AHIP 2027 Final Exam – Medicare Certification –
Actual Questions & Answers (AHIP) Guarantee Pass
Question 1. Which of the following individuals is generally eligible for Medicare
based on age?
A. A person who is 62 years old and retired
B. A person who is 65 years old and a U.S. citizen or legal resident for at least 5 years
C. A person who is 60 years old and has a disability
D. A person who is 67 years old and has never worked
Correct Answer: B
Rationale:
Medicare eligibility based on age generally begins at 65 for U.S. citizens or legal
residents who have lived in the U.S. for at least 5 continuous years. A person 62 (A) is
not eligible based solely on age. A 60-year-old with a disability (C) may qualify after 24
months of disability benefits, but the question asks about age-based eligibility. A 67-
year-old who has never worked (D) may still qualify through a spouse or if they meet
other criteria, but the standard age-based eligibility is 65 and citizenship/residency
requirement.
Question 2. What is the initial enrollment period (IEP) for Medicare Part A and Part
B for someone turning 65?
A. The 3 months before the 65th birthday month, the birthday month, and the 3 months
after
B. The 6 months before the 65th birthday month
C. The 12 months after the 65th birthday month
D. The month of the 65th birthday only
Correct Answer: A
Rationale:
The Initial Enrollment Period (IEP) is a 7-month period that includes the 3 months before
the month a person turns 65, the month they turn 65, and the 3 months after. Option B
is incorrect; it's not 6 months before. Option C is the General Enrollment Period for
some, not IEP. Option D is only one month, not the full IEP.
Question 3. Which part of Medicare covers inpatient hospital stays, skilled nursing
facility care, and hospice care?
,A. Part A
B. Part B
C. Part C
D. Part D
Correct Answer: A
Rationale:
Medicare Part A covers inpatient hospital care, skilled nursing facility care, hospice, and
some home health care. Part B (B) covers outpatient and physician services. Part C (C) is
Medicare Advantage. Part D (D) is prescription drug coverage.
Question 4. What does Medicare Part B generally cover?
A. Prescription drugs
B. Inpatient hospital care
C. Medically necessary outpatient services, physician visits, and preventive services
D. Long-term custodial care
Correct Answer: C
Rationale:
Part B covers medically necessary outpatient services, physician visits, preventive
services, and durable medical equipment. Part D (A) covers prescription drugs. Part A (B)
covers inpatient care. Custodial care (D) is generally not covered by Medicare.
Question 5. What is Medicare Part C commonly known as?
A. Medicare Advantage
B. Medigap
C. Medicare Prescription Drug Plan
D. Original Medicare
Correct Answer: A
Rationale:
Medicare Part C is Medicare Advantage, which allows private insurers to provide
Medicare benefits. Medigap (B) is supplemental insurance. Part D (C) is prescription drug
coverage. Original Medicare (D) refers to Parts A and B.
Question 6. What is the purpose of Medicare Part D?
,A. To provide hospital insurance
B. To provide prescription drug coverage
C. To provide supplemental insurance
D. To provide hospice care
Correct Answer: B
Rationale:
Part D provides outpatient prescription drug coverage. Part A (A) is hospital insurance.
Medigap (C) is supplemental. Hospice (D) is covered under Part A.
Question 7. Which of the following is a characteristic of Original Medicare (Parts A
and B)?
A. It is a fee-for-service program
B. It requires enrollment in a Medicare Advantage plan
C. It includes prescription drug coverage
D. It is only available through private insurers
Correct Answer: A
Rationale:
Original Medicare is a fee-for-service program administered by the federal government.
It does not require Medicare Advantage (B), does not include prescription drug
coverage (C), and is not only through private insurers (D).
Question 8. What is the Medicare Advantage Open Enrollment Period (MA OEP)?
A. January 1 – March 31
B. October 15 – December 7
C. April 1 – June 30
D. November 1 – December 31
Correct Answer: A
Rationale:
The Medicare Advantage Open Enrollment Period runs from January 1 to March 31.
During this time, individuals enrolled in a Medicare Advantage plan can switch to
another Medicare Advantage plan or drop Medicare Advantage and return to Original
Medicare. October 15 – December 7 (B) is the Annual Enrollment Period. April 1 – June
30 (C) is not a standard enrollment period. November 1 – December 31 (D) is not the
MA OEP.
, Question 9. During the Annual Enrollment Period (AEP), what can a Medicare
beneficiary do?
A. Enroll in or change Medicare Advantage plans
B. Enroll in or change Part D plans
C. Switch between Original Medicare and Medicare Advantage
D. All of the above
Correct Answer: D
Rationale:
During AEP (October 15 – December 7), beneficiaries can enroll in, change, or drop
Medicare Advantage plans, enroll in or change Part D plans, and switch between
Original Medicare and Medicare Advantage. Therefore, all of the above are correct.
Question 10. What is the General Enrollment Period (GEP) for Medicare Part A and
Part B?
A. January 1 – March 31
B. April 1 – June 30
C. July 1 – September 30
D. October 1 – December 31
Correct Answer: A
Rationale:
The General Enrollment Period for Part A and Part B is January 1 – March 31 each year.
Coverage begins the first day of the month after enrollment. The other periods are
incorrect.
Question 11. Which of the following is a late enrollment penalty for Medicare Part
B?
A. A 10% increase in premium for each 12-month period without coverage
B. A 5% increase in premium for each 6-month period without coverage
C. A flat fee of $50 per month
D. No penalty if enrolled within 5 years
Correct Answer: A
Rationale:
The Part B late enrollment penalty is a 10% increase in the premium for each full 12-
Actual Questions & Answers (AHIP) Guarantee Pass
Question 1. Which of the following individuals is generally eligible for Medicare
based on age?
A. A person who is 62 years old and retired
B. A person who is 65 years old and a U.S. citizen or legal resident for at least 5 years
C. A person who is 60 years old and has a disability
D. A person who is 67 years old and has never worked
Correct Answer: B
Rationale:
Medicare eligibility based on age generally begins at 65 for U.S. citizens or legal
residents who have lived in the U.S. for at least 5 continuous years. A person 62 (A) is
not eligible based solely on age. A 60-year-old with a disability (C) may qualify after 24
months of disability benefits, but the question asks about age-based eligibility. A 67-
year-old who has never worked (D) may still qualify through a spouse or if they meet
other criteria, but the standard age-based eligibility is 65 and citizenship/residency
requirement.
Question 2. What is the initial enrollment period (IEP) for Medicare Part A and Part
B for someone turning 65?
A. The 3 months before the 65th birthday month, the birthday month, and the 3 months
after
B. The 6 months before the 65th birthday month
C. The 12 months after the 65th birthday month
D. The month of the 65th birthday only
Correct Answer: A
Rationale:
The Initial Enrollment Period (IEP) is a 7-month period that includes the 3 months before
the month a person turns 65, the month they turn 65, and the 3 months after. Option B
is incorrect; it's not 6 months before. Option C is the General Enrollment Period for
some, not IEP. Option D is only one month, not the full IEP.
Question 3. Which part of Medicare covers inpatient hospital stays, skilled nursing
facility care, and hospice care?
,A. Part A
B. Part B
C. Part C
D. Part D
Correct Answer: A
Rationale:
Medicare Part A covers inpatient hospital care, skilled nursing facility care, hospice, and
some home health care. Part B (B) covers outpatient and physician services. Part C (C) is
Medicare Advantage. Part D (D) is prescription drug coverage.
Question 4. What does Medicare Part B generally cover?
A. Prescription drugs
B. Inpatient hospital care
C. Medically necessary outpatient services, physician visits, and preventive services
D. Long-term custodial care
Correct Answer: C
Rationale:
Part B covers medically necessary outpatient services, physician visits, preventive
services, and durable medical equipment. Part D (A) covers prescription drugs. Part A (B)
covers inpatient care. Custodial care (D) is generally not covered by Medicare.
Question 5. What is Medicare Part C commonly known as?
A. Medicare Advantage
B. Medigap
C. Medicare Prescription Drug Plan
D. Original Medicare
Correct Answer: A
Rationale:
Medicare Part C is Medicare Advantage, which allows private insurers to provide
Medicare benefits. Medigap (B) is supplemental insurance. Part D (C) is prescription drug
coverage. Original Medicare (D) refers to Parts A and B.
Question 6. What is the purpose of Medicare Part D?
,A. To provide hospital insurance
B. To provide prescription drug coverage
C. To provide supplemental insurance
D. To provide hospice care
Correct Answer: B
Rationale:
Part D provides outpatient prescription drug coverage. Part A (A) is hospital insurance.
Medigap (C) is supplemental. Hospice (D) is covered under Part A.
Question 7. Which of the following is a characteristic of Original Medicare (Parts A
and B)?
A. It is a fee-for-service program
B. It requires enrollment in a Medicare Advantage plan
C. It includes prescription drug coverage
D. It is only available through private insurers
Correct Answer: A
Rationale:
Original Medicare is a fee-for-service program administered by the federal government.
It does not require Medicare Advantage (B), does not include prescription drug
coverage (C), and is not only through private insurers (D).
Question 8. What is the Medicare Advantage Open Enrollment Period (MA OEP)?
A. January 1 – March 31
B. October 15 – December 7
C. April 1 – June 30
D. November 1 – December 31
Correct Answer: A
Rationale:
The Medicare Advantage Open Enrollment Period runs from January 1 to March 31.
During this time, individuals enrolled in a Medicare Advantage plan can switch to
another Medicare Advantage plan or drop Medicare Advantage and return to Original
Medicare. October 15 – December 7 (B) is the Annual Enrollment Period. April 1 – June
30 (C) is not a standard enrollment period. November 1 – December 31 (D) is not the
MA OEP.
, Question 9. During the Annual Enrollment Period (AEP), what can a Medicare
beneficiary do?
A. Enroll in or change Medicare Advantage plans
B. Enroll in or change Part D plans
C. Switch between Original Medicare and Medicare Advantage
D. All of the above
Correct Answer: D
Rationale:
During AEP (October 15 – December 7), beneficiaries can enroll in, change, or drop
Medicare Advantage plans, enroll in or change Part D plans, and switch between
Original Medicare and Medicare Advantage. Therefore, all of the above are correct.
Question 10. What is the General Enrollment Period (GEP) for Medicare Part A and
Part B?
A. January 1 – March 31
B. April 1 – June 30
C. July 1 – September 30
D. October 1 – December 31
Correct Answer: A
Rationale:
The General Enrollment Period for Part A and Part B is January 1 – March 31 each year.
Coverage begins the first day of the month after enrollment. The other periods are
incorrect.
Question 11. Which of the following is a late enrollment penalty for Medicare Part
B?
A. A 10% increase in premium for each 12-month period without coverage
B. A 5% increase in premium for each 6-month period without coverage
C. A flat fee of $50 per month
D. No penalty if enrolled within 5 years
Correct Answer: A
Rationale:
The Part B late enrollment penalty is a 10% increase in the premium for each full 12-
