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AHIP Final Exam Practice Exam and Study Guide 2026/2027 – Medicare Certification – Complete Practice Questions with Verified Answers

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This document contains 135 AHIP final exam practice questions with verified answers covering Medicare Parts A, B, C (Medicare Advantage), Part D, Medigap, enrollment periods, Special Enrollment Periods (SEPs), Medicare Savings Programs, marketing guidelines, compliance requirements, and beneficiary eligibility. It is designed as a comprehensive exam preparation resource with scenario-based questions that reflect common AHIP certification topics. The material also includes Medicare Prescription Payment Plan updates, appeals, PACE, MSA plans, and CMS marketing regulations. It serves as a complete study guide for candidates preparing for the AHIP Medicare certification exam. Keywords AHIP exam Medicare Part A Medicare Part B Medicare Part C Medicare Advantage Medicare Part D Medigap Prescription drug plans Enrollment periods Special Enrollment Period Annual Election Period Initial Coverage Election Period PACE Medicare Savings Account Skilled nursing facility Hospice benefits Appeals process Low Income Subsidy TrOOP CMS marketing guidelines Compliance Scope of Appointment Practice questions Exam answers Study guide

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AHIP FINAL EXAM, PRACTICE
EXAM AND STUDY GUIDE
LATEST 2026/2027 ACTUAL
EXAM 135 QUESTIONS WITH
CORRECT ANSWERS 100%
VERIFIED GRADED A+

Mrs. Shields is covered by Original Medicare. She sustained a hip

fracture and is being successfully treated for that condition. However,

she and her physicians feel that after her lengthy hospital stay, she will

need a month or two of nursing and rehabilitative care. What should you

tell them about Original Medicare's coverage of care in a skilled nursing

facility? - ANSWER ✔✔Medicare will cover Mrs. Shield's skilled

,nursing services provided during the first 20 days of her stay, after which

she would have a copay until she has been in the facility for 100 days.

Mrs. West wears glasses and dentures and has enjoyed considerable

pain relief from arthritis through massage therapy. She is concerned

about whether or not Medicare will cover these items and services. What

should you tell her? - ANSWER ✔✔Medicare does not cover

massage therapy, or, in general, glasses or dentures.

Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What

could you tell Mrs. Park that might be of assistance? - ANSWER

✔✔She should contact her state Medicaid agency to see if she qualifies

for one of several programs that can help with Medicare costs for which

she is responsible.

Mr. Alonso receives some help paying for his two generic prescription

drugs from his employer's retiree coverage, but he wants to compare it

to a Part D prescription drug plan. He asks you what costs he would

generally expect to encounter when enrolling into a standard Medicare

Part D prescription drug plan. What should you tell him? - ANSWER

✔✔He generally would pay a monthly premium, annual deductible, and

per-prescription cost-sharing.

,Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy

as well, but it provides no drug coverage. She would like to keep the

coverage she has but replace her existing Medigap plan with one that

provides drug coverage. What should you tell her? - ANSWER

✔✔Mrs. Gonzalez cannot purchase a Medigap plan that covers drugs,

but she could keep her Medigap policy and enroll in a Part D prescription

drug plan.

Mr. Davis is 52 years old and has recently been diagnosed with end-

stage renal disease (ESRD) and will soon begin dialysis. He is

wondering if he can obtain coverage under Medicare. What should you

tell him? - ANSWER ✔✔He may sign-up for Medicare at any time

however coverage usually begins on the fourth month after dialysis

treatments start.

Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has

recently reviewed her Medicare Summary Notice (MSN) and disagrees

with a determination that partially denied one of her claims for services.

What advice would you give her? - ANSWER ✔✔Mrs. Duarte should

file an appeal of this initial determination within 120 days of the date she

received the MSN in the mail.




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, Mrs. Geisler's neighbor told her she should look at her Part D options

during the annual Medicare enrollment period because the features of

Part D might have changed. Mrs. Geisler can't remember what Part D is

so she called you to ask what her neighbor was talking about. What

could you tell her? - ANSWER ✔✔Part D covers prescription drugs

and she should look at her premiums, formulary, and cost-sharing

among other factors to see if they have changed.

Mr. Rainey is experiencing paranoid delusions and his physician feels

that he should be hospitalized. What should you tell Mr. Rainey (or his

representative) about the length of an inpatient psychiatric hospital stay

that Medicare will cover? - ANSWER ✔✔Medicare will cover a total of

190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime.

Mr. Xi will soon turn age 65 and has come to you for advice as to what

services are provided under Original Medicare. What should you tell Mr.

Xi that best describes the health coverage provided to Medicare

beneficiaries? - ANSWER ✔✔Beneficiaries under Original Medicare

have no cost-sharing for most preventive services.

Mr. Singh would like drug coverage but does not want to be enrolled in a

Medicare Advantage plan. What should you tell him? - ANSWER

✔✔Mr. Singh can enroll in a stand-alone prescription drug plan and

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