AHIP Certification Study Guide Questions and
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant Download Pdf
1. Which organization primarily oversees the Medicare program in
the United States?
A. Department of Labor
B. Social Security Administration
C. Centers for Medicare & Medicaid Services (CMS)
D. Internal Revenue Service
Rationale: CMS administers the Medicare program, establishes
regulations, oversees Medicare Advantage and Part D plans, and
ensures compliance with federal standards. While the Social Security
Administration handles Medicare enrollment for many beneficiaries,
CMS is responsible for operating and regulating the program.
2. Which part of Medicare primarily covers inpatient hospital
services?
A. Medicare Part B
B. Medicare Part C
,C. Medicare Part D
D. Medicare Part A
Rationale: Medicare Part A covers inpatient hospital care, skilled
nursing facility care following qualifying hospital stays, hospice care,
and certain home health services. Most beneficiaries receive Part A
without paying a premium if they meet work history requirements.
3. Medicare Part B generally covers which of the following?
A. Prescription drugs only
B. Hospice care only
C. Long-term custodial nursing home care
D. Physician services and outpatient medical care
Rationale: Medicare Part B provides coverage for physician visits,
outpatient care, preventive services, laboratory testing, durable
medical equipment, and various medically necessary services. It does
not generally cover long-term custodial care.
4. Medicare Part C is also known as:
A. Medigap Insurance
B. Medicare Supplement Insurance
C. Medicare Advantage
D. Original Medicare
,Rationale: Medicare Advantage plans are offered by private insurers
approved by CMS and combine Part A and Part B coverage while often
including additional benefits such as prescription drugs, dental, vision,
and hearing coverage.
5. Which Medicare component provides outpatient prescription drug
coverage?
A. Part A
B. Part B
C. Part C only
D. Part D
Rationale: Medicare Part D provides outpatient prescription drug
benefits through private insurance companies contracted with CMS.
Beneficiaries may obtain Part D through standalone Prescription Drug
Plans or Medicare Advantage Prescription Drug plans.
6. A beneficiary first becomes eligible for Medicare primarily at what
age?
A. 60
B. 62
C. 65
D. 67
, Rationale: Most individuals become eligible for Medicare at age 65.
However, younger individuals may qualify earlier because of certain
disabilities or specific medical conditions such as ESRD or ALS.
7. Which beneficiary is generally eligible for Medicare before age 65?
A. Anyone receiving Social Security for one year
B. An individual receiving Social Security Disability Insurance for the
required qualifying period
C. Anyone with employer-sponsored insurance
D. Any veteran
Rationale: Individuals receiving Social Security Disability Insurance
typically become eligible for Medicare after the required disability
waiting period. Certain conditions such as ALS and ESRD have
separate eligibility provisions.
8. Original Medicare consists of:
A. Parts B and D
B. Parts C and D
C. Parts A and C
D. Parts A and B
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant Download Pdf
1. Which organization primarily oversees the Medicare program in
the United States?
A. Department of Labor
B. Social Security Administration
C. Centers for Medicare & Medicaid Services (CMS)
D. Internal Revenue Service
Rationale: CMS administers the Medicare program, establishes
regulations, oversees Medicare Advantage and Part D plans, and
ensures compliance with federal standards. While the Social Security
Administration handles Medicare enrollment for many beneficiaries,
CMS is responsible for operating and regulating the program.
2. Which part of Medicare primarily covers inpatient hospital
services?
A. Medicare Part B
B. Medicare Part C
,C. Medicare Part D
D. Medicare Part A
Rationale: Medicare Part A covers inpatient hospital care, skilled
nursing facility care following qualifying hospital stays, hospice care,
and certain home health services. Most beneficiaries receive Part A
without paying a premium if they meet work history requirements.
3. Medicare Part B generally covers which of the following?
A. Prescription drugs only
B. Hospice care only
C. Long-term custodial nursing home care
D. Physician services and outpatient medical care
Rationale: Medicare Part B provides coverage for physician visits,
outpatient care, preventive services, laboratory testing, durable
medical equipment, and various medically necessary services. It does
not generally cover long-term custodial care.
4. Medicare Part C is also known as:
A. Medigap Insurance
B. Medicare Supplement Insurance
C. Medicare Advantage
D. Original Medicare
,Rationale: Medicare Advantage plans are offered by private insurers
approved by CMS and combine Part A and Part B coverage while often
including additional benefits such as prescription drugs, dental, vision,
and hearing coverage.
5. Which Medicare component provides outpatient prescription drug
coverage?
A. Part A
B. Part B
C. Part C only
D. Part D
Rationale: Medicare Part D provides outpatient prescription drug
benefits through private insurance companies contracted with CMS.
Beneficiaries may obtain Part D through standalone Prescription Drug
Plans or Medicare Advantage Prescription Drug plans.
6. A beneficiary first becomes eligible for Medicare primarily at what
age?
A. 60
B. 62
C. 65
D. 67
, Rationale: Most individuals become eligible for Medicare at age 65.
However, younger individuals may qualify earlier because of certain
disabilities or specific medical conditions such as ESRD or ALS.
7. Which beneficiary is generally eligible for Medicare before age 65?
A. Anyone receiving Social Security for one year
B. An individual receiving Social Security Disability Insurance for the
required qualifying period
C. Anyone with employer-sponsored insurance
D. Any veteran
Rationale: Individuals receiving Social Security Disability Insurance
typically become eligible for Medicare after the required disability
waiting period. Certain conditions such as ALS and ESRD have
separate eligibility provisions.
8. Original Medicare consists of:
A. Parts B and D
B. Parts C and D
C. Parts A and C
D. Parts A and B
