AHIP Medicare Practice Exam – 120 Questions with Answers

AHIP Medicare Certification Practice Exam

1. At what age does an individual generally first become eligible for Medicare
based on age alone?
A. 62
B. 65
C. 67
D. 70
Correct Answer: B. 65
Rationale: Individuals generally become eligible for Medicare at age 65, regardless of
full Social Security retirement age, which may differ.

2. Which of the following individuals under age 65 would generally qualify for
Medicare based on disability?
A. Anyone who is unemployed for more than 6 months
B. A person who has received Social Security Disability Insurance (SSDI) benefits
for 24 months
C. Anyone with a chronic but non-disabling condition
D. A person who has never worked
Correct Answer: B. A person who has received Social Security Disability
Insurance (SSDI) benefits for 24 months
Rationale: Individuals under 65 generally become eligible for Medicare after receiving
SSDI benefits for 24 months. Certain conditions, such as ALS, waive the waiting
period.

,3. Which condition allows a person to qualify for Medicare at any age without a
waiting period?
A. Type 2 diabetes
B. End-Stage Renal Disease (ESRD) only, with a waiting period
C. Amyotrophic Lateral Sclerosis (ALS)
D. Chronic asthma
Correct Answer: C. Amyotrophic Lateral Sclerosis (ALS)
Rationale: Individuals diagnosed with ALS (Lou Gehrig's disease) are eligible for
Medicare immediately upon receiving SSDI, without the standard 24-month waiting
period. ESRD has its own separate qualifying rules with a different waiting period.

4. Medicare is best described as which type of program?
A. A means-tested welfare program for low-income individuals only
B. A federal health insurance program primarily for people 65 and older and certain
younger people with disabilities
C. A state-administered program that varies completely by state
D. A private employer-sponsored retiree benefit
Correct Answer: B. A federal health insurance program primarily for people 65
and older and certain younger people with disabilities
Rationale: Medicare is a federal program, administered by CMS, primarily serving
people age 65+ and certain younger individuals with qualifying disabilities or ESRD.
Unlike Medicaid, it is not means-tested.

5. Which federal agency has primary responsibility for administering the
Medicare program?
A. Department of Labor
B. Internal Revenue Service
C. Centers for Medicare & Medicaid Services (CMS)
D. Social Security Administration only
Correct Answer: C. Centers for Medicare & Medicaid Services (CMS)
Rationale: CMS, part of the Department of Health and Human Services, administers
Medicare, while the Social Security Administration handles enrollment and premium
withholding functions.

,6. What is the primary difference between Medicare and Medicaid?
A. Medicare is state-run; Medicaid is federally run
B. Medicare is primarily age/disability-based federal insurance; Medicaid is a joint
federal-state program based on financial need
C. Medicaid only covers prescription drugs
D. There is no meaningful difference
Correct Answer: B. Medicare is primarily age/disability-based federal insurance;
Medicaid is a joint federal-state program based on financial need
Rationale: Medicare eligibility is generally based on age or disability status, while
Medicaid eligibility is based on financial need and is jointly funded and administered by
federal and state governments.

7. A beneficiary who has both Medicare and Medicaid is commonly referred to
as:
A. A dual-eligible beneficiary
B. A Medigap enrollee
C. A creditable coverage holder
D. An ESRD beneficiary
Correct Answer: A. A dual-eligible beneficiary
Rationale: Individuals entitled to both Medicare and Medicaid are called dual eligibles,
and they often qualify for additional programs such as D-SNPs and the Low-Income
Subsidy.

8. Which of the following is NOT one of the four parts of Medicare?
A. Part A
B. Part B
C. Part E
D. Part D
Correct Answer: C. Part E
Rationale: Medicare has Parts A, B, C, and D. There is no 'Part E.' Part C refers to
Medicare Advantage.

, 9. Initial Medicare enrollment for most people is handled through which entity?
A. The employer's HR department only
B. The Social Security Administration
C. A private insurance broker exclusively
D. The state Medicaid office
Correct Answer: B. The Social Security Administration
Rationale: The Social Security Administration processes most initial Medicare
enrollments and manages premium withholding from Social Security benefits.

10. A beneficiary who delays enrolling in Medicare Part B without other
creditable coverage may face which consequence?
A. No consequence at all
B. A permanent late enrollment penalty added to the Part B premium
C. Automatic disqualification from Medicare for life
D. A one-time small fee only
Correct Answer: B. A permanent late enrollment penalty added to the Part B
premium
Rationale: Delaying Part B enrollment without creditable coverage (such as active
employer coverage) can result in a lifetime late enrollment penalty added to the
monthly premium.

11. Medicare Part A primarily covers which type of care?
A. Routine outpatient physician visits
B. Inpatient hospital care, skilled nursing facility care, hospice, and some home
health care
C. Prescription drugs only
D. Routine dental and vision care
Correct Answer: B. Inpatient hospital care, skilled nursing facility care, hospice,
and some home health care
Rationale: Part A is often called 'hospital insurance' and covers inpatient hospital stays,
skilled nursing facility care (under certain conditions), hospice care, and some home
health services.