2026 AHIP
FINAL EXAM
Verified Edition with Rationales
Questions and Correct Answers with Detailed Explanations
Medicare Parts A, B, C & D | Medicare Advantage | Medigap | Enrollment | Compliance
Complete Update 2026 with Verified Solutions
Total Questions 100
Medicare Parts A-D, Medicare Advantage,
Topics
Medigap, Enrollment Periods, PDP, SNP,
Compliance, Marketing
Format Multiple Choice with Correct Answers &
Rationales
Version AHIP 2026 - Latest Verified Edition
,Section 1: Medicare Basics (Parts A, B, C & D)
This section covers the fundamentals of the Medicare program, including eligibility,
coverage under each Part, premiums, deductibles, and cost-sharing. (Questions 1-25)
Question 1 of 100
Which of the following best describes Medicare Part A?
A. It covers outpatient medical services and doctor visits
B. It covers inpatient hospital care, skilled nursing facility care, hospice, and some
home health services
C. It covers prescription drugs only
D. It covers vision, dental, and hearing services exclusively
Correct Answer: B
Rationale: Medicare Part A is hospital insurance that covers inpatient hospital
stays, skilled nursing facility care, hospice care, and limited home health services.
Outpatient services are covered under Part B, and prescription drugs are covered
under Part D.
Question 2 of 100
Which of the following individuals is generally eligible for Medicare?
A. Anyone who purchases a private health insurance plan
B. People age 65 or older who are U.S. citizens or legal residents for at least 5 years
C. Onlypeople who are currently employed full-time
D. Anyone under age 65 regardless of disability status
Correct Answer: B
Rationale: Medicare eligibility generally begins at age 65 for U.S. citizens or
legal residents who have lived in the U.S. for at least 5 continuous years. People
under 65 may qualify if they have certain disabilities or End-Stage Renal Disease
(ESRD).
Question 3 of 100
What is the standard premium for Medicare Part A for most beneficiaries?
A. $174.70 per month
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2026 AHIP Final Exam - Verified Edition with Rationales
, B. $0 (premium-free) for most beneficiaries who paid Medicare taxes
C. $500 per month
D. $50 per month
Correct Answer: B
Rationale: Most people do not pay a premium for Part A because they or their
spouse paid Medicare taxes while working. Those who must buy Part A may pay
up to $505 per month (2026 figure) if they have fewer than 30 quarters of
Medicare-covered employment.
Question 4 of 100
Which of the following services is covered under Medicare Part B?
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2026 AHIP Final Exam - Verified Edition with Rationales
, A. Inpatienthospital stays
B. Doctor visits, outpatient care, preventive services, and medical equipment
C. Prescription
drugs obtained at a pharmacy
D. Long-term custodial care in a nursing home
Correct Answer: B
Rationale: Medicare Part B covers medically necessary outpatient services
including doctor visits, outpatient care, preventive services (like screenings and
vaccinations), durable medical equipment, and some home health services. Part A
covers inpatient care, and Part D covers prescription drugs.
Question 5 of 100
What is the Medicare Part B late enrollment penalty based on?
A. A flat fee of $100 per year
B. 10% of the Part B premium for each full 12-month period the person could
have had Part B but did not enroll
C. A one-time penalty of $500
D. 5% of annual income
Correct Answer: B
Rationale: The Part B late enrollment penalty is 10% of the Part B premium for
each full 12-month period an individual was eligible for Part B but did not enroll.
This penalty is added to the monthly premium and typically lasts as long as the
person has Part B.
Question 6 of 100
Which of the following statements about Medicare Part C (Medicare Advantage) is correct?
A. Part C is a separate Medicare program that replaces Parts A and B
B. Part C plans are offered by private insurance companies approved by Medicare
and must cover all services that Original Medicare covers
C. Part C only covers prescription drugs
D. Part C is available only to people with low income
Correct Answer: B
Rationale: Medicare Advantage (Part C) plans are offered by Medicare-approved
private insurance companies. They must cover all services that Original Medicare
(Parts A and B) covers, and most also include prescription drug coverage (Part
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2026 AHIP Final Exam - Verified Edition with Rationales
FINAL EXAM
Verified Edition with Rationales
Questions and Correct Answers with Detailed Explanations
Medicare Parts A, B, C & D | Medicare Advantage | Medigap | Enrollment | Compliance
Complete Update 2026 with Verified Solutions
Total Questions 100
Medicare Parts A-D, Medicare Advantage,
Topics
Medigap, Enrollment Periods, PDP, SNP,
Compliance, Marketing
Format Multiple Choice with Correct Answers &
Rationales
Version AHIP 2026 - Latest Verified Edition
,Section 1: Medicare Basics (Parts A, B, C & D)
This section covers the fundamentals of the Medicare program, including eligibility,
coverage under each Part, premiums, deductibles, and cost-sharing. (Questions 1-25)
Question 1 of 100
Which of the following best describes Medicare Part A?
A. It covers outpatient medical services and doctor visits
B. It covers inpatient hospital care, skilled nursing facility care, hospice, and some
home health services
C. It covers prescription drugs only
D. It covers vision, dental, and hearing services exclusively
Correct Answer: B
Rationale: Medicare Part A is hospital insurance that covers inpatient hospital
stays, skilled nursing facility care, hospice care, and limited home health services.
Outpatient services are covered under Part B, and prescription drugs are covered
under Part D.
Question 2 of 100
Which of the following individuals is generally eligible for Medicare?
A. Anyone who purchases a private health insurance plan
B. People age 65 or older who are U.S. citizens or legal residents for at least 5 years
C. Onlypeople who are currently employed full-time
D. Anyone under age 65 regardless of disability status
Correct Answer: B
Rationale: Medicare eligibility generally begins at age 65 for U.S. citizens or
legal residents who have lived in the U.S. for at least 5 continuous years. People
under 65 may qualify if they have certain disabilities or End-Stage Renal Disease
(ESRD).
Question 3 of 100
What is the standard premium for Medicare Part A for most beneficiaries?
A. $174.70 per month
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2026 AHIP Final Exam - Verified Edition with Rationales
, B. $0 (premium-free) for most beneficiaries who paid Medicare taxes
C. $500 per month
D. $50 per month
Correct Answer: B
Rationale: Most people do not pay a premium for Part A because they or their
spouse paid Medicare taxes while working. Those who must buy Part A may pay
up to $505 per month (2026 figure) if they have fewer than 30 quarters of
Medicare-covered employment.
Question 4 of 100
Which of the following services is covered under Medicare Part B?
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2026 AHIP Final Exam - Verified Edition with Rationales
, A. Inpatienthospital stays
B. Doctor visits, outpatient care, preventive services, and medical equipment
C. Prescription
drugs obtained at a pharmacy
D. Long-term custodial care in a nursing home
Correct Answer: B
Rationale: Medicare Part B covers medically necessary outpatient services
including doctor visits, outpatient care, preventive services (like screenings and
vaccinations), durable medical equipment, and some home health services. Part A
covers inpatient care, and Part D covers prescription drugs.
Question 5 of 100
What is the Medicare Part B late enrollment penalty based on?
A. A flat fee of $100 per year
B. 10% of the Part B premium for each full 12-month period the person could
have had Part B but did not enroll
C. A one-time penalty of $500
D. 5% of annual income
Correct Answer: B
Rationale: The Part B late enrollment penalty is 10% of the Part B premium for
each full 12-month period an individual was eligible for Part B but did not enroll.
This penalty is added to the monthly premium and typically lasts as long as the
person has Part B.
Question 6 of 100
Which of the following statements about Medicare Part C (Medicare Advantage) is correct?
A. Part C is a separate Medicare program that replaces Parts A and B
B. Part C plans are offered by private insurance companies approved by Medicare
and must cover all services that Original Medicare covers
C. Part C only covers prescription drugs
D. Part C is available only to people with low income
Correct Answer: B
Rationale: Medicare Advantage (Part C) plans are offered by Medicare-approved
private insurance companies. They must cover all services that Original Medicare
(Parts A and B) covers, and most also include prescription drug coverage (Part
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2026 AHIP Final Exam - Verified Edition with Rationales
