Test bank for AHIP Practice Questions — 1
to 109 with Answers & Rationales
(2025/2026 Style)
1. Medicare Part A primarily covers which type of
service?
Answer: Inpatient hospital care
Rationale: Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and
some home health services.
2. Enrollment in a Medicare Advantage plan requires the
beneficiary to:
Answer: Be enrolled in both Part A and Part B
Rationale: Medicare Advantage plans (Part C) require beneficiaries to have both Parts A and B
to receive coverage.
3. Which organization oversees Medicare marketing
rules?
Answer: CMS (Centers for Medicare & Medicaid Services)
Rationale: CMS regulates marketing, communications, and enrollment standards for Medicare
plans.
4. A Special Enrollment Period (SEP) is triggered when:
, Answer: A beneficiary permanently moves out of their plan’s service area
Rationale: SEPs allow enrollment changes due to qualifying events, such as moving, losing
coverage, or gaining dual eligibility.
5. Medicare Part B generally covers:
Answer: Physician services and outpatient care
Rationale: Part B covers medically necessary physician visits, outpatient services, preventive
services, and durable medical equipment.
6. Which benefit is not required in Medicare Advantage?
Answer: Hospice
Rationale: Hospice is still covered under Original Medicare even if the beneficiary is enrolled in
Medicare Advantage.
7. The Initial Coverage Election Period (ICEP) allows a
beneficiary to:
Answer: Enroll in MA when first becoming eligible for Medicare
Rationale: ICEP is the first opportunity for new Medicare beneficiaries to enroll in Part C or D
plans.
8. One goal of FWA laws is to:
Answer: Protect Medicare funds from improper payments
Rationale: FWA (Fraud, Waste, and Abuse) training ensures the integrity of the program and
prevents misuse of funds.
9. The Late Enrollment Penalty for Part D is based on:
Answer: Number of months without creditable coverage
Rationale: Penalties are calculated by the number of months a beneficiary went without
adequate Part D coverage.
10. A producer may contact a beneficiary only when:
Answer: The beneficiary provided permission to contact
Rationale: CMS rules require written or verbal permission before any marketing contact.
to 109 with Answers & Rationales
(2025/2026 Style)
1. Medicare Part A primarily covers which type of
service?
Answer: Inpatient hospital care
Rationale: Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and
some home health services.
2. Enrollment in a Medicare Advantage plan requires the
beneficiary to:
Answer: Be enrolled in both Part A and Part B
Rationale: Medicare Advantage plans (Part C) require beneficiaries to have both Parts A and B
to receive coverage.
3. Which organization oversees Medicare marketing
rules?
Answer: CMS (Centers for Medicare & Medicaid Services)
Rationale: CMS regulates marketing, communications, and enrollment standards for Medicare
plans.
4. A Special Enrollment Period (SEP) is triggered when:
, Answer: A beneficiary permanently moves out of their plan’s service area
Rationale: SEPs allow enrollment changes due to qualifying events, such as moving, losing
coverage, or gaining dual eligibility.
5. Medicare Part B generally covers:
Answer: Physician services and outpatient care
Rationale: Part B covers medically necessary physician visits, outpatient services, preventive
services, and durable medical equipment.
6. Which benefit is not required in Medicare Advantage?
Answer: Hospice
Rationale: Hospice is still covered under Original Medicare even if the beneficiary is enrolled in
Medicare Advantage.
7. The Initial Coverage Election Period (ICEP) allows a
beneficiary to:
Answer: Enroll in MA when first becoming eligible for Medicare
Rationale: ICEP is the first opportunity for new Medicare beneficiaries to enroll in Part C or D
plans.
8. One goal of FWA laws is to:
Answer: Protect Medicare funds from improper payments
Rationale: FWA (Fraud, Waste, and Abuse) training ensures the integrity of the program and
prevents misuse of funds.
9. The Late Enrollment Penalty for Part D is based on:
Answer: Number of months without creditable coverage
Rationale: Penalties are calculated by the number of months a beneficiary went without
adequate Part D coverage.
10. A producer may contact a beneficiary only when:
Answer: The beneficiary provided permission to contact
Rationale: CMS rules require written or verbal permission before any marketing contact.
