Latest AHIP Final Exam Prep 2027 2028
Study Guide Questions Answers PDF
Verified Master Key Updated
Question 1
Mr. Chen is turning 65 next month and is currently covered under his employer's
group health plan. He wants to know if he must enroll in Medicare Part A and Part
B. What should you tell him?
• A) He must enroll in both Part A and Part B immediately upon turning 65
• B) He can delay Part A without penalty but must enroll in Part B
• C) He can delay Part B without penalty if he has creditable coverage through
his employer
• D) He must enroll in Part A but can delay Part B
Correct Answer: C
Rationale: Individuals who are still working and have employer-sponsored
coverage at age 65 can delay enrollment in Part B without penalty under the
Special Enrollment Period (SEP). Part A is premium-free for most individuals and
can be enrolled in at any time .
Question 2
What is the duration of the Initial Enrollment Period (IEP) for Medicare?
• A) A 3-month period beginning on the first day of the month of the 65th
birthday
• B) A 7-month period beginning 3 months before the month of the 65th
birthday
• C) A 6-month period beginning the month of the 65th birthday
, • D) A 12-month period beginning at age 64
Correct Answer: B
Rationale: The Initial Enrollment Period (IEP) is a 7-month window that includes
the 3 months before the month of the beneficiary's 65th birthday, the birthday
month itself, and the 3 months following. Enrollment in the first 3 months ensures
coverage begins the first day of the birthday month .
Question 3
Which of the following individuals is eligible for Medicare?
• A) A 50-year-old with no disabilities
• B) A 62-year-old retired teacher
• C) A 58-year-old receiving Social Security Disability for 24 months
• D) A 60-year-old with employer coverage only
Correct Answer: C
Rationale: Individuals under age 65 who have been receiving Social Security
Disability Insurance (SSDI) for 24 months qualify for Medicare. This is a key
eligibility exception tested on the AHIP exam .
Question 4
Mr. Rodriguez is 67 and has delayed Medicare enrollment because he has
coverage through his wife's employer plan. His wife is now retiring. What
enrollment period applies?
• A) Initial Enrollment Period
• B) General Enrollment Period
• C) Special Enrollment Period
• D) Open Enrollment Period
,Correct Answer: C
Rationale: The Special Enrollment Period (SEP) allows individuals who delayed
Medicare enrollment due to coverage under an employer group health plan to
enroll without penalty. The SEP begins when the employer coverage ends and
lasts for 8 months .
Question 5
What is the General Enrollment Period (GEP) for Medicare Part B?
• A) January 1 – March 31 each year
• B) October 15 – December 7 each year
• C) April 1 – June 30 each year
• D) January 1 – December 31 each year
Correct Answer: A
Rationale: The General Enrollment Period for Medicare Part B runs from January 1
through March 31 each year. Beneficiaries who did not enroll during their IEP can
enroll during this period, though they may face late enrollment penalties .
Question 6
Mrs. Thompson is 64 and has been diagnosed with End-Stage Renal Disease
(ESRD). She has been receiving dialysis treatments for 4 months. Is she eligible for
Medicare?
• A) No, she must be 65 to enroll
• B) No, she must receive dialysis for at least 1 year
• C) Yes, she is eligible for Medicare with ESRD
• D) Only if she also receives Social Security Disability
Correct Answer: C
Rationale: Individuals with End-Stage Renal Disease (ESRD) are eligible for
, Medicare regardless of age. Eligibility begins the first day of the fourth month of
dialysis treatments (with certain exceptions) .
Question 7
Which statement about Medicare eligibility for individuals with disabilities is
CORRECT?
• A) Individuals receiving Social Security Disability must wait 5 years for
Medicare
• B) Individuals receiving Social Security Disability for 24 months qualify for
Medicare
• C) Disability does not qualify anyone for Medicare under age 65
• D) All disabled individuals qualify for Medicare immediately
Correct Answer: B
Rationale: Individuals who receive Social Security Disability benefits for 24
months are automatically enrolled in Medicare, regardless of age .
Question 8
Medicare Part A covers which of the following?
• A) Outpatient physical therapy
• B) Routine dental care
• C) Inpatient hospital stays
• D) Prescription drugs
Correct Answer: C
Rationale: Medicare Part A covers inpatient hospital stays, skilled nursing facility
care, hospice care, and some home health services. Outpatient physical therapy is
covered under Part B, and prescription drugs are covered under Part D .
Study Guide Questions Answers PDF
Verified Master Key Updated
Question 1
Mr. Chen is turning 65 next month and is currently covered under his employer's
group health plan. He wants to know if he must enroll in Medicare Part A and Part
B. What should you tell him?
• A) He must enroll in both Part A and Part B immediately upon turning 65
• B) He can delay Part A without penalty but must enroll in Part B
• C) He can delay Part B without penalty if he has creditable coverage through
his employer
• D) He must enroll in Part A but can delay Part B
Correct Answer: C
Rationale: Individuals who are still working and have employer-sponsored
coverage at age 65 can delay enrollment in Part B without penalty under the
Special Enrollment Period (SEP). Part A is premium-free for most individuals and
can be enrolled in at any time .
Question 2
What is the duration of the Initial Enrollment Period (IEP) for Medicare?
• A) A 3-month period beginning on the first day of the month of the 65th
birthday
• B) A 7-month period beginning 3 months before the month of the 65th
birthday
• C) A 6-month period beginning the month of the 65th birthday
, • D) A 12-month period beginning at age 64
Correct Answer: B
Rationale: The Initial Enrollment Period (IEP) is a 7-month window that includes
the 3 months before the month of the beneficiary's 65th birthday, the birthday
month itself, and the 3 months following. Enrollment in the first 3 months ensures
coverage begins the first day of the birthday month .
Question 3
Which of the following individuals is eligible for Medicare?
• A) A 50-year-old with no disabilities
• B) A 62-year-old retired teacher
• C) A 58-year-old receiving Social Security Disability for 24 months
• D) A 60-year-old with employer coverage only
Correct Answer: C
Rationale: Individuals under age 65 who have been receiving Social Security
Disability Insurance (SSDI) for 24 months qualify for Medicare. This is a key
eligibility exception tested on the AHIP exam .
Question 4
Mr. Rodriguez is 67 and has delayed Medicare enrollment because he has
coverage through his wife's employer plan. His wife is now retiring. What
enrollment period applies?
• A) Initial Enrollment Period
• B) General Enrollment Period
• C) Special Enrollment Period
• D) Open Enrollment Period
,Correct Answer: C
Rationale: The Special Enrollment Period (SEP) allows individuals who delayed
Medicare enrollment due to coverage under an employer group health plan to
enroll without penalty. The SEP begins when the employer coverage ends and
lasts for 8 months .
Question 5
What is the General Enrollment Period (GEP) for Medicare Part B?
• A) January 1 – March 31 each year
• B) October 15 – December 7 each year
• C) April 1 – June 30 each year
• D) January 1 – December 31 each year
Correct Answer: A
Rationale: The General Enrollment Period for Medicare Part B runs from January 1
through March 31 each year. Beneficiaries who did not enroll during their IEP can
enroll during this period, though they may face late enrollment penalties .
Question 6
Mrs. Thompson is 64 and has been diagnosed with End-Stage Renal Disease
(ESRD). She has been receiving dialysis treatments for 4 months. Is she eligible for
Medicare?
• A) No, she must be 65 to enroll
• B) No, she must receive dialysis for at least 1 year
• C) Yes, she is eligible for Medicare with ESRD
• D) Only if she also receives Social Security Disability
Correct Answer: C
Rationale: Individuals with End-Stage Renal Disease (ESRD) are eligible for
, Medicare regardless of age. Eligibility begins the first day of the fourth month of
dialysis treatments (with certain exceptions) .
Question 7
Which statement about Medicare eligibility for individuals with disabilities is
CORRECT?
• A) Individuals receiving Social Security Disability must wait 5 years for
Medicare
• B) Individuals receiving Social Security Disability for 24 months qualify for
Medicare
• C) Disability does not qualify anyone for Medicare under age 65
• D) All disabled individuals qualify for Medicare immediately
Correct Answer: B
Rationale: Individuals who receive Social Security Disability benefits for 24
months are automatically enrolled in Medicare, regardless of age .
Question 8
Medicare Part A covers which of the following?
• A) Outpatient physical therapy
• B) Routine dental care
• C) Inpatient hospital stays
• D) Prescription drugs
Correct Answer: C
Rationale: Medicare Part A covers inpatient hospital stays, skilled nursing facility
care, hospice care, and some home health services. Outpatient physical therapy is
covered under Part B, and prescription drugs are covered under Part D .
