AHIP - Final examination Latest
2026/2027 Questions with all the
correct answers(Actual test 100%
verified)
Course
AHIP
1. Which Medicare Part primarily provides hospital insurance?
A. Part A
B. Part B
C. Part C
D. Part D
Answer: A. Part A
Rationale: Medicare Part A provides hospital insurance and generally covers inpatient hospital
care, skilled nursing facility care under qualifying circumstances, hospice care, and certain home
health services.
2. Which Medicare Part primarily covers physician and outpatient medical services?
A. Part A
B. Part B
C. Part C
D. Part D
Answer: B. Part B
Rationale: Medicare Part B is medical insurance covering eligible physician services, outpatient
care, preventive services, and other medically necessary services.
3. What is Medicare Part C commonly called?
A. Medigap
B. Medicare Advantage
C. Medicare Supplement
D. Medicaid
Answer: B. Medicare Advantage
,Rationale: Medicare Advantage plans are Medicare-approved private health plans that provide
Medicare-covered Part A and Part B benefits through the plan.
4. What does Medicare Part D primarily cover?
A. Inpatient hospitalization
B. Prescription drugs
C. Long-term custodial care
D. Dental implants
Answer: B. Prescription drugs
Rationale: Part D provides outpatient prescription drug coverage through private Medicare-
approved prescription drug plans and Medicare Advantage plans that include prescription
coverage.
5. A beneficiary has Original Medicare and wants additional coverage for certain Medicare
cost-sharing expenses. Which product may meet this need?
A. Medicare Supplement insurance
B. Medicaid only
C. Part D only
D. Employer workers' compensation
Answer: A. Medicare Supplement insurance
Rationale: Medicare Supplement, or Medigap, policies are designed to help cover certain costs
not paid by Original Medicare.
6. Which statement BEST describes Medicare Advantage?
A. It replaces Social Security
B. It is an alternative way to receive Medicare Part A and Part B benefits through a Medicare-
approved private plan
C. It is identical to Medicaid
D. It only covers prescription drugs
Answer: B. It is an alternative way to receive Medicare Part A and Part B benefits through a
Medicare-approved private plan
Rationale: Medicare Advantage plans administer Medicare-covered services through private
organizations that contract with Medicare.
7. Which person generally becomes eligible for Medicare based on age at 65?
,A. Anyone who has lived in the United States for one month
B. A person meeting Medicare eligibility requirements who reaches age 65
C. Only people who are retired
D. Only people receiving Medicaid
Answer: B. A person meeting Medicare eligibility requirements who reaches age 65
Rationale: Medicare eligibility at age 65 depends on applicable entitlement and eligibility
requirements; retirement itself is not required.
8. Which statement about Medicare and employment is correct?
A. Everyone must enroll in Part B at age 65 regardless of employment coverage
B. Certain individuals with qualifying employer coverage may be able to delay Part B without a
late-enrollment penalty
C. Employer coverage never affects Medicare enrollment
D. Medicare automatically terminates employer coverage
Answer: B. Certain individuals with qualifying employer coverage may be able to delay Part B
without a late-enrollment penalty
Rationale: Coordination between Medicare and employer coverage depends on factors such as
employer size and the individual's circumstances.
9. What is the Initial Enrollment Period for someone first becoming eligible for Medicare
because of age?
A. A 3-month period only after turning 65
B. A 7-month period surrounding the 65th birthday
C. A 12-month period beginning at age 64
D. A 2-month period after retirement
Answer: B. A 7-month period surrounding the 65th birthday
Rationale: The Initial Enrollment Period generally begins three months before the month of
turning 65, includes the birthday month, and continues for three months afterward.
10. Which Medicare enrollment period occurs annually and generally allows beneficiaries to
make certain changes to Medicare Advantage and Part D coverage?
A. Annual Election Period
B. Initial Coverage Period
C. Lifetime Enrollment Period
D. Medical Enrollment Period
, Answer: A. Annual Election Period
Rationale: The Annual Election Period provides an annual opportunity for eligible beneficiaries
to make specified Medicare Advantage and Part D enrollment changes.
11. What is the primary purpose of a Special Enrollment Period?
A. To allow enrollment or plan changes when a qualifying life event occurs
B. To eliminate Medicare premiums permanently
C. To replace Medicare eligibility rules
D. To guarantee enrollment in any plan at any time
Answer: A. To allow enrollment or plan changes when a qualifying life event occurs
Rationale: Certain circumstances, such as losing qualifying coverage or moving, may create a
Special Enrollment Period.
12. Which organization administers Medicare at the federal level?
A. CMS
B. FDA
C. OSHA
D. IRS
Answer: A. CMS
Rationale: The Centers for Medicare & Medicaid Services administers Medicare and oversees
Medicare Advantage and Part D programs.
13. Which statement BEST describes a Medicare Advantage HMO?
A. It generally uses a network of providers and may require members to follow referral or
network rules depending on the plan
B. It never uses provider networks
C. It is identical to Original Medicare
D. It only covers prescription medications
Answer: A. It generally uses a network of providers and may require members to follow
referral or network rules depending on the plan
Rationale: HMO Medicare Advantage plans generally emphasize coordinated care through a
provider network.
14. Which Medicare Advantage plan type generally provides greater flexibility to obtain care
from both in-network and out-of-network providers, although costs may differ?
2026/2027 Questions with all the
correct answers(Actual test 100%
verified)
Course
AHIP
1. Which Medicare Part primarily provides hospital insurance?
A. Part A
B. Part B
C. Part C
D. Part D
Answer: A. Part A
Rationale: Medicare Part A provides hospital insurance and generally covers inpatient hospital
care, skilled nursing facility care under qualifying circumstances, hospice care, and certain home
health services.
2. Which Medicare Part primarily covers physician and outpatient medical services?
A. Part A
B. Part B
C. Part C
D. Part D
Answer: B. Part B
Rationale: Medicare Part B is medical insurance covering eligible physician services, outpatient
care, preventive services, and other medically necessary services.
3. What is Medicare Part C commonly called?
A. Medigap
B. Medicare Advantage
C. Medicare Supplement
D. Medicaid
Answer: B. Medicare Advantage
,Rationale: Medicare Advantage plans are Medicare-approved private health plans that provide
Medicare-covered Part A and Part B benefits through the plan.
4. What does Medicare Part D primarily cover?
A. Inpatient hospitalization
B. Prescription drugs
C. Long-term custodial care
D. Dental implants
Answer: B. Prescription drugs
Rationale: Part D provides outpatient prescription drug coverage through private Medicare-
approved prescription drug plans and Medicare Advantage plans that include prescription
coverage.
5. A beneficiary has Original Medicare and wants additional coverage for certain Medicare
cost-sharing expenses. Which product may meet this need?
A. Medicare Supplement insurance
B. Medicaid only
C. Part D only
D. Employer workers' compensation
Answer: A. Medicare Supplement insurance
Rationale: Medicare Supplement, or Medigap, policies are designed to help cover certain costs
not paid by Original Medicare.
6. Which statement BEST describes Medicare Advantage?
A. It replaces Social Security
B. It is an alternative way to receive Medicare Part A and Part B benefits through a Medicare-
approved private plan
C. It is identical to Medicaid
D. It only covers prescription drugs
Answer: B. It is an alternative way to receive Medicare Part A and Part B benefits through a
Medicare-approved private plan
Rationale: Medicare Advantage plans administer Medicare-covered services through private
organizations that contract with Medicare.
7. Which person generally becomes eligible for Medicare based on age at 65?
,A. Anyone who has lived in the United States for one month
B. A person meeting Medicare eligibility requirements who reaches age 65
C. Only people who are retired
D. Only people receiving Medicaid
Answer: B. A person meeting Medicare eligibility requirements who reaches age 65
Rationale: Medicare eligibility at age 65 depends on applicable entitlement and eligibility
requirements; retirement itself is not required.
8. Which statement about Medicare and employment is correct?
A. Everyone must enroll in Part B at age 65 regardless of employment coverage
B. Certain individuals with qualifying employer coverage may be able to delay Part B without a
late-enrollment penalty
C. Employer coverage never affects Medicare enrollment
D. Medicare automatically terminates employer coverage
Answer: B. Certain individuals with qualifying employer coverage may be able to delay Part B
without a late-enrollment penalty
Rationale: Coordination between Medicare and employer coverage depends on factors such as
employer size and the individual's circumstances.
9. What is the Initial Enrollment Period for someone first becoming eligible for Medicare
because of age?
A. A 3-month period only after turning 65
B. A 7-month period surrounding the 65th birthday
C. A 12-month period beginning at age 64
D. A 2-month period after retirement
Answer: B. A 7-month period surrounding the 65th birthday
Rationale: The Initial Enrollment Period generally begins three months before the month of
turning 65, includes the birthday month, and continues for three months afterward.
10. Which Medicare enrollment period occurs annually and generally allows beneficiaries to
make certain changes to Medicare Advantage and Part D coverage?
A. Annual Election Period
B. Initial Coverage Period
C. Lifetime Enrollment Period
D. Medical Enrollment Period
, Answer: A. Annual Election Period
Rationale: The Annual Election Period provides an annual opportunity for eligible beneficiaries
to make specified Medicare Advantage and Part D enrollment changes.
11. What is the primary purpose of a Special Enrollment Period?
A. To allow enrollment or plan changes when a qualifying life event occurs
B. To eliminate Medicare premiums permanently
C. To replace Medicare eligibility rules
D. To guarantee enrollment in any plan at any time
Answer: A. To allow enrollment or plan changes when a qualifying life event occurs
Rationale: Certain circumstances, such as losing qualifying coverage or moving, may create a
Special Enrollment Period.
12. Which organization administers Medicare at the federal level?
A. CMS
B. FDA
C. OSHA
D. IRS
Answer: A. CMS
Rationale: The Centers for Medicare & Medicaid Services administers Medicare and oversees
Medicare Advantage and Part D programs.
13. Which statement BEST describes a Medicare Advantage HMO?
A. It generally uses a network of providers and may require members to follow referral or
network rules depending on the plan
B. It never uses provider networks
C. It is identical to Original Medicare
D. It only covers prescription medications
Answer: A. It generally uses a network of providers and may require members to follow
referral or network rules depending on the plan
Rationale: HMO Medicare Advantage plans generally emphasize coordinated care through a
provider network.
14. Which Medicare Advantage plan type generally provides greater flexibility to obtain care
from both in-network and out-of-network providers, although costs may differ?
