AHIP 2027 Final Exam – Medicare Certification – Actual Questions & Answers (AHIP) Guarantee Pass (Updated Pdf)

AHIP 2027 FINAL EXAM – MEDICARE CERTIFICATION –
ACTUAL QUESTIONS & ANSWERS (AHIP) GUARANTEE PASS
(UPDATED PDF)


AHIP Medicare Certification Practice Questions (Original)
Question 1

A beneficiary is approaching age 65 and wants to enroll in Medicare when first eligible. Which
enrollment period is specifically designed for this purpose?
A. Annual Election Period (AEP)

B. Initial Enrollment Period (IEP)

C. General Enrollment Period (GEP)

D. Special Enrollment Period (SEP)

Correct Answer: B. Initial Enrollment Period (IEP)

Rationale:
The Initial Enrollment Period is the first opportunity for most individuals to enroll in Medicare.
It generally surrounds the month they become eligible for Medicare due to age.



Question 2

Which Medicare Part generally covers physician office visits, preventive services, and outpatient
care?

A. Part A

B. Part B
C. Part C

D. Part D

Correct Answer: B. Part B

Rationale:
Part B covers medically necessary outpatient services, physician visits, preventive care,
diagnostic testing, and durable medical equipment when coverage requirements are met.

,Question 3

A Medicare Advantage plan is best described as:

A. A supplemental insurance policy that only pays deductibles

B. A private health plan approved by Medicare that provides Medicare-covered benefits

C. A Medicaid program

D. A prescription drug discount program

Correct Answer: B. A private health plan approved by Medicare that provides Medicare-
covered benefits

Rationale:
Medicare Advantage (Part C) plans are offered by private insurers that contract with Medicare
and must provide all Medicare-covered services, except hospice remains covered by Original
Medicare in most situations.



Question 4

Which Medicare Part is specifically designed to help cover outpatient prescription drugs?

A. Part A

B. Part B

C. Part C only
D. Part D

Correct Answer: D. Part D
Rationale:
Part D provides outpatient prescription drug coverage through Medicare-approved prescription
drug plans or Medicare Advantage plans that include drug coverage.


Question 5

A beneficiary with Original Medicare wants help paying deductibles and coinsurance. Which
option is generally intended for this purpose?

A. Medicaid only

B. Medigap policy

, C. Part D plan

D. Employer insurance only

Correct Answer: B. Medigap policy

Rationale:
Medigap policies supplement Original Medicare by helping pay certain out-of-pocket costs such
as deductibles, copayments, and coinsurance, depending on the plan.



Question 6

Which federal agency administers the Medicare program?

A. Department of Veterans Affairs

B. Centers for Medicare & Medicaid Services (CMS)

C. Internal Revenue Service (IRS)

D. Department of Labor
Correct Answer: B. Centers for Medicare & Medicaid Services (CMS)

Rationale:
CMS oversees the Medicare program, establishes program regulations, contracts with Medicare
Advantage and Part D plans, and monitors compliance.


Question 7

A beneficiary moves outside the service area of their Medicare Advantage plan. What may
occur?

A. They automatically lose Medicare.

B. They may qualify for a Special Enrollment Period.

C. They must wait until age 70.

D. They can never enroll in another Medicare plan.

Correct Answer: B. They may qualify for a Special Enrollment Period.

Rationale:
Moving outside a plan's service area is a qualifying event that may trigger a Special Enrollment
Period, allowing the beneficiary to change coverage.