2026 AHIP CERTIFICATION EXAM Actual Questions and Answers

2026 AHIP
CERTIFICATION EXAM
Actual Questions and Answers


What’s Inside?
 Actual AHIP 2026 Certification Exam questions with verified
and explained answers
 Fully aligned with the latest CMS & AHIP training modules
 Detailed coverage of all exam sections,
 Each question includes rationales and key references to reinforce
understanding
 Content designed to mirror the official AHIP
testing environment




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,**1. Edward suffered from serious kidney disease. As a result, Edward
became eligible for Medicare coverage due to end-stage renal disease
(ESRD). A close relative donated their kidney and Edward
successfully underwent transplant surgery 12 months ago. Edward is
now age 50 and asks you if his Medicare coverage will continue, what
should you say?**


A. His Medicare coverage will end 12 months after transplant surgery,
regardless of his age.
B. His Medicare coverage will continue as long as he receives follow-up
care for the transplant.
C. His Medicare coverage will end 36 months after the transplant unless he
otherwise qualifies.
D. His Medicare coverage ends immediately after transplant surgery.


**Correct Answer: C. His Medicare coverage will end 36 months after
the transplant unless he otherwise qualifies.**


**Expert Rationale:** For individuals eligible for Medicare due to ESRD,
coverage ends 36 months after a successful kidney transplant unless they
qualify for Medicare due to age or disability. Edward’s coverage will
continue for 3 years post-transplant unless he turns 65 or qualifies for
disability.


---


**2. Ms. Henderson believes that she will qualify for Medicare
Coverage when she turns 65, without paying any premiums, because




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,she has been working for 40 years and paying Medicare taxes. What
should you tell her?**xx xx xx




A. She is not eligible for any Medicare coverage.
xx xx xx xx xx xx xx




B. She will receive Medicare Part A without premiums, but must pay
xx xx xx xx xx xx xx xx xx xx xx



premiums for Part B. xx xx xx




C. She will not need to pay any premiums for Part A or Part B.
xx xx xx xx xx xx xx xx xx xx xx xx xx




D. She is only eligible for Medicare Part B.
xx xx xx xx xx xx xx




**Correct Answer: B. She will receive Medicare Part A without premiu
xx xx xx xx xx xx xx xx xx xx



ms, but must pay premiums for Part B.**
xx xx xx xx xx xx xx




**Expert Rationale:** Individuals with sufficient work credits (generally 40
xx xx xx xx xx xx xx xx xx



quarters) receive premium- xx xx



free Part A at age 65. However, Part B requires a monthly premium, which i
xx xx xx xx xx xx xx xx xx xx xx xx xx xx



s income-
xx



adjusted. This often causes confusion, but Part B premiums are always req
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uired unless she qualifies for Medicaid or other coverage.
xx xx xx xx xx xx xx xx




---


**3. Ms. Lewis has aggressive cancer and would like to know if Medic
xx xx xx xx xx xx xx xx xx xx xx xx



are will cover hospice services in case she needs them. What should
xx xx xx xx xx xx xx xx xx xx xx xx



you tell her?**
xx xx




A. Hospice is not covered under Original Medicare.
xx xx xx xx xx xx




B. Hospice is covered under Medicare Part A.
xx xx xx xx xx xx




C. Hospice is covered under Medicare Part B.
xx xx xx xx xx xx




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, D. Hospice is only covered if she has a Medicare Advantage plan.
xx xx xx xx xx xx xx xx xx xx




**Correct Answer: B. Hospice is covered under Medicare Part A.**
xx xx xx xx xx xx xx xx xx




**Expert Rationale:** Hospice care is a benefit under Part A of Medicare,
xx xx xx xx xx xx xx xx xx xx xx xx



available to terminally ill individuals who elect to focus on comfort care rat
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her than curative treatment. Coverage includes pain relief, symptom mana
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gement, and support services. xx xx xx




---


**4. Mr. Capadona would like to purchase a Medicare Advantage (MA)
xx xx xx xx xx xx xx xx xx xx xx



plan and a Medigap plan to pick up costs not covered by that plan.
xx xx xx xx xx xx xx xx xx xx xx xx xx



What should you tell him?**
xx xx xx xx




A. He can enroll in both MA and Medigap plans.
xx xx xx xx xx xx xx xx




B. Medigap can only be used with Original Medicare, not MA plans.
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C. Medigap will cover costs not included by MA plans.
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D. He does not need any plan.
xx xx xx xx xx




**Correct Answer: B. Medigap can only be used with Original Medica
xx xx xx xx xx xx xx xx xx xx



re, not MA plans.**
xx xx xx




**Expert Rationale:** Federal law prohibits the sale of Medigap policies to i
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ndividuals enrolled in Medicare Advantage, since Medigap supplements onl
xx xx xx xx xx xx xx xx



y Original Medicare (Part A and Part B), not Medicare Advantage plans.
xx xx xx xx xx xx xx xx xx xx xx




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