AHIP PRACTICE EXAM QUESTIONS AND ANSWERS | VERIFIED
ANSWERS GRADED A+ | LATEST EXAM 2025|2026
1. What does Medicare Part A primarily cover?
A. Doctor visits
B. Prescription drugs
C. Inpatient hospital care
D. Dental services
Correct Answer: C — Medicare Part A covers inpatient hospital care, skilled nursing facility
care, hospice, and limited home health services.
2. Which Medicare part covers outpatient medical services?
A. Part A
B. Part B
C. Part C
D. Part D
Correct Answer: B — Medicare Part B covers outpatient care such as doctor visits, preventive
services, and durable medical equipment.
3. Medicare Advantage plans are also known as:
A. Medigap plans
B. PDP plans
C. Part C plans
D. Employer group plans
Correct Answer: C — Medicare Advantage plans are referred to as Medicare Part C.
4. Which entity administers Original Medicare?
A. Private insurance companies
B. CMS
,C. State Medicaid offices
D. Employers
Correct Answer: B — The Centers for Medicare & Medicaid Services (CMS) administers
Original Medicare.
5. Which benefit is NOT covered by Original Medicare?
A. Hospital care
B. Preventive services
C. Prescription drugs
D. Doctor visits
Correct Answer: C — Prescription drug coverage requires Part D or a Medicare Advantage
plan.
6. What is the standard Medicare Part B premium based on?
A. Age
B. Health status
C. Income
D. Location
Correct Answer: C — Part B premiums are income-based under IRMAA rules.
7. When does Medicare coverage generally begin?
A. On the first day of the month after enrollment
B. On the enrollee’s birthday
C. On January 1
D. Immediately upon application
Correct Answer: A — Coverage usually begins the first day of the month of eligibility or
enrollment.
8. What does IRMAA stand for?
, A. Income-Related Monthly Adjustment Amount
B. Internal Revenue Medicare Adjustment Act
C. Individual Risk Medicare Assessment Amount
D. Insurance Rate Medicare Adjustment Agreement
Correct Answer: A — IRMAA adjusts Part B and Part D premiums based on income.
9. Which Medicare plan allows members to use providers nationwide?
A. HMO
B. PPO
C. SNP
D. HMO-POS
Correct Answer: B — PPO plans allow members to use both in-network and out-of-network
providers.
10. What is a Special Enrollment Period (SEP)?
A. Annual enrollment window
B. A penalty period
C. Enrollment triggered by a qualifying event
D. Employer-only enrollment
Correct Answer: C — SEPs occur due to qualifying life events such as moving or losing
coverage.
11. What is the Annual Election Period (AEP)?
A. January 1–March 31
B. October 15–December 7
C. April 1–June 30
D. July 1–September 30
Correct Answer: B — AEP runs from October 15 through December 7 each year.
12. During AEP, beneficiaries may:
ANSWERS GRADED A+ | LATEST EXAM 2025|2026
1. What does Medicare Part A primarily cover?
A. Doctor visits
B. Prescription drugs
C. Inpatient hospital care
D. Dental services
Correct Answer: C — Medicare Part A covers inpatient hospital care, skilled nursing facility
care, hospice, and limited home health services.
2. Which Medicare part covers outpatient medical services?
A. Part A
B. Part B
C. Part C
D. Part D
Correct Answer: B — Medicare Part B covers outpatient care such as doctor visits, preventive
services, and durable medical equipment.
3. Medicare Advantage plans are also known as:
A. Medigap plans
B. PDP plans
C. Part C plans
D. Employer group plans
Correct Answer: C — Medicare Advantage plans are referred to as Medicare Part C.
4. Which entity administers Original Medicare?
A. Private insurance companies
B. CMS
,C. State Medicaid offices
D. Employers
Correct Answer: B — The Centers for Medicare & Medicaid Services (CMS) administers
Original Medicare.
5. Which benefit is NOT covered by Original Medicare?
A. Hospital care
B. Preventive services
C. Prescription drugs
D. Doctor visits
Correct Answer: C — Prescription drug coverage requires Part D or a Medicare Advantage
plan.
6. What is the standard Medicare Part B premium based on?
A. Age
B. Health status
C. Income
D. Location
Correct Answer: C — Part B premiums are income-based under IRMAA rules.
7. When does Medicare coverage generally begin?
A. On the first day of the month after enrollment
B. On the enrollee’s birthday
C. On January 1
D. Immediately upon application
Correct Answer: A — Coverage usually begins the first day of the month of eligibility or
enrollment.
8. What does IRMAA stand for?
, A. Income-Related Monthly Adjustment Amount
B. Internal Revenue Medicare Adjustment Act
C. Individual Risk Medicare Assessment Amount
D. Insurance Rate Medicare Adjustment Agreement
Correct Answer: A — IRMAA adjusts Part B and Part D premiums based on income.
9. Which Medicare plan allows members to use providers nationwide?
A. HMO
B. PPO
C. SNP
D. HMO-POS
Correct Answer: B — PPO plans allow members to use both in-network and out-of-network
providers.
10. What is a Special Enrollment Period (SEP)?
A. Annual enrollment window
B. A penalty period
C. Enrollment triggered by a qualifying event
D. Employer-only enrollment
Correct Answer: C — SEPs occur due to qualifying life events such as moving or losing
coverage.
11. What is the Annual Election Period (AEP)?
A. January 1–March 31
B. October 15–December 7
C. April 1–June 30
D. July 1–September 30
Correct Answer: B — AEP runs from October 15 through December 7 each year.
12. During AEP, beneficiaries may:
