AHIP Final Exam Actual Exam 2026/2027 | Complete Medicare Certification Test Bank with 50 Verified Questions & Correct Answers | Updated for Current CMS Guidelines | A+ Graded

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AHIP Final Exam Actual Exam 2026/2027 | Complete Medicare
Certification Test Bank with 50 Verified Questions & Correct
Answers | Updated for Current CMS Guidelines | A+ Graded



Examination Overview
The AHIP Medicare Training and Certification Exam is the industry standard for
insurance agents and brokers who wish to sell Medicare Advantage (MA) and
Prescription Drug Plans (PDP). The exam covers the five core pillars of the AHIP
curriculum: Medicare Basics, Medicare Advantage (Part C), Medicare Part D
Prescription Drug Coverage, Marketing and Enrollment Guidelines, and Fraud,
Waste & Abuse (FWA).
All questions in this study guide are fully updated for the 2026/2027 AHIP
certification period and aligned with CMS guidelines.


Key CMS Updates for 2026/2027

Topic 2026/2027 Update

Part D Deductible (2026) $615.00

Part D Out-of-Pocket Maximum
$2,100
(2026)

Medicare Open Enrollment October 15 – December 7

Part A Inpatient Deductible (2026) $1,736 per benefit period




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Topic 2026/2027 Update

June 1, 2026 (marketing changes effective October 1,
CY 2027 Final Rule Effective Date
2026)



Topic 1: Medicare Basics (Parts A, B, C, D, and Medigap)
1. A 65-year-old patient who is newly eligible for Medicare asks about
enrollment. When does the Initial Enrollment Period (IEP) begin?
A. 1 month before the 65th birthday
B. 3 months before the 65th birthday
C. 6 months before the 65th birthday
D. On the 65th birthday

Correct Answer: B. 3 months before the 65th birthday

RATIONALE: The Initial Enrollment Period (IEP) for Medicare begins 3 months
before the month of the 65th birthday, includes the birthday month, and ends 3
months after the birthday month—a total of 7 months. Enrolling during this
period ensures coverage begins on time and avoids late enrollment penalties.


2. A Medicare beneficiary is enrolled in Original Medicare (Parts A and B) and
has a Medigap policy. Which of the following is true regarding Medigap?
A. Medigap plans cover prescription drugs
B. Medigap plans work with Medicare Advantage plans
C. Medigap plans fill the "gaps" in Original Medicare coverage
D. Medigap plans are offered by the federal government

Correct Answer: C. Medigap plans fill the "gaps" in Original Medicare
coverage

RATIONALE: Medigap (Medicare Supplement Insurance) policies are sold by
private insurance companies to help pay for out-of-pocket costs not covered by


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Original Medicare, such as copayments, coinsurance, and deductibles. Medigap
plans do not cover prescription drugs (Part D is separate), do not work with
Medicare Advantage plans, and are offered by private insurers, not the federal
government.


Topic 2: Medicare Advantage (Part C)
3. Which statement about Medicare Advantage (MA) plans is correct?
A. MA plans are the same as Original Medicare
B. MA plans are offered by private insurance companies approved by Medicare
C. MA plans do not cover emergency services
D. MA plans require beneficiaries to purchase separate Part D coverage

Correct Answer: B. MA plans are offered by private insurance companies
approved by Medicare

RATIONALE: Medicare Advantage (Part C) plans are offered by private
insurance companies that contract with Medicare to provide all Part A and Part B
benefits. MA plans often include additional benefits such as prescription drug
coverage (Part D), vision, dental, and hearing. MA plans must cover emergency
and urgent care services.


Topic 3: Medicare Part D Prescription Drug Coverage
4. A beneficiary is enrolling in a Part D prescription drug plan. Which of the
following is true regarding the Part D deductible for 2026?
A. The Part D deductible is waived for all beneficiaries
B. The Part D deductible is $615.00
C. The Part D deductible is $500.00
D. The Part D deductible is determined by each plan sponsor

Correct Answer: B. The Part D deductible is $615.00

RATIONALE: For 2026, the Medicare Part D standard deductible is $615.00.
Plans may offer alternative benefits with a different deductible, but the standard


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deductible is set by CMS each year and is subject to change. The Part D out-of-
pocket maximum for 2026 is $2,100.


Topic 4: Enrollment Periods
5. A Medicare beneficiary missed their Initial Enrollment Period. When can they
enroll in Medicare Part A and Part B without a late enrollment penalty?
A. During the General Enrollment Period (January 1 – March 31)
B. During the Annual Open Enrollment Period (October 15 – December 7)
C. They can never enroll without a penalty
D. During the Medicare Advantage Open Enrollment Period (January 1 – March
31)

Correct Answer: A. During the General Enrollment Period (January 1 – March
31)

RATIONALE: Beneficiaries who missed their Initial Enrollment Period can
enroll in Medicare Part A and Part B during the General Enrollment Period (GEP)
from January 1 to March 31, with coverage starting July 1. However, late
enrollment penalties may apply for most beneficiaries. The Annual Open
Enrollment Period (October 15 – December 7) is for changing Medicare
Advantage or Part D plans, not for initial enrollment in Part A and Part B.


6. During which period can a Medicare beneficiary switch from a Medicare
Advantage plan to Original Medicare?
A. General Enrollment Period (January 1 – March 31)
B. Medicare Advantage Open Enrollment Period (January 1 – March 31)
C. Annual Open Enrollment Period (October 15 – December 7)
D. Initial Enrollment Period

Correct Answer: B. Medicare Advantage Open Enrollment Period (January 1
– March 31)

RATIONALE: The Medicare Advantage Open Enrollment Period (MA OEP) runs
from January 1 to March 31 each year. During this period, beneficiaries enrolled

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