AHIP CERTIFIED
OBJECTIVE ASSESSMENT - EXAM
AHIP 2026/2027 Module 1 to 5
Exam Questions and Verified Answers
100% Guarantee Pass 2026/2027
Medicare Advantage + Part D Certification Exam
50 100%
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
* Medicare Program Basics * Marketing Compliance Rules
* Medicare Health Plans * Enrollment Periods & SEPs
* Part D Drug Coverage * Fraud, Waste & Abuse
AHIP - 2026/2027 | Passing Score: 80% | Page 1 of 52 COVER PAGE - 1
, SECTION 1 | Overview of Medicare Program Basics | Q1-Q10 | AHIP 2026/2027
Q1 Question 1 of 50
Mrs. Alvarez, age 68, recently retired and is reviewing her Medicare coverage options. She
asks you whether she must enroll in Medicare Part B if she already has premium-free Part A.
What is the most accurate guidance you can provide?
A. Part B is optional, but if she delays enrollment without other creditable coverage, she will face a
lifetime late enrollment penalty and may have to wait for a General Enrollment Period.
B. Enrollment in Part B is mandatory for all Medicare beneficiaries, and failure to enroll will result in
immediate loss of Part A coverage.
C. Part B enrollment is only required for beneficiaries with incomes above the federal poverty level,
so she can defer indefinitely without penalty.
D. Since she has premium-free Part A, Part B is automatically included at no additional cost and
requires no separate action on her part.
Correct Answer: A
Rationale:
Part B is voluntary, but delaying enrollment without creditable employer coverage triggers a 10% per-year
lifetime late enrollment penalty and limited enrollment windows. Option B is wrong because Part A is not
contingent on Part B. Option C incorrectly ties Part B to income. Option D is wrong because Part B has a
separate monthly premium.
Q2 Question 2 of 50
Mr. Chen, age 72, has Original Medicare and is hospitalized for pneumonia. He stays in the
hospital for 75 days. Which statement accurately describes his cost-sharing responsibility
under Medicare Part A for this inpatient stay?
A. He pays nothing for the first 60 days, then a flat copayment for each additional day regardless of
how long the stay lasts.
B. He pays the Part A deductible for days 1-60, then a daily coinsurance for days 61-90, and finally
uses lifetime reserve days for days 91 onward.
C. He pays the Part A deductible only once per calendar year, covering the entire 75-day stay with
no additional cost-sharing.
D. He is responsible for the full cost of the hospitalization because pneumonia is not on Medicare's
list of covered inpatient conditions.
Correct Answer: D
AHIP - 2026/2027 | Passing Score: 80% | Page 2 of 52
, SECTION 1 | Overview of Medicare Program Basics | Q1-Q10 | AHIP 2026/2027
Rationale:
Under Part A, the beneficiary pays the inpatient deductible for the benefit period covering days 1-60, then a
daily coinsurance for days 61-90, and lifetime reserve days (with higher coinsurance) for days 91-150.
Option A understates the cost structure. Option B is wrong because it misstates the deductible timing. Option
C is wrong because the deductible applies per benefit period, not per year.
Q3 Question 3 of 50
Ms. Thompson, age 70, visits her primary care physician for an annual wellness visit and a flu
shot. She also receives a blood test that her doctor deems medically necessary. Which of
these services is covered at 100% under Medicare Part B with no cost-sharing to the
beneficiary?
A. The seasonal influenza vaccine administered during the office visit, which is classified as a
preventive service covered at 100%.
B. The office visit copayment for seeing her primary care physician, which is waived for all
beneficiaries over age 65.
C. The medically necessary blood test ordered by her physician to monitor her chronic condition,
which is subject to the Part B deductible and 20% coinsurance.
D. The cost of her transportation to and from the physician's office, which Medicare covers as an
essential component of medical care.
Correct Answer: A
Rationale:
Preventive services like annual wellness visits, flu shots, and pneumococcal vaccines are covered at 100%
under Part B. Option B is wrong because office visit copayments are not waived based on age. Option C
describes a diagnostic test subject to cost-sharing. Option D is wrong because Medicare does not cover
transportation to routine appointments.
AHIP - 2026/2027 | Passing Score: 80% | Page 3 of 52
, SECTION 1 | Overview of Medicare Program Basics | Q1-Q10 | AHIP 2026/2027
Q4 Question 4 of 50
Mr. Jackson, age 65, has been receiving Social Security disability benefits for 20 months due
to a severe heart condition. He asks when he will become eligible for Medicare. What should
you tell him?
A. He must wait until age 65 regardless of his disability status, as Medicare eligibility is strictly
age-based for all beneficiaries.
B. He is already eligible because heart conditions qualify for immediate Medicare coverage upon
disability approval, with no waiting period.
C. He must submit a separate application to CMS and wait for a determination, which typically
takes 90 days from the date of application.
D. He will be automatically enrolled in Medicare after receiving disability benefits for 24 months,
with coverage beginning in the 25th month.
Correct Answer: D
Rationale:
Individuals under 65 who receive Social Security disability benefits for 24 months are automatically enrolled
in Medicare in the 25th month. Option A is wrong because disability creates an eligibility pathway before age
65. Option B is wrong because there is a 24-month waiting period for most disabilities (ALS and ESRD are
exceptions). Option C is incorrect because enrollment is automatic, not application-based.
Q5 Question 5 of 50
Mrs. Patel, age 66, has Original Medicare and is considering whether to purchase a Medigap
policy. She wants to know which of the following costs a Medigap plan would most likely help
cover. What is the correct answer?
A. Her monthly Medicare Part B premium, which Medigap plans are required to pay on her behalf.
B. The Medicare Part A hospital deductible and Part B coinsurance for physician services, which
are common gaps in Original Medicare.
C. The cost of long-term custodial care in a nursing home, which Original Medicare does not cover
at all.
D. Her prescription drug costs, since all Medigap plans sold after 2010 include Part D drug
coverage as a standard benefit.
Correct Answer: B
AHIP - 2026/2027 | Passing Score: 80% | Page 4 of 52
OBJECTIVE ASSESSMENT - EXAM
AHIP 2026/2027 Module 1 to 5
Exam Questions and Verified Answers
100% Guarantee Pass 2026/2027
Medicare Advantage + Part D Certification Exam
50 100%
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
* Medicare Program Basics * Marketing Compliance Rules
* Medicare Health Plans * Enrollment Periods & SEPs
* Part D Drug Coverage * Fraud, Waste & Abuse
AHIP - 2026/2027 | Passing Score: 80% | Page 1 of 52 COVER PAGE - 1
, SECTION 1 | Overview of Medicare Program Basics | Q1-Q10 | AHIP 2026/2027
Q1 Question 1 of 50
Mrs. Alvarez, age 68, recently retired and is reviewing her Medicare coverage options. She
asks you whether she must enroll in Medicare Part B if she already has premium-free Part A.
What is the most accurate guidance you can provide?
A. Part B is optional, but if she delays enrollment without other creditable coverage, she will face a
lifetime late enrollment penalty and may have to wait for a General Enrollment Period.
B. Enrollment in Part B is mandatory for all Medicare beneficiaries, and failure to enroll will result in
immediate loss of Part A coverage.
C. Part B enrollment is only required for beneficiaries with incomes above the federal poverty level,
so she can defer indefinitely without penalty.
D. Since she has premium-free Part A, Part B is automatically included at no additional cost and
requires no separate action on her part.
Correct Answer: A
Rationale:
Part B is voluntary, but delaying enrollment without creditable employer coverage triggers a 10% per-year
lifetime late enrollment penalty and limited enrollment windows. Option B is wrong because Part A is not
contingent on Part B. Option C incorrectly ties Part B to income. Option D is wrong because Part B has a
separate monthly premium.
Q2 Question 2 of 50
Mr. Chen, age 72, has Original Medicare and is hospitalized for pneumonia. He stays in the
hospital for 75 days. Which statement accurately describes his cost-sharing responsibility
under Medicare Part A for this inpatient stay?
A. He pays nothing for the first 60 days, then a flat copayment for each additional day regardless of
how long the stay lasts.
B. He pays the Part A deductible for days 1-60, then a daily coinsurance for days 61-90, and finally
uses lifetime reserve days for days 91 onward.
C. He pays the Part A deductible only once per calendar year, covering the entire 75-day stay with
no additional cost-sharing.
D. He is responsible for the full cost of the hospitalization because pneumonia is not on Medicare's
list of covered inpatient conditions.
Correct Answer: D
AHIP - 2026/2027 | Passing Score: 80% | Page 2 of 52
, SECTION 1 | Overview of Medicare Program Basics | Q1-Q10 | AHIP 2026/2027
Rationale:
Under Part A, the beneficiary pays the inpatient deductible for the benefit period covering days 1-60, then a
daily coinsurance for days 61-90, and lifetime reserve days (with higher coinsurance) for days 91-150.
Option A understates the cost structure. Option B is wrong because it misstates the deductible timing. Option
C is wrong because the deductible applies per benefit period, not per year.
Q3 Question 3 of 50
Ms. Thompson, age 70, visits her primary care physician for an annual wellness visit and a flu
shot. She also receives a blood test that her doctor deems medically necessary. Which of
these services is covered at 100% under Medicare Part B with no cost-sharing to the
beneficiary?
A. The seasonal influenza vaccine administered during the office visit, which is classified as a
preventive service covered at 100%.
B. The office visit copayment for seeing her primary care physician, which is waived for all
beneficiaries over age 65.
C. The medically necessary blood test ordered by her physician to monitor her chronic condition,
which is subject to the Part B deductible and 20% coinsurance.
D. The cost of her transportation to and from the physician's office, which Medicare covers as an
essential component of medical care.
Correct Answer: A
Rationale:
Preventive services like annual wellness visits, flu shots, and pneumococcal vaccines are covered at 100%
under Part B. Option B is wrong because office visit copayments are not waived based on age. Option C
describes a diagnostic test subject to cost-sharing. Option D is wrong because Medicare does not cover
transportation to routine appointments.
AHIP - 2026/2027 | Passing Score: 80% | Page 3 of 52
, SECTION 1 | Overview of Medicare Program Basics | Q1-Q10 | AHIP 2026/2027
Q4 Question 4 of 50
Mr. Jackson, age 65, has been receiving Social Security disability benefits for 20 months due
to a severe heart condition. He asks when he will become eligible for Medicare. What should
you tell him?
A. He must wait until age 65 regardless of his disability status, as Medicare eligibility is strictly
age-based for all beneficiaries.
B. He is already eligible because heart conditions qualify for immediate Medicare coverage upon
disability approval, with no waiting period.
C. He must submit a separate application to CMS and wait for a determination, which typically
takes 90 days from the date of application.
D. He will be automatically enrolled in Medicare after receiving disability benefits for 24 months,
with coverage beginning in the 25th month.
Correct Answer: D
Rationale:
Individuals under 65 who receive Social Security disability benefits for 24 months are automatically enrolled
in Medicare in the 25th month. Option A is wrong because disability creates an eligibility pathway before age
65. Option B is wrong because there is a 24-month waiting period for most disabilities (ALS and ESRD are
exceptions). Option C is incorrect because enrollment is automatic, not application-based.
Q5 Question 5 of 50
Mrs. Patel, age 66, has Original Medicare and is considering whether to purchase a Medigap
policy. She wants to know which of the following costs a Medigap plan would most likely help
cover. What is the correct answer?
A. Her monthly Medicare Part B premium, which Medigap plans are required to pay on her behalf.
B. The Medicare Part A hospital deductible and Part B coinsurance for physician services, which
are common gaps in Original Medicare.
C. The cost of long-term custodial care in a nursing home, which Original Medicare does not cover
at all.
D. Her prescription drug costs, since all Medigap plans sold after 2010 include Part D drug
coverage as a standard benefit.
Correct Answer: B
AHIP - 2026/2027 | Passing Score: 80% | Page 4 of 52
