AHIP Final Exam Medicare Advantage Part D
Compliance FWA Certification Official
Practice Exam Actual Exam 2026/2027 with
Detailed Rationales | Complete Exam-Style
Questions | Pass Guaranteed – A+ Graded
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SECTION 1: MEDICARE BASICS & ELIGIBILITY Q1 – Q10
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Question 1 of 50
Robert turned 65 on March 15. He delayed enrolling in Medicare Part B because he was
covered under his wife's employer group health plan with 28 active employees. His wife
retired on June 1, and her coverage ended on June 30. Robert wants to know when he
can enroll in Part B without a late enrollment penalty.
. He must enroll during the General Enrollment Period from January 1 to March 31 of
A
the following year.
B. He has an 8-month Special Enrollment Period that begins the month after his group
coverage ends. ✓ CORRECT
C. He can enroll anytime during the Medicare Advantage Open Enrollment Period from
January 1 to March 31.
D. He must wait until the next Annual Election Period from October 15 to December 7.
Correct Answer: B
,Rationale: Individuals covered under an employer group health plan with 20 or more
employees qualify for a Special Enrollment Period lasting 8 months that begins the
month after employment or group coverage ends, whichever comes first. The General
Enrollment Period applies to those who missed their Initial Enrollment Period without
qualifying coverage, not to those losing employer coverage. The MA OEP and AEP are
for Medicare Advantage and Part D plan selection, not for initial Part B enrollment.
Question 2 of 50
Maria is 68 years old and has been receiving Social Security disability benefits for 24
months due to a chronic condition. She recently received her Medicare card but is
confused about which parts she is automatically enrolled in and which require a
separate application.
. She is automatically enrolled in Parts A and B, but must actively enroll in Part D if she
A
wants prescription drug coverage.
B. She is automatically enrolled in Part A only and must actively enroll in Parts B and D.
✓ CORRECT
C. She is automatically enrolled in Parts A, B, and D, but may opt out of Part D if she has
creditable coverage.
D. She is automatically enrolled in Parts A and C, but must choose between Original
Medicare and Medicare Advantage.
Correct Answer: B
Rationale: Individuals under 65 who qualify for Medicare through disability are
automatically enrolled in Part A after 24 months of Social Security disability benefits,
but they must actively enroll in Part B and Part D. Automatic enrollment in Part D does
not occur; beneficiaries must elect coverage during their Initial Enrollment Period or a
,Special Enrollment Period. Part C (Medicare Advantage) is always an active election,
never automatic.
Question 3 of 50
James, age 72, has been enrolled in Medicare Part A since turning 65 but declined Part
B because he was covered by his large employer's health plan. He retired last month
and lost that coverage. He is now concerned about the Part B late enrollment penalty
because he did not enroll when first eligible.
. He will pay a 10% premium increase for each full 12-month period he could have had
A
Part B but did not enroll, and this penalty lasts for 10 years.
B. He will pay a 10% premium increase for each full 12-month period he could have had
Part B but did not enroll, and this penalty lasts for life. ✓ CORRECT
C. He will pay a 1% premium increase for each month he delayed Part B enrollment, and
this penalty lasts for life.
D. He will not incur a late enrollment penalty because he had creditable employer
coverage with more than 20 employees.
Correct Answer: B
The Part B late enrollment penalty is 10% of the standard premium for each full
12-month period of delay, and unlike some other penalties, it lasts for the beneficiary's
lifetime. The 1% per month calculation applies to the Part D late enrollment penalty, not
Part B. While James did have creditable coverage, the penalty is still assessed for the
months between the end of his Initial Enrollment Period and the start of his Special
Enrollment Period if he delays beyond the SEP window.
Question 4 of 50
, A 67-year-old beneficiary with End-Stage Renal Disease (ESRD) approaches you during
an educational event. She currently has Original Medicare and wants to know if she can
join a Medicare Advantage plan immediately.
. She can join any Medicare Advantage plan immediately upon diagnosis of ESRD
A
without restrictions.
B. She can join a Medicare Advantage plan during her next available enrollment period,
but only if the plan is a Special Needs Plan for ESRD beneficiaries. ✓ CORRECT
C. She must remain on Original Medicare for 24 months before she is eligible to join any
Medicare Advantage plan.
D. She can join a Medicare Advantage plan only if she first disenrolls from Medicare
Part A and B.
Correct Answer: B
Rationale: Beneficiaries with ESRD are generally prohibited from enrolling in most
Medicare Advantage plans, with exceptions for Special Needs Plans specifically
designed for ESRD beneficiaries and certain other limited circumstances. The 24-month
waiting period applies to Medicare eligibility based on disability, not ESRD. Disenrolling
from Parts A and B would terminate Medicare coverage entirely, which is not a
requirement for MA enrollment.
Question 5 of 50
During a community presentation, a 64-year-old attendee asks when she should sign up
for Medicare to avoid any gaps in coverage when she turns 65. Her 65th birthday is on
August 10, and she does not have any other health insurance.
. She can sign up anytime during the 7-month Initial Enrollment Period that begins 3
A
months before her 65th birthday month and ends 3 months after. ✓ CORRECT
Compliance FWA Certification Official
Practice Exam Actual Exam 2026/2027 with
Detailed Rationales | Complete Exam-Style
Questions | Pass Guaranteed – A+ Graded
═════════════════════════════════════
═
SECTION 1: MEDICARE BASICS & ELIGIBILITY Q1 – Q10
══════════════════════════════════════
Question 1 of 50
Robert turned 65 on March 15. He delayed enrolling in Medicare Part B because he was
covered under his wife's employer group health plan with 28 active employees. His wife
retired on June 1, and her coverage ended on June 30. Robert wants to know when he
can enroll in Part B without a late enrollment penalty.
. He must enroll during the General Enrollment Period from January 1 to March 31 of
A
the following year.
B. He has an 8-month Special Enrollment Period that begins the month after his group
coverage ends. ✓ CORRECT
C. He can enroll anytime during the Medicare Advantage Open Enrollment Period from
January 1 to March 31.
D. He must wait until the next Annual Election Period from October 15 to December 7.
Correct Answer: B
,Rationale: Individuals covered under an employer group health plan with 20 or more
employees qualify for a Special Enrollment Period lasting 8 months that begins the
month after employment or group coverage ends, whichever comes first. The General
Enrollment Period applies to those who missed their Initial Enrollment Period without
qualifying coverage, not to those losing employer coverage. The MA OEP and AEP are
for Medicare Advantage and Part D plan selection, not for initial Part B enrollment.
Question 2 of 50
Maria is 68 years old and has been receiving Social Security disability benefits for 24
months due to a chronic condition. She recently received her Medicare card but is
confused about which parts she is automatically enrolled in and which require a
separate application.
. She is automatically enrolled in Parts A and B, but must actively enroll in Part D if she
A
wants prescription drug coverage.
B. She is automatically enrolled in Part A only and must actively enroll in Parts B and D.
✓ CORRECT
C. She is automatically enrolled in Parts A, B, and D, but may opt out of Part D if she has
creditable coverage.
D. She is automatically enrolled in Parts A and C, but must choose between Original
Medicare and Medicare Advantage.
Correct Answer: B
Rationale: Individuals under 65 who qualify for Medicare through disability are
automatically enrolled in Part A after 24 months of Social Security disability benefits,
but they must actively enroll in Part B and Part D. Automatic enrollment in Part D does
not occur; beneficiaries must elect coverage during their Initial Enrollment Period or a
,Special Enrollment Period. Part C (Medicare Advantage) is always an active election,
never automatic.
Question 3 of 50
James, age 72, has been enrolled in Medicare Part A since turning 65 but declined Part
B because he was covered by his large employer's health plan. He retired last month
and lost that coverage. He is now concerned about the Part B late enrollment penalty
because he did not enroll when first eligible.
. He will pay a 10% premium increase for each full 12-month period he could have had
A
Part B but did not enroll, and this penalty lasts for 10 years.
B. He will pay a 10% premium increase for each full 12-month period he could have had
Part B but did not enroll, and this penalty lasts for life. ✓ CORRECT
C. He will pay a 1% premium increase for each month he delayed Part B enrollment, and
this penalty lasts for life.
D. He will not incur a late enrollment penalty because he had creditable employer
coverage with more than 20 employees.
Correct Answer: B
The Part B late enrollment penalty is 10% of the standard premium for each full
12-month period of delay, and unlike some other penalties, it lasts for the beneficiary's
lifetime. The 1% per month calculation applies to the Part D late enrollment penalty, not
Part B. While James did have creditable coverage, the penalty is still assessed for the
months between the end of his Initial Enrollment Period and the start of his Special
Enrollment Period if he delays beyond the SEP window.
Question 4 of 50
, A 67-year-old beneficiary with End-Stage Renal Disease (ESRD) approaches you during
an educational event. She currently has Original Medicare and wants to know if she can
join a Medicare Advantage plan immediately.
. She can join any Medicare Advantage plan immediately upon diagnosis of ESRD
A
without restrictions.
B. She can join a Medicare Advantage plan during her next available enrollment period,
but only if the plan is a Special Needs Plan for ESRD beneficiaries. ✓ CORRECT
C. She must remain on Original Medicare for 24 months before she is eligible to join any
Medicare Advantage plan.
D. She can join a Medicare Advantage plan only if she first disenrolls from Medicare
Part A and B.
Correct Answer: B
Rationale: Beneficiaries with ESRD are generally prohibited from enrolling in most
Medicare Advantage plans, with exceptions for Special Needs Plans specifically
designed for ESRD beneficiaries and certain other limited circumstances. The 24-month
waiting period applies to Medicare eligibility based on disability, not ESRD. Disenrolling
from Parts A and B would terminate Medicare coverage entirely, which is not a
requirement for MA enrollment.
Question 5 of 50
During a community presentation, a 64-year-old attendee asks when she should sign up
for Medicare to avoid any gaps in coverage when she turns 65. Her 65th birthday is on
August 10, and she does not have any other health insurance.
. She can sign up anytime during the 7-month Initial Enrollment Period that begins 3
A
months before her 65th birthday month and ends 3 months after. ✓ CORRECT
