AHIP Modules 1-5 Exam ACTUAL
EXAM 2026/2027 | Complete Exam-
Style Q&A | Verified Q&A | Pass
Guaranteed - A+ Graded
Table of Contents
Section 1: Module 1 — Medicare Basics & Eligibility (Questions 1–10) ...... 2
Section 2: Module 2 — Medicare Advantage (Part C) Plans (Questions 11–20) ...... 2
Section 3: Module 3 — Medicare Part D Prescription Drug Coverage (Questions 21–30) ...... 2
Section 4: Module 4 — Compliance & Ethics (Questions 31–40) ...... 2
Section 5: Module 5 — Enrollment & Marketing Rules (Questions 41–50) ...... 2
Section 1: Module 1 — Medicare Basics & Eligibility
Q1: A 67-year-old individual who worked and paid Medicare taxes for 45 quarters is eligible for which of
the following?
A. Medicare Part A with a monthly premium
B. Medicare Part A premium-free. [CORRECT]
C. Only Medicare Part B
D. Medicare Part D only
Correct Answer: B
Rationale: Individuals who have worked and paid Medicare taxes for at least 40 quarters (10 years) are
eligible for premium-free Medicare Part A (Hospital Insurance). This individual's 45 quarters of covered
employment exceeds the 40-quarter threshold, so they qualify for premium-free Part A coverage.
Q2: Medicare Part B primarily covers which of the following services?
A. Inpatient hospital stays and skilled nursing facility care
B. Physician services, outpatient care, preventive services, and durable medical equipment. [CORRECT]
C. Prescription drug coverage
D. Long-term custodial care in a nursing home
,Correct Answer: B
Rationale: Medicare Part B (Medical Insurance) covers medically necessary services including physician
visits, outpatient hospital services, preventive care screenings, durable medical equipment, and certain
home health services. It does not cover inpatient hospital care (Part A) or prescription drugs (Part D).
Q3: An individual first becomes eligible for Medicare at age 65. Their Initial Enrollment Period (IEP) for
Medicare begins:
A. Three months before their 65th birthday, includes their birthday month, and ends three months after.
[CORRECT]
B. On their 65th birthday and lasts for six months
C. During the Annual Election Period only
D. One year before their 65th birthday
Correct Answer: A
Rationale: The Initial Enrollment Period (IEP) is a 7-month window that begins three months before the
month an individual turns 65, includes their birthday month, and ends three months after. This is the
first opportunity for most individuals to enroll in Medicare Parts A, B, C, and D.
Q4: A 45-year-old individual has been receiving Social Security Disability Insurance (SSDI) for 26 months.
When does Medicare coverage begin?
A. Immediately upon SSDI approval
B. After 24 months of SSDI benefits, with coverage beginning in the 25th month. [CORRECT]
C. Only at age 65
D. After 36 months of SSDI benefits
Correct Answer: B
Rationale: Individuals under age 65 who have been entitled to Social Security Disability Insurance (SSDI)
benefits for 24 months automatically become eligible for Medicare in the 25th month of disability. This
individual has received SSDI for 26 months, so Medicare coverage began in their 25th month of disability
entitlement.
Q5: A beneficiary with End-Stage Renal Disease (ESRD) becomes eligible for Medicare:
A. Only at age 65
B. 12 months after beginning dialysis, or in the fourth month of dialysis, or upon hospital admission for a
kidney transplant. [CORRECT]
, C. Immediately upon diagnosis without any waiting period
D. Only if they also have a disability
Correct Answer: B
Rationale: ESRD Medicare eligibility begins in the fourth month of dialysis treatments, or in the first
month for individuals who participate in a self-dialysis training program, or in the month of hospital
admission for a kidney transplant. There is no age requirement for ESRD-related Medicare eligibility.
Q6: Medicare Part A covers hospice care when:
A. The beneficiary has a terminal illness with a life expectancy of six months or less and elects hospice
care. [CORRECT]
B. The beneficiary requests it at any time
C. The beneficiary has exhausted all other treatment options
D. The beneficiary is in a skilled nursing facility
Correct Answer: A
Rationale: Medicare Part A covers hospice care for beneficiaries who have a terminal illness with a
prognosis of six months or less if the disease runs its normal course, and who elect to receive hospice
care instead of curative treatment. The beneficiary must sign a statement choosing hospice care over
other Medicare-covered benefits for the terminal illness.
Q7: Which of the following is NOT covered by Original Medicare Part A?
A. Inpatient hospital care
B. Skilled nursing facility care following a qualifying hospital stay
C. Custodial long-term care in a nursing home. [CORRECT]
D. Hospice care
Correct Answer: C
Rationale: Original Medicare Part A does not cover custodial or long-term care in a nursing home when
that is the only type of care needed. Medicare Part A covers skilled nursing facility care only when it is
medically necessary and follows a qualifying hospital inpatient stay of at least three days. Custodial care
(help with daily living activities) is not a Medicare-covered benefit.
Q8: The standard Medicare Part B monthly premium in 2026 is:
A. Free for all beneficiaries
B. Income-adjusted based on the beneficiary's modified adjusted gross income (MAGI) from two years
prior. [CORRECT]
EXAM 2026/2027 | Complete Exam-
Style Q&A | Verified Q&A | Pass
Guaranteed - A+ Graded
Table of Contents
Section 1: Module 1 — Medicare Basics & Eligibility (Questions 1–10) ...... 2
Section 2: Module 2 — Medicare Advantage (Part C) Plans (Questions 11–20) ...... 2
Section 3: Module 3 — Medicare Part D Prescription Drug Coverage (Questions 21–30) ...... 2
Section 4: Module 4 — Compliance & Ethics (Questions 31–40) ...... 2
Section 5: Module 5 — Enrollment & Marketing Rules (Questions 41–50) ...... 2
Section 1: Module 1 — Medicare Basics & Eligibility
Q1: A 67-year-old individual who worked and paid Medicare taxes for 45 quarters is eligible for which of
the following?
A. Medicare Part A with a monthly premium
B. Medicare Part A premium-free. [CORRECT]
C. Only Medicare Part B
D. Medicare Part D only
Correct Answer: B
Rationale: Individuals who have worked and paid Medicare taxes for at least 40 quarters (10 years) are
eligible for premium-free Medicare Part A (Hospital Insurance). This individual's 45 quarters of covered
employment exceeds the 40-quarter threshold, so they qualify for premium-free Part A coverage.
Q2: Medicare Part B primarily covers which of the following services?
A. Inpatient hospital stays and skilled nursing facility care
B. Physician services, outpatient care, preventive services, and durable medical equipment. [CORRECT]
C. Prescription drug coverage
D. Long-term custodial care in a nursing home
,Correct Answer: B
Rationale: Medicare Part B (Medical Insurance) covers medically necessary services including physician
visits, outpatient hospital services, preventive care screenings, durable medical equipment, and certain
home health services. It does not cover inpatient hospital care (Part A) or prescription drugs (Part D).
Q3: An individual first becomes eligible for Medicare at age 65. Their Initial Enrollment Period (IEP) for
Medicare begins:
A. Three months before their 65th birthday, includes their birthday month, and ends three months after.
[CORRECT]
B. On their 65th birthday and lasts for six months
C. During the Annual Election Period only
D. One year before their 65th birthday
Correct Answer: A
Rationale: The Initial Enrollment Period (IEP) is a 7-month window that begins three months before the
month an individual turns 65, includes their birthday month, and ends three months after. This is the
first opportunity for most individuals to enroll in Medicare Parts A, B, C, and D.
Q4: A 45-year-old individual has been receiving Social Security Disability Insurance (SSDI) for 26 months.
When does Medicare coverage begin?
A. Immediately upon SSDI approval
B. After 24 months of SSDI benefits, with coverage beginning in the 25th month. [CORRECT]
C. Only at age 65
D. After 36 months of SSDI benefits
Correct Answer: B
Rationale: Individuals under age 65 who have been entitled to Social Security Disability Insurance (SSDI)
benefits for 24 months automatically become eligible for Medicare in the 25th month of disability. This
individual has received SSDI for 26 months, so Medicare coverage began in their 25th month of disability
entitlement.
Q5: A beneficiary with End-Stage Renal Disease (ESRD) becomes eligible for Medicare:
A. Only at age 65
B. 12 months after beginning dialysis, or in the fourth month of dialysis, or upon hospital admission for a
kidney transplant. [CORRECT]
, C. Immediately upon diagnosis without any waiting period
D. Only if they also have a disability
Correct Answer: B
Rationale: ESRD Medicare eligibility begins in the fourth month of dialysis treatments, or in the first
month for individuals who participate in a self-dialysis training program, or in the month of hospital
admission for a kidney transplant. There is no age requirement for ESRD-related Medicare eligibility.
Q6: Medicare Part A covers hospice care when:
A. The beneficiary has a terminal illness with a life expectancy of six months or less and elects hospice
care. [CORRECT]
B. The beneficiary requests it at any time
C. The beneficiary has exhausted all other treatment options
D. The beneficiary is in a skilled nursing facility
Correct Answer: A
Rationale: Medicare Part A covers hospice care for beneficiaries who have a terminal illness with a
prognosis of six months or less if the disease runs its normal course, and who elect to receive hospice
care instead of curative treatment. The beneficiary must sign a statement choosing hospice care over
other Medicare-covered benefits for the terminal illness.
Q7: Which of the following is NOT covered by Original Medicare Part A?
A. Inpatient hospital care
B. Skilled nursing facility care following a qualifying hospital stay
C. Custodial long-term care in a nursing home. [CORRECT]
D. Hospice care
Correct Answer: C
Rationale: Original Medicare Part A does not cover custodial or long-term care in a nursing home when
that is the only type of care needed. Medicare Part A covers skilled nursing facility care only when it is
medically necessary and follows a qualifying hospital inpatient stay of at least three days. Custodial care
(help with daily living activities) is not a Medicare-covered benefit.
Q8: The standard Medicare Part B monthly premium in 2026 is:
A. Free for all beneficiaries
B. Income-adjusted based on the beneficiary's modified adjusted gross income (MAGI) from two years
prior. [CORRECT]
