AHIP 2027 Final Exam –Newest Questions & Answers
Complete Medicare Certification Study Guide | Latest
2026/2027 | 100% Verified
SECTION 1: MEDICARE ELIGIBILITY & PARTS A, B, C, AND D (Questions 1–25)
1. Mr. Chen is turning 65 next month and currently has employer-sponsored coverage
through a large company with over 100 employees. He is considering whether to
enroll in Medicare Part B. What should you tell him about his eligibility and
enrollment?
A) He must enroll in Part B during his Initial Enrollment Period to avoid a late enrollment
penalty, regardless of his employer coverage
B) He can delay Part B enrollment without penalty if he has creditable employer
coverage through a large employer, and he will have a Special Enrollment Period
when that coverage ends
C) He cannot delay Part B enrollment because he is turning 65
D) He should enroll in Part B now to receive preventive services at no cost
,Answer: B
Individuals who are turning 65 and have creditable employer coverage through a large
employer (20+ employees) can delay Medicare Part B enrollment without penalty. They will
have a Special Enrollment Period (SEP) to enroll in Part B when the employer coverage
ends or employment ends, whichever comes first. This is a common scenario tested on the
AHIP exam .
2. Mrs. Johnson is 67 and has been enrolled in Original Medicare (Parts A and B)
since age 65. She is considering enrolling in a Medicare Advantage (MA) plan. Which
of the following is TRUE regarding her eligibility?
A) She must be enrolled in Part A and Part B to join an MA plan
B) She can join an MA plan with Part A only
C) She must live outside the plan's service area to be eligible
D) She cannot join an MA plan because she is over 65
Answer: A
To enroll in a Medicare Advantage plan, a beneficiary must be entitled to Part A and
enrolled in Part B. Additionally, the beneficiary must reside in the plan's service area .
3. Medicare Part A primarily covers which of the following services?
,A) Outpatient physician services and durable medical equipment
B) Inpatient hospital stays, skilled nursing facility care, hospice, and some home
health care
C) Prescription drugs
D) Routine dental and vision care
Answer: B
Medicare Part A is "hospital insurance." It covers inpatient hospital stays, skilled nursing
facility care (not custodial care), hospice care, and some home health services. Most
beneficiaries do not pay a Part A premium if they or their spouse paid Medicare taxes for 40
quarters .
4. Mr. Vasquez is in good health and is preparing a budget in anticipation of his
retirement. He wants to understand his costs for inpatient hospital services under
Original Medicare. What should you tell him?
A) He will pay a copayment for each day of a hospital stay with no deductible
B) Under Original Medicare, there is a single deductible amount due for the first 60
days of any inpatient hospital stay, after which it converts into a per-day coinsurance
amount through day 90. After day 90, he would pay a daily amount up to 60 days over
his lifetime, after which he would be responsible for all costs
C) Original Medicare covers 100% of all hospital costs with no cost-sharing
D) He will pay a monthly premium for Part A hospital coverage
Answer: B
, Original Medicare Part A has a benefit period structure: a deductible for days 1-60, daily
coinsurance for days 61-90, and lifetime reserve days after day 90. Beneficiaries should
understand these cost-sharing obligations when planning for healthcare costs in retirement .
5. Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare
Advantage plan. What should you tell him?
A) He must enroll in a Medicare Advantage plan to get drug coverage
B) Mr. Singh can enroll in a stand-alone Prescription Drug Plan (PDP) and continue to
be covered for Part A and Part B services through Original Fee-for-Service Medicare
C) He cannot get drug coverage unless he enrolls in Part C
D) He should purchase a Medigap plan that includes drug coverage
Answer: B
Beneficiaries who prefer Original Medicare (Parts A and B) can obtain prescription drug
coverage through a stand-alone Part D Prescription Drug Plan (PDP). This allows them to
retain Original Medicare while adding drug benefits. Many Medigap plans do not include
drug coverage .
6. Medicare Part D provides which of the following?
A) Inpatient hospital coverage
B) Outpatient physician coverage
Complete Medicare Certification Study Guide | Latest
2026/2027 | 100% Verified
SECTION 1: MEDICARE ELIGIBILITY & PARTS A, B, C, AND D (Questions 1–25)
1. Mr. Chen is turning 65 next month and currently has employer-sponsored coverage
through a large company with over 100 employees. He is considering whether to
enroll in Medicare Part B. What should you tell him about his eligibility and
enrollment?
A) He must enroll in Part B during his Initial Enrollment Period to avoid a late enrollment
penalty, regardless of his employer coverage
B) He can delay Part B enrollment without penalty if he has creditable employer
coverage through a large employer, and he will have a Special Enrollment Period
when that coverage ends
C) He cannot delay Part B enrollment because he is turning 65
D) He should enroll in Part B now to receive preventive services at no cost
,Answer: B
Individuals who are turning 65 and have creditable employer coverage through a large
employer (20+ employees) can delay Medicare Part B enrollment without penalty. They will
have a Special Enrollment Period (SEP) to enroll in Part B when the employer coverage
ends or employment ends, whichever comes first. This is a common scenario tested on the
AHIP exam .
2. Mrs. Johnson is 67 and has been enrolled in Original Medicare (Parts A and B)
since age 65. She is considering enrolling in a Medicare Advantage (MA) plan. Which
of the following is TRUE regarding her eligibility?
A) She must be enrolled in Part A and Part B to join an MA plan
B) She can join an MA plan with Part A only
C) She must live outside the plan's service area to be eligible
D) She cannot join an MA plan because she is over 65
Answer: A
To enroll in a Medicare Advantage plan, a beneficiary must be entitled to Part A and
enrolled in Part B. Additionally, the beneficiary must reside in the plan's service area .
3. Medicare Part A primarily covers which of the following services?
,A) Outpatient physician services and durable medical equipment
B) Inpatient hospital stays, skilled nursing facility care, hospice, and some home
health care
C) Prescription drugs
D) Routine dental and vision care
Answer: B
Medicare Part A is "hospital insurance." It covers inpatient hospital stays, skilled nursing
facility care (not custodial care), hospice care, and some home health services. Most
beneficiaries do not pay a Part A premium if they or their spouse paid Medicare taxes for 40
quarters .
4. Mr. Vasquez is in good health and is preparing a budget in anticipation of his
retirement. He wants to understand his costs for inpatient hospital services under
Original Medicare. What should you tell him?
A) He will pay a copayment for each day of a hospital stay with no deductible
B) Under Original Medicare, there is a single deductible amount due for the first 60
days of any inpatient hospital stay, after which it converts into a per-day coinsurance
amount through day 90. After day 90, he would pay a daily amount up to 60 days over
his lifetime, after which he would be responsible for all costs
C) Original Medicare covers 100% of all hospital costs with no cost-sharing
D) He will pay a monthly premium for Part A hospital coverage
Answer: B
, Original Medicare Part A has a benefit period structure: a deductible for days 1-60, daily
coinsurance for days 61-90, and lifetime reserve days after day 90. Beneficiaries should
understand these cost-sharing obligations when planning for healthcare costs in retirement .
5. Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare
Advantage plan. What should you tell him?
A) He must enroll in a Medicare Advantage plan to get drug coverage
B) Mr. Singh can enroll in a stand-alone Prescription Drug Plan (PDP) and continue to
be covered for Part A and Part B services through Original Fee-for-Service Medicare
C) He cannot get drug coverage unless he enrolls in Part C
D) He should purchase a Medigap plan that includes drug coverage
Answer: B
Beneficiaries who prefer Original Medicare (Parts A and B) can obtain prescription drug
coverage through a stand-alone Part D Prescription Drug Plan (PDP). This allows them to
retain Original Medicare while adding drug benefits. Many Medigap plans do not include
drug coverage .
6. Medicare Part D provides which of the following?
A) Inpatient hospital coverage
B) Outpatient physician coverage
