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
1. Who is eligible for Medicare Part A without paying a premium?
• A) Anyone age 65 or older
• B) Individuals age 65 or older who have worked and paid Medicare
taxes for at least 40 quarters (10 years)
• C) All U.S. citizens regardless of work history
• D) Individuals with any disability
Correct ,,,,answer,,,,: B
Rationale: Medicare Part A is premium-free for individuals age 65 or
older who have worked at least 40 quarters (10 years) in Medicare-
covered employment, or who are entitled to Social Security or Railroad
Retirement benefits. Others may purchase Part A with a premium.
2. Which of the following individuals is eligible for Medicare?
• A) A 55-year-old with no disabilities
, • B) A 62-year-old retiree
• C) A 67-year-old U.S. citizen or permanent legal resident who has
lived in the U.S. for at least 5 years
• D) A 60-year-old with private insurance
Correct ,,,,answer,,,,: C
Rationale: Medicare eligibility generally begins at age 65 for U.S. citizens
or permanent legal residents who have resided in the U.S. for at least 5
continuous years. Individuals under 65 may qualify if they have certain
disabilities or End-Stage Renal Disease (ESRD).
3. Medicare Part A primarily covers:
• A) Outpatient services and doctor visits
• B) Prescription drugs
• C) Hospital inpatient care, skilled nursing facility care, hospice, and
some home health care
• D) Dental and vision services
Correct ,,,,answer,,,,: C
Rationale: Medicare Part A (Hospital Insurance) covers inpatient
hospital stays, skilled nursing facility care (not custodial or long-term
care), hospice care, and some home health care. Part B covers
outpatient services, and Part D covers prescription drugs.
4. Medicare Part B covers which of the following services?
, • A) Inpatient hospital stays
• B) Long-term custodial care
• C) Physician services, outpatient care, durable medical equipment,
and preventive services
• D) Prescription medications
Correct ,,,,answer,,,,: C
Rationale: Medicare Part B (Medical Insurance) covers physician
services, outpatient care, durable medical equipment (DME), home
health care (when not covered by Part A), and many preventive services
such as flu shots and cancer screenings.
5. What is the Initial Enrollment Period (IEP) for Medicare?
• A) A 3-month period starting on the 65th birthday
• B) A 7-month period that begins 3 months before the month of the
65th birthday, includes the birthday month, and ends 3 months
after
• C) A 12-month period beginning at age 65
• D) A one-time open enrollment period at any age
Correct ,,,,answer,,,,: B
Rationale: The Initial Enrollment Period (IEP) is a 7-month window: 3
months before the month you turn 65, the month you turn 65, and 3
months after. Enrolling during this period helps avoid late enrollment
penalties.
, 6. Mrs. Johnson is turning 65 next month. She is still working and has
employer coverage. She wants to delay Part B enrollment. Which
statement is correct?
• A) She must enroll in Part B now or face a permanent late penalty
• B) She can delay Part B without penalty if she has creditable
coverage through her or her spouse's current employment
• C) She cannot delay Part B under any circumstances
• D) She must drop her employer coverage to enroll in Medicare later
Correct ,,,,answer,,,,: B
Rationale: Individuals with creditable coverage (coverage at least as
good as Medicare's) through current employment (their own or a
spouse's) may delay Part B enrollment without penalty. A Special
Enrollment Period (SEP) allows enrollment when the employment or
coverage ends.
7. Which of the following is NOT covered by Original Medicare (Parts
A and B)?
• A) Hospital stays
• B) Routine dental care, eye exams for glasses, and hearing aids
• C) Doctor visits
• D) Preventive screenings
Correct ,,,,answer,,,,: B
Rationale: Original Medicare generally does not cover routine dental
care, most eye exams for glasses, or hearing aids. These services may be
| Complete Medicare Certification Test
Bank with 50 Verified Questions &
Correct Answers | Updated for Current
CMS Guidelines | A+ Graded
1. Who is eligible for Medicare Part A without paying a premium?
• A) Anyone age 65 or older
• B) Individuals age 65 or older who have worked and paid Medicare
taxes for at least 40 quarters (10 years)
• C) All U.S. citizens regardless of work history
• D) Individuals with any disability
Correct ,,,,answer,,,,: B
Rationale: Medicare Part A is premium-free for individuals age 65 or
older who have worked at least 40 quarters (10 years) in Medicare-
covered employment, or who are entitled to Social Security or Railroad
Retirement benefits. Others may purchase Part A with a premium.
2. Which of the following individuals is eligible for Medicare?
• A) A 55-year-old with no disabilities
, • B) A 62-year-old retiree
• C) A 67-year-old U.S. citizen or permanent legal resident who has
lived in the U.S. for at least 5 years
• D) A 60-year-old with private insurance
Correct ,,,,answer,,,,: C
Rationale: Medicare eligibility generally begins at age 65 for U.S. citizens
or permanent legal residents who have resided in the U.S. for at least 5
continuous years. Individuals under 65 may qualify if they have certain
disabilities or End-Stage Renal Disease (ESRD).
3. Medicare Part A primarily covers:
• A) Outpatient services and doctor visits
• B) Prescription drugs
• C) Hospital inpatient care, skilled nursing facility care, hospice, and
some home health care
• D) Dental and vision services
Correct ,,,,answer,,,,: C
Rationale: Medicare Part A (Hospital Insurance) covers inpatient
hospital stays, skilled nursing facility care (not custodial or long-term
care), hospice care, and some home health care. Part B covers
outpatient services, and Part D covers prescription drugs.
4. Medicare Part B covers which of the following services?
, • A) Inpatient hospital stays
• B) Long-term custodial care
• C) Physician services, outpatient care, durable medical equipment,
and preventive services
• D) Prescription medications
Correct ,,,,answer,,,,: C
Rationale: Medicare Part B (Medical Insurance) covers physician
services, outpatient care, durable medical equipment (DME), home
health care (when not covered by Part A), and many preventive services
such as flu shots and cancer screenings.
5. What is the Initial Enrollment Period (IEP) for Medicare?
• A) A 3-month period starting on the 65th birthday
• B) A 7-month period that begins 3 months before the month of the
65th birthday, includes the birthday month, and ends 3 months
after
• C) A 12-month period beginning at age 65
• D) A one-time open enrollment period at any age
Correct ,,,,answer,,,,: B
Rationale: The Initial Enrollment Period (IEP) is a 7-month window: 3
months before the month you turn 65, the month you turn 65, and 3
months after. Enrolling during this period helps avoid late enrollment
penalties.
, 6. Mrs. Johnson is turning 65 next month. She is still working and has
employer coverage. She wants to delay Part B enrollment. Which
statement is correct?
• A) She must enroll in Part B now or face a permanent late penalty
• B) She can delay Part B without penalty if she has creditable
coverage through her or her spouse's current employment
• C) She cannot delay Part B under any circumstances
• D) She must drop her employer coverage to enroll in Medicare later
Correct ,,,,answer,,,,: B
Rationale: Individuals with creditable coverage (coverage at least as
good as Medicare's) through current employment (their own or a
spouse's) may delay Part B enrollment without penalty. A Special
Enrollment Period (SEP) allows enrollment when the employment or
coverage ends.
7. Which of the following is NOT covered by Original Medicare (Parts
A and B)?
• A) Hospital stays
• B) Routine dental care, eye exams for glasses, and hearing aids
• C) Doctor visits
• D) Preventive screenings
Correct ,,,,answer,,,,: B
Rationale: Original Medicare generally does not cover routine dental
care, most eye exams for glasses, or hearing aids. These services may be
