diagnosis with no waiting period
Answer: A
Rationale: ESRD Medicare coverage usually begins in the
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fourth month of dialysis or sooner if the beneficiary begins
home dialysis training or receives a kidney transplant.
105. A beneficiary is eligible for Medicare due to
Amyotrophic Lateral Sclerosis (ALS). When does coverage
begin?
A. The first month they receive Social Security Disability
Insurance (SSDI) benefits
B. 24 months after SSDI begins
C. 12 months after diagnosis
D. Only at age 65
Answer: A
Rationale: ALS (Lou Gehrig's disease) has an exception:
Medicare coverage begins the same month as SSDI
benefits, without the 24-month waiting period.
106. Which of the following is the Medicare Part B
deductible for 2026?
A. $257 (subject to annual adjustment)
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AHIP Medicare Certification – Expanded Study Guide & Original
Q&A Bank (Questions 101–250)
Section 1: Medicare Basics and Eligibility (Questions 101–120)
101. A 64-year-old individual is approaching Medicare
eligibility. Which of the following statements is accurate
regarding automatic enrollment?
A. Individuals already receiving Social Security retirement
benefits are automatically enrolled in Medicare Parts A and
B when they turn 65
B. Everyone must apply for Medicare in person
C. Automatic enrollment occurs only for Part D
D. No one is automatically enrolled
Answer: A
Rationale: Individuals receiving Social Security or Railroad
Retirement Board benefits for at least 4 months before
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turning 65 are automatically enrolled in Medicare Parts A
and B starting the first day of the month they turn 65.
102. A beneficiary who is automatically enrolled in Medicare
Part B but does not want it can:
A. Decline Part B coverage by following the instructions on
the Medicare card
B. Do nothing; it is mandatory
C. Only decline if they have no other insurance
D. Decline only during AEP
Answer: A
Rationale: Beneficiaries who are automatically enrolled can
decline Part B by following the instructions provided with
their Medicare card if they have other creditable coverage.
103. Which of the following individuals is eligible for
Medicare based solely on age?
A. A 65-year-old U.S. citizen or permanent legal resident
who has lived in the U.S. for at least 5 continuous years
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B. A 60-year-old with a disability
C. A 55-year-old with ESRD
D. A 70-year-old non-resident
Answer: A
Rationale: Medicare eligibility based on age requires the
individual to be 65 or older and a U.S. citizen or legal
resident for 5+ years.
104. A beneficiary is eligible for Medicare due to End-Stage
Renal Disease (ESRD). When does their coverage begin?
A. Typically the first day of the month of their first dialysis
treatment, or earlier under certain circumstances
B. 24 months after diagnosis
C. Only at age 65
D. Immediately upon diagnosis with no waiting period
Answer: A
Rationale: ESRD Medicare coverage usually begins in the
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fourth month of dialysis or sooner if the beneficiary begins
home dialysis training or receives a kidney transplant.
105. A beneficiary is eligible for Medicare due to
Amyotrophic Lateral Sclerosis (ALS). When does coverage
begin?
A. The first month they receive Social Security Disability
Insurance (SSDI) benefits
B. 24 months after SSDI begins
C. 12 months after diagnosis
D. Only at age 65
Answer: A
Rationale: ALS (Lou Gehrig's disease) has an exception:
Medicare coverage begins the same month as SSDI
benefits, without the 24-month waiting period.
106. Which of the following is the Medicare Part B
deductible for 2026?
A. $257 (subject to annual adjustment)
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