AHIP Exam Bundle – 2025/2026 Edition
150 High-Yield MCQs for Certification Prep
Section 1: Medicare Basics and Eligibility (Q1–Q25)
Q1. Which part of Medicare covers inpatient hospital stays, skilled nursing facility care,
hospice care, and some home health care?
A. Medicare Part A
B. Medicare Part B
C. Medicare Part C
D. Medicare Part D
Answer: A
Rationale: Medicare Part A specifically covers institutional and inpatient care services, including
hospital stays, skilled nursing facility care, hospice, and some home health care. Part B covers
outpatient services, Part C is Medicare Advantage, and Part D covers prescription drugs.
Q2. How many quarters of coverage must an individual (or their spouse) earn through payroll
taxes to be entitled to Medicare Part A without paying a monthly premium?
A. 20 quarters
B. 30 quarters
C. 40 quarters
D. 50 quarters
Answer: C
Rationale: Individuals who have worked at least 40 quarters (10 years) in Medicare-covered
employment do not pay a premium for Part A.
Q3. What is the standard monthly premium for Medicare Part B based upon?
A. The beneficiary's zip code
B. The beneficiary's modified adjusted gross income (MAGI)
C. The beneficiary's health status and pre-existing conditions
D. The number of years the beneficiary has been retired
Answer: B
Rationale: Higher-income beneficiaries pay a higher Part B premium based on Modified
Adjusted Gross Income, known as the Income-Related Monthly Adjustment Amount (IRMAA).
,Q4. Medicare Part B covers which of the following services?
A. Inpatient surgery
B. Outpatient physician services and preventive care
C. Long-term custodial care in a nursing home
D. Routine cosmetic procedures
Answer: B
Rationale: Part B covers medically necessary outpatient services, doctor visits, durable medical
equipment, and preventive care. Part A covers inpatient surgery, custodial care is not covered,
and routine cosmetic procedures are excluded.
Q5. What percentage of the Medicare-approved amount does a beneficiary typically pay for
Part B covered services after meeting their annual deductible?
A. 10%
B. 20%
C. 30%
D. 50%
Answer: B
Rationale: Under Original Medicare Part B, the beneficiary is responsible for a 20% coinsurance
after the annual deductible is satisfied.
Q6. What is another common name for Medicare Part C plans?
A. Medicare Supplement Plans
B. Medicare Advantage Plans
C. Standalone Prescription Drug Plans
D. Medicaid Wrap Plans
Answer: B
Rationale: Medicare Part C is officially known as Medicare Advantage. These plans are offered
by private companies approved by Medicare.
Q7. Which individuals are eligible for Medicare-Medicaid Plans (MMPs)?
A. Those enrolled in Medicare Part A only
B. Medicare and Medicaid dual eligibles, including Part D coverage
C. Individuals under age 65 without disabilities
D. Those with employer-sponsored plans only
,Answer: B
Rationale: MMPs serve individuals who are dually eligible for both Medicare and Medicaid,
integrating benefits including Part D coverage.
Q8. When can individuals with End-Stage Renal Disease (ESRD) enroll in Medicare?
A. Only during the Annual Enrollment Period (AEP)
B. Anytime, with coverage beginning the fourth month after dialysis starts
C. During a Special Enrollment Period (SEP) for employment changes
D. Only at age 65
Answer: B
Rationale: Individuals with ESRD can enroll in Medicare at any time, with coverage typically
beginning the fourth month after dialysis starts.
Q9. What are the dates for the General Enrollment Period (GEP) for those not enrolling in Part
B when first eligible?
A. April 1 to June 30
B. January 1 to March 31, with coverage starting July 1
C. October 15 to December 7
D. July 1 to September 30
Answer: B
Rationale: The GEP runs from January 1 to March 31 each year, with coverage beginning July 1.
Q10. When can individuals with employer group health coverage enroll in Part A and/or Part
B?
A. Only during the Initial Enrollment Period (IEP)
B. Anytime while on group coverage during a Special Enrollment Period (SEP)
C. After age 70
D. During the Annual Election Period (AEP) only
Answer: B
Rationale: Individuals with employer group health coverage can enroll during a Special
Enrollment Period while still covered by the group plan.
Q11. What is the Annual Enrollment Period (AEP) for Medicare Advantage and Part D plans?
A. January 1 to March 31
B. April 1 to June 30
, C. October 15 to December 7
D. July 1 to September 30
Answer: C
Rationale: The AEP, also called the Annual Election Period, runs from October 15 to December
7 each year.
Q12. How many questions are included in the AHIP final exam?
A. 25
B. 50
C. 75
D. 100
Answer: B
Rationale: The AHIP final exam consists of 50 questions.
Q13. What is the minimum passing score required for the AHIP exam?
A. 70%
B. 80%
C. 90%
D. 95%
Answer: C
Rationale: Candidates must achieve a score of 90% on the 50-question final exam to pass.
Q14. How many attempts are allowed to pass the AHIP exam?
A. 1
B. 2
C. 3
D. Unlimited
Answer: C
Rationale: Candidates are allowed up to three attempts to pass the AHIP exam.
Q15. What does Medicare Part A cover?
A. Outpatient services, doctor visits, and preventive care
B. Inpatient hospital stays
150 High-Yield MCQs for Certification Prep
Section 1: Medicare Basics and Eligibility (Q1–Q25)
Q1. Which part of Medicare covers inpatient hospital stays, skilled nursing facility care,
hospice care, and some home health care?
A. Medicare Part A
B. Medicare Part B
C. Medicare Part C
D. Medicare Part D
Answer: A
Rationale: Medicare Part A specifically covers institutional and inpatient care services, including
hospital stays, skilled nursing facility care, hospice, and some home health care. Part B covers
outpatient services, Part C is Medicare Advantage, and Part D covers prescription drugs.
Q2. How many quarters of coverage must an individual (or their spouse) earn through payroll
taxes to be entitled to Medicare Part A without paying a monthly premium?
A. 20 quarters
B. 30 quarters
C. 40 quarters
D. 50 quarters
Answer: C
Rationale: Individuals who have worked at least 40 quarters (10 years) in Medicare-covered
employment do not pay a premium for Part A.
Q3. What is the standard monthly premium for Medicare Part B based upon?
A. The beneficiary's zip code
B. The beneficiary's modified adjusted gross income (MAGI)
C. The beneficiary's health status and pre-existing conditions
D. The number of years the beneficiary has been retired
Answer: B
Rationale: Higher-income beneficiaries pay a higher Part B premium based on Modified
Adjusted Gross Income, known as the Income-Related Monthly Adjustment Amount (IRMAA).
,Q4. Medicare Part B covers which of the following services?
A. Inpatient surgery
B. Outpatient physician services and preventive care
C. Long-term custodial care in a nursing home
D. Routine cosmetic procedures
Answer: B
Rationale: Part B covers medically necessary outpatient services, doctor visits, durable medical
equipment, and preventive care. Part A covers inpatient surgery, custodial care is not covered,
and routine cosmetic procedures are excluded.
Q5. What percentage of the Medicare-approved amount does a beneficiary typically pay for
Part B covered services after meeting their annual deductible?
A. 10%
B. 20%
C. 30%
D. 50%
Answer: B
Rationale: Under Original Medicare Part B, the beneficiary is responsible for a 20% coinsurance
after the annual deductible is satisfied.
Q6. What is another common name for Medicare Part C plans?
A. Medicare Supplement Plans
B. Medicare Advantage Plans
C. Standalone Prescription Drug Plans
D. Medicaid Wrap Plans
Answer: B
Rationale: Medicare Part C is officially known as Medicare Advantage. These plans are offered
by private companies approved by Medicare.
Q7. Which individuals are eligible for Medicare-Medicaid Plans (MMPs)?
A. Those enrolled in Medicare Part A only
B. Medicare and Medicaid dual eligibles, including Part D coverage
C. Individuals under age 65 without disabilities
D. Those with employer-sponsored plans only
,Answer: B
Rationale: MMPs serve individuals who are dually eligible for both Medicare and Medicaid,
integrating benefits including Part D coverage.
Q8. When can individuals with End-Stage Renal Disease (ESRD) enroll in Medicare?
A. Only during the Annual Enrollment Period (AEP)
B. Anytime, with coverage beginning the fourth month after dialysis starts
C. During a Special Enrollment Period (SEP) for employment changes
D. Only at age 65
Answer: B
Rationale: Individuals with ESRD can enroll in Medicare at any time, with coverage typically
beginning the fourth month after dialysis starts.
Q9. What are the dates for the General Enrollment Period (GEP) for those not enrolling in Part
B when first eligible?
A. April 1 to June 30
B. January 1 to March 31, with coverage starting July 1
C. October 15 to December 7
D. July 1 to September 30
Answer: B
Rationale: The GEP runs from January 1 to March 31 each year, with coverage beginning July 1.
Q10. When can individuals with employer group health coverage enroll in Part A and/or Part
B?
A. Only during the Initial Enrollment Period (IEP)
B. Anytime while on group coverage during a Special Enrollment Period (SEP)
C. After age 70
D. During the Annual Election Period (AEP) only
Answer: B
Rationale: Individuals with employer group health coverage can enroll during a Special
Enrollment Period while still covered by the group plan.
Q11. What is the Annual Enrollment Period (AEP) for Medicare Advantage and Part D plans?
A. January 1 to March 31
B. April 1 to June 30
, C. October 15 to December 7
D. July 1 to September 30
Answer: C
Rationale: The AEP, also called the Annual Election Period, runs from October 15 to December
7 each year.
Q12. How many questions are included in the AHIP final exam?
A. 25
B. 50
C. 75
D. 100
Answer: B
Rationale: The AHIP final exam consists of 50 questions.
Q13. What is the minimum passing score required for the AHIP exam?
A. 70%
B. 80%
C. 90%
D. 95%
Answer: C
Rationale: Candidates must achieve a score of 90% on the 50-question final exam to pass.
Q14. How many attempts are allowed to pass the AHIP exam?
A. 1
B. 2
C. 3
D. Unlimited
Answer: C
Rationale: Candidates are allowed up to three attempts to pass the AHIP exam.
Q15. What does Medicare Part A cover?
A. Outpatient services, doctor visits, and preventive care
B. Inpatient hospital stays
