2027 AHIP FINAL EXAM — MEDICARE
CERTIFICATION PRACTICE TEST.
America's Health Insurance Plans | 2027 Update
1. A beneficiary turns 65 on March 15, 2027. Their Initial Enrollment Period (IEP)
for Medicare Part A and Part B begins and ends on which dates?
A) January 1, 2027 – March 31, 2027
B) March 1, 2027 – September 30, 2027
C) December 1, 2026 – June 30, 2027
D) March 1, 2027 – July 31, 2027
2. Which of the following individuals is NOT eligible for Medicare based on the
standard eligibility criteria?
A) A 66-year-old who has worked and paid Medicare taxes for 12 years
B) A 62-year-old with Amyotrophic Lateral Sclerosis (ALS) who receives Social
Security Disability Insurance (SSDI)
C) A 55-year-old with End-Stage Renal Disease (ESRD) requiring dialysis who has
paid Medicare taxes for 8 years
D) A 64-year-old who has been receiving SSDI benefits for 28 months
3. Medicare Part A primarily covers which of the following services?
A) Outpatient physician visits, preventive screenings, and durable medical
equipment
B) Inpatient hospital stays, skilled nursing facility care, hospice, and limited home
health services
C) Prescription medications obtained at retail pharmacies
D) Routine dental, vision, and hearing services
4. A beneficiary is enrolled in Original Medicare (Parts A and B) and wants
coverage for prescription drugs. Which option is NOT available to them?
A) Enrolling in a standalone Medicare Part D Prescription Drug Plan (PDP)
B) Enrolling in a Medicare Advantage Prescription Drug plan (MA-PD)
,C) Purchasing a Medigap policy that includes prescription drug coverage
D) Using a Medicare Medical Savings Account (MSA) plan with integrated drug
coverage
5. Which statement accurately describes the difference between Medicare
Advantage (Part C) and Medigap (Medicare Supplement Insurance)?
A) Medigap plans are offered by private insurers and replace Original Medicare,
while Medicare Advantage supplements Original Medicare coverage
B) Medicare Advantage plans replace Original Medicare and often include
additional benefits, while Medigap policies supplement Original Medicare by
covering cost-sharing
C) Both Medicare Advantage and Medigap are government-run programs with
identical coverage rules nationwide
D) Medigap plans are only available to beneficiaries under age 65, while Medicare
Advantage is for those 65 and older
6. A 68-year-old beneficiary loses employer-sponsored health coverage when they
retire on June 1, 2027. They have been enrolled in Medicare Part A since age 65
but delayed Part B because they had employer coverage. What enrollment period
applies for signing up for Part B?
A) Initial Enrollment Period
B) General Enrollment Period
C) Special Enrollment Period (SEP)
D) Medicare Advantage Open Enrollment Period
7. The Medicare General Enrollment Period (GEP) occurs annually from:
A) October 15 – December 7
B) January 1 – March 31
C) April 1 – June 30
D) July 1 – September 30
8. A beneficiary enrolled in a Medicare Advantage plan wants to switch to Original
Medicare with a Medigap policy during the Medicare Advantage Open Enrollment
Period (MA OEP). Which statement is correct?
, A) They can switch to another Medicare Advantage plan or return to Original
Medicare, but they are not guaranteed Medigap coverage
B) They can only switch to another Medicare Advantage plan; returning to
Original Medicare is prohibited during this period
C) They are automatically enrolled in a Medigap plan when they return to Original
Medicare
D) The MA OEP runs from October 15 – December 7 each year
Medicare Advantage (Part C) (Questions 9–14)
9. A beneficiary enrolled in a Medicare Advantage HMO plan visits a specialist
without obtaining a required referral from their primary care physician. What is
the most likely outcome?
A) The plan will cover the visit at 100% because all Medicare Advantage plans
cover specialist visits without referrals
B) The beneficiary will be responsible for the full cost of the visit unless it
qualifies as an emergency
C) The plan will cover 80% of the cost, and the beneficiary pays 20% coinsurance
D) The beneficiary can file an appeal, and the plan must retroactively approve the
referral
10. Which Medicare Advantage plan type allows beneficiaries to see any
Medicare-approved provider who accepts the plan's payment terms, without
network restrictions?
A) Health Maintenance Organization (HMO)
B) Preferred Provider Organization (PPO)
C) Private Fee-for-Service (PFFS)
D) Special Needs Plan (SNP)
11. A Special Needs Plan (SNP) is designed specifically for which populations?
A) Only beneficiaries under age 65 with disabilities
B) Beneficiaries with specific diseases, dual eligibles, or those institutionalized in
long-term care facilities
C) Any beneficiary who wants enhanced dental and vision benefits
D) Beneficiaries who travel frequently and need nationwide coverage
CERTIFICATION PRACTICE TEST.
America's Health Insurance Plans | 2027 Update
1. A beneficiary turns 65 on March 15, 2027. Their Initial Enrollment Period (IEP)
for Medicare Part A and Part B begins and ends on which dates?
A) January 1, 2027 – March 31, 2027
B) March 1, 2027 – September 30, 2027
C) December 1, 2026 – June 30, 2027
D) March 1, 2027 – July 31, 2027
2. Which of the following individuals is NOT eligible for Medicare based on the
standard eligibility criteria?
A) A 66-year-old who has worked and paid Medicare taxes for 12 years
B) A 62-year-old with Amyotrophic Lateral Sclerosis (ALS) who receives Social
Security Disability Insurance (SSDI)
C) A 55-year-old with End-Stage Renal Disease (ESRD) requiring dialysis who has
paid Medicare taxes for 8 years
D) A 64-year-old who has been receiving SSDI benefits for 28 months
3. Medicare Part A primarily covers which of the following services?
A) Outpatient physician visits, preventive screenings, and durable medical
equipment
B) Inpatient hospital stays, skilled nursing facility care, hospice, and limited home
health services
C) Prescription medications obtained at retail pharmacies
D) Routine dental, vision, and hearing services
4. A beneficiary is enrolled in Original Medicare (Parts A and B) and wants
coverage for prescription drugs. Which option is NOT available to them?
A) Enrolling in a standalone Medicare Part D Prescription Drug Plan (PDP)
B) Enrolling in a Medicare Advantage Prescription Drug plan (MA-PD)
,C) Purchasing a Medigap policy that includes prescription drug coverage
D) Using a Medicare Medical Savings Account (MSA) plan with integrated drug
coverage
5. Which statement accurately describes the difference between Medicare
Advantage (Part C) and Medigap (Medicare Supplement Insurance)?
A) Medigap plans are offered by private insurers and replace Original Medicare,
while Medicare Advantage supplements Original Medicare coverage
B) Medicare Advantage plans replace Original Medicare and often include
additional benefits, while Medigap policies supplement Original Medicare by
covering cost-sharing
C) Both Medicare Advantage and Medigap are government-run programs with
identical coverage rules nationwide
D) Medigap plans are only available to beneficiaries under age 65, while Medicare
Advantage is for those 65 and older
6. A 68-year-old beneficiary loses employer-sponsored health coverage when they
retire on June 1, 2027. They have been enrolled in Medicare Part A since age 65
but delayed Part B because they had employer coverage. What enrollment period
applies for signing up for Part B?
A) Initial Enrollment Period
B) General Enrollment Period
C) Special Enrollment Period (SEP)
D) Medicare Advantage Open Enrollment Period
7. The Medicare General Enrollment Period (GEP) occurs annually from:
A) October 15 – December 7
B) January 1 – March 31
C) April 1 – June 30
D) July 1 – September 30
8. A beneficiary enrolled in a Medicare Advantage plan wants to switch to Original
Medicare with a Medigap policy during the Medicare Advantage Open Enrollment
Period (MA OEP). Which statement is correct?
, A) They can switch to another Medicare Advantage plan or return to Original
Medicare, but they are not guaranteed Medigap coverage
B) They can only switch to another Medicare Advantage plan; returning to
Original Medicare is prohibited during this period
C) They are automatically enrolled in a Medigap plan when they return to Original
Medicare
D) The MA OEP runs from October 15 – December 7 each year
Medicare Advantage (Part C) (Questions 9–14)
9. A beneficiary enrolled in a Medicare Advantage HMO plan visits a specialist
without obtaining a required referral from their primary care physician. What is
the most likely outcome?
A) The plan will cover the visit at 100% because all Medicare Advantage plans
cover specialist visits without referrals
B) The beneficiary will be responsible for the full cost of the visit unless it
qualifies as an emergency
C) The plan will cover 80% of the cost, and the beneficiary pays 20% coinsurance
D) The beneficiary can file an appeal, and the plan must retroactively approve the
referral
10. Which Medicare Advantage plan type allows beneficiaries to see any
Medicare-approved provider who accepts the plan's payment terms, without
network restrictions?
A) Health Maintenance Organization (HMO)
B) Preferred Provider Organization (PPO)
C) Private Fee-for-Service (PFFS)
D) Special Needs Plan (SNP)
11. A Special Needs Plan (SNP) is designed specifically for which populations?
A) Only beneficiaries under age 65 with disabilities
B) Beneficiaries with specific diseases, dual eligibles, or those institutionalized in
long-term care facilities
C) Any beneficiary who wants enhanced dental and vision benefits
D) Beneficiaries who travel frequently and need nationwide coverage
