AHIP FINAL EXAM (MEDICARE ADVANTAGE & PART D)
{2 VERSIONS} QUESTIONS WITH ANSWERS AND
RATIONALES (2026 EDITION) LATEST UPDATE THIS YEAR
INSTANT DOWNLOAD PDF
Topics AHIP Medicare Advantage & Part D training typically emphasizes:
Medicare basics (Parts A, B, C, D)
Medicare Advantage (MA) plans: HMO, PPO, SNP, etc.
Part D benefit design, formularies, coverage phases
Eligibility, enrollment periods, and special enrollment
Compliance, ethics, fraud/waste/abuse (FWA)
Marketing, communications, and beneficiary protections
Care coordination, quality (Star Ratings), and health equity
Format: single best answer, correct option in bold, with a brief rationale. Use this
as a study aid only, not as the real AHIP exam.
Medicare Basics & Program Structure (Q1–25)
1. Which of the following best describes Medicare Part A?
A. Outpatient prescription drug coverage
B. Hospital Insurance covering inpatient hospital, skilled nursing facility,
,hospice, and some home health
C. Supplemental coverage for dental and vision only
D. Long-term care insurance
Part A is Hospital Insurance with inpatient-focused benefits.
2. A beneficiary is admitted as an inpatient to a hospital. Which part of
Medicare is primarily billed for this stay?
A. Part B
B. Part A
C. Part D
D. Medigap
Inpatient hospital services are covered under Part A.
3. Which of the following best describes Medicare Part B?
A. Inpatient hospital coverage only
B. Medical Insurance covering physician services, outpatient care, preventive
services, and some home health
C. Prescription drug coverage only
D. Long-term custodial care
Part B covers medically necessary outpatient and physician services.
,4. A beneficiary receives a routine office visit with a primary care provider.
Which part of Medicare is primarily used?
A. Part A
B. Part B
C. Part D
D. Medicaid
Office visits are Part B services.
5. Which of the following best describes Medicare Part C?
A. Original Medicare only
B. Medicare Advantage plans offered by private insurers that provide Part A and
Part B benefits, often with Part D
C. Stand-alone prescription drug plans only
D. Medigap supplemental plans
Part C is Medicare Advantage (MA), an alternative to Original Medicare.
6. A beneficiary enrolls in a Medicare Advantage HMO. Which statement is most
accurate?
A. They cannot have any drug coverage
B. They receive Part A and Part B benefits through the plan, often with
additional benefits
, C. They are no longer eligible for Medicare
D. They must use only out-of-network providers
MA plans deliver A and B benefits, often with extras and network rules.
7. Which of the following best describes Medicare Part D?
A. Hospital insurance
B. Voluntary outpatient prescription drug coverage offered through private
plans
C. Dental and vision coverage
D. Long-term care coverage
Part D provides outpatient drug coverage via PDPs and MA-PDs.
8. A beneficiary takes several brand-name medications and enrolls in a stand-
alone prescription drug plan. Which part of Medicare is this?
A. Part A
B. Part B
C. Part D
D. Part C
Stand-alone drug plans are Part D.
9. Which of the following best describes “Original Medicare”?
{2 VERSIONS} QUESTIONS WITH ANSWERS AND
RATIONALES (2026 EDITION) LATEST UPDATE THIS YEAR
INSTANT DOWNLOAD PDF
Topics AHIP Medicare Advantage & Part D training typically emphasizes:
Medicare basics (Parts A, B, C, D)
Medicare Advantage (MA) plans: HMO, PPO, SNP, etc.
Part D benefit design, formularies, coverage phases
Eligibility, enrollment periods, and special enrollment
Compliance, ethics, fraud/waste/abuse (FWA)
Marketing, communications, and beneficiary protections
Care coordination, quality (Star Ratings), and health equity
Format: single best answer, correct option in bold, with a brief rationale. Use this
as a study aid only, not as the real AHIP exam.
Medicare Basics & Program Structure (Q1–25)
1. Which of the following best describes Medicare Part A?
A. Outpatient prescription drug coverage
B. Hospital Insurance covering inpatient hospital, skilled nursing facility,
,hospice, and some home health
C. Supplemental coverage for dental and vision only
D. Long-term care insurance
Part A is Hospital Insurance with inpatient-focused benefits.
2. A beneficiary is admitted as an inpatient to a hospital. Which part of
Medicare is primarily billed for this stay?
A. Part B
B. Part A
C. Part D
D. Medigap
Inpatient hospital services are covered under Part A.
3. Which of the following best describes Medicare Part B?
A. Inpatient hospital coverage only
B. Medical Insurance covering physician services, outpatient care, preventive
services, and some home health
C. Prescription drug coverage only
D. Long-term custodial care
Part B covers medically necessary outpatient and physician services.
,4. A beneficiary receives a routine office visit with a primary care provider.
Which part of Medicare is primarily used?
A. Part A
B. Part B
C. Part D
D. Medicaid
Office visits are Part B services.
5. Which of the following best describes Medicare Part C?
A. Original Medicare only
B. Medicare Advantage plans offered by private insurers that provide Part A and
Part B benefits, often with Part D
C. Stand-alone prescription drug plans only
D. Medigap supplemental plans
Part C is Medicare Advantage (MA), an alternative to Original Medicare.
6. A beneficiary enrolls in a Medicare Advantage HMO. Which statement is most
accurate?
A. They cannot have any drug coverage
B. They receive Part A and Part B benefits through the plan, often with
additional benefits
, C. They are no longer eligible for Medicare
D. They must use only out-of-network providers
MA plans deliver A and B benefits, often with extras and network rules.
7. Which of the following best describes Medicare Part D?
A. Hospital insurance
B. Voluntary outpatient prescription drug coverage offered through private
plans
C. Dental and vision coverage
D. Long-term care coverage
Part D provides outpatient drug coverage via PDPs and MA-PDs.
8. A beneficiary takes several brand-name medications and enrolls in a stand-
alone prescription drug plan. Which part of Medicare is this?
A. Part A
B. Part B
C. Part D
D. Part C
Stand-alone drug plans are Part D.
9. Which of the following best describes “Original Medicare”?
