AHIP (America’s Health Insurance Plans) 2027
NEWEST VERSION 50 Questions with Verified
Correct Answers | GRADED A+
Typical content domains include:
1. Medicare eligibility & enrollment (Parts A/B, MA, Part D, Medigap basics)
2. Medicare Advantage (Part C) plan types, benefits, costs, network rules
3. Part D coverage phases, formulary, MTM, LIS/subsidies
4. Enrollment periods (IEP, ICEP, AEP, OEP, SEPs, MA Disenrollment, etc.)
5. Compliance & ethics: marketing rules, SOA, documentation, fraud/waste/abuse,
grievances/appeals, star ratings impact.stuvia+2
Medicare Basics & Eligibility (Q1–10)
Q1. A 66-year-old U.S. citizen with 40 quarters of Medicare taxes is eligible for which
Medicare parts without premium for hospital insurance?
A. Part B only
B. Part A only
C. Part D only
D. Medigap only
,B. Part A only
Part A is premium-free with sufficient work history.
Q2. A 65-year-old enrolls in Part B during their Initial Enrollment Period and receives a
notice of income-related monthly adjustment. What does this adjustment affect?
A. Part A premium only
B. Part B and Part D premiums
C. Medigap premium only
D. Medicare Advantage premium only
B. Part B and Part D premiums
IRMAA applies to B and D.
Q3. A 62-year-old with end-stage renal disease asks about Medicare eligibility before age
65. Which statement is correct?
A. Not eligible until age 65
B. Eligible based on ESRD criteria regardless of age
C. Eligible only with disability from SSA
D. Eligible only with Medicaid
B. Eligible based on ESRD criteria regardless of age
ESRD qualifies for Medicare.
Q4. A 70-year-old with Original Medicare wants prescription drug coverage but does not
want a Medicare Advantage plan. Which option is appropriate?
, A. Enroll in standalone Part D plan
B. Enroll in Medigap Plan G only
C. Enroll in MA only
D. No drug coverage allowed
A. Enroll in standalone Part D plan
Part D adds drug coverage to Original Medicare.
Q5. A 65-year-old delays Part B because they have employer group coverage. When can
they enroll without penalty later?
A. Never, must enroll at 65
B. During a Special Enrollment Period while or soon after coverage ends
C. Only during AEP each year
D. Only during OEP
B. During a Special Enrollment Period while or soon after coverage ends
SEP for employer coverage.
Q6. A beneficiary with Original Medicare and Medigap Plan G asks about out-of-pocket
costs for Part B services. Which statement is most accurate?
A. All costs are fully covered with no copays
B. Plan G covers most Part B cost-sharing after deductible
C. Plan G does not cover any Part B costs
D. Plan G covers Part D drugs only
B. Plan G covers most Part B cost-sharing after deductible
Medigap G is comprehensive.
NEWEST VERSION 50 Questions with Verified
Correct Answers | GRADED A+
Typical content domains include:
1. Medicare eligibility & enrollment (Parts A/B, MA, Part D, Medigap basics)
2. Medicare Advantage (Part C) plan types, benefits, costs, network rules
3. Part D coverage phases, formulary, MTM, LIS/subsidies
4. Enrollment periods (IEP, ICEP, AEP, OEP, SEPs, MA Disenrollment, etc.)
5. Compliance & ethics: marketing rules, SOA, documentation, fraud/waste/abuse,
grievances/appeals, star ratings impact.stuvia+2
Medicare Basics & Eligibility (Q1–10)
Q1. A 66-year-old U.S. citizen with 40 quarters of Medicare taxes is eligible for which
Medicare parts without premium for hospital insurance?
A. Part B only
B. Part A only
C. Part D only
D. Medigap only
,B. Part A only
Part A is premium-free with sufficient work history.
Q2. A 65-year-old enrolls in Part B during their Initial Enrollment Period and receives a
notice of income-related monthly adjustment. What does this adjustment affect?
A. Part A premium only
B. Part B and Part D premiums
C. Medigap premium only
D. Medicare Advantage premium only
B. Part B and Part D premiums
IRMAA applies to B and D.
Q3. A 62-year-old with end-stage renal disease asks about Medicare eligibility before age
65. Which statement is correct?
A. Not eligible until age 65
B. Eligible based on ESRD criteria regardless of age
C. Eligible only with disability from SSA
D. Eligible only with Medicaid
B. Eligible based on ESRD criteria regardless of age
ESRD qualifies for Medicare.
Q4. A 70-year-old with Original Medicare wants prescription drug coverage but does not
want a Medicare Advantage plan. Which option is appropriate?
, A. Enroll in standalone Part D plan
B. Enroll in Medigap Plan G only
C. Enroll in MA only
D. No drug coverage allowed
A. Enroll in standalone Part D plan
Part D adds drug coverage to Original Medicare.
Q5. A 65-year-old delays Part B because they have employer group coverage. When can
they enroll without penalty later?
A. Never, must enroll at 65
B. During a Special Enrollment Period while or soon after coverage ends
C. Only during AEP each year
D. Only during OEP
B. During a Special Enrollment Period while or soon after coverage ends
SEP for employer coverage.
Q6. A beneficiary with Original Medicare and Medigap Plan G asks about out-of-pocket
costs for Part B services. Which statement is most accurate?
A. All costs are fully covered with no copays
B. Plan G covers most Part B cost-sharing after deductible
C. Plan G does not cover any Part B costs
D. Plan G covers Part D drugs only
B. Plan G covers most Part B cost-sharing after deductible
Medigap G is comprehensive.
