AHIP Final Exam 2026/2027: Practice
Questions with Rationales – Complete
Study Guide
Question 1
Mrs. West wears glasses and dentures and has enjoyed considerable pain
relief from arthritis through acupuncture. She is concerned about whether
Medicare will cover these items and services. What should you tell her?
A. Medicare covers acupuncture, glasses, and dentures
B. Medicare covers acupuncture only
C. Medicare covers glasses and dentures only
D. Medicare does not cover acupuncture, or, in general, glasses or dentures
Correct Answer: D
Rationale: Original Medicare does not cover acupuncture, or, in general,
glasses or dentures. While some Medicare Advantage plans may offer
supplemental benefits that cover these items, Original Medicare Parts A
and B do not cover routine vision, dental, or acupuncture services. This is a
key distinction when explaining Medicare coverage to beneficiaries .
Question 2
Mr. Capadona would like to purchase a Medicare Advantage (MA) plan. He
,is 67 years old and has been enrolled in Original Medicare Parts A and B.
Which enrollment period is he in if he wants to join an MA plan?
A. Initial Enrollment Period (IEP)
B. Annual Enrollment Period (AEP)
C. Special Enrollment Period (SEP)
D. Medicare Advantage Open Enrollment Period (MA OEP)
Correct Answer: B
Rationale: The Annual Enrollment Period (AEP) runs from October 15 to
December 7 each year. During this period, beneficiaries enrolled in Original
Medicare can join a Medicare Advantage plan. Since Mr. Capadona is
already enrolled in Parts A and B, the AEP is the appropriate enrollment
period. IEP is for when a beneficiary first becomes eligible for Medicare, SEP
requires a qualifying event, and MA OEP is for beneficiaries already enrolled
in MA plans .
Question 3
Which of the following is true about Medicare Part A?
A. It covers outpatient medical services and doctor visits
B. It covers inpatient hospital care, skilled nursing facility care, hospice, and
some home health services
C. It covers prescription drugs only
D. It covers vision, dental, and hearing services exclusively
Correct Answer: B
Rationale: Medicare Part A is hospital insurance that covers inpatient
hospital stays, skilled nursing facility care, hospice care, and limited home
,health services. Outpatient services are covered under Part B, and
prescription drugs are covered under Part D. Part A does not cover routine
vision, dental, or hearing .
Question 4
What is the standard monthly premium for Medicare Part B for 2026?
A. $0 (premium-free)
B. $174.70 per month
C. $278.50 per month
D. $500.00 per month
Correct Answer: B
Rationale: The standard monthly premium for Medicare Part B is $174.70
for 2026. Higher-income beneficiaries may pay more due to Income-
Related Monthly Adjustment Amount (IRMAA). Part A is premium-free for
most beneficiaries who worked at least 40 quarters .
Question 5
Mrs. Park is an elderly retiree who has Medicare Part A and Part B. She is
concerned about costs because she has heard there are some gaps in her
coverage. What can you tell her?
A. Medigap plans cover the gaps in Original Medicare coverage
B. Medicare Advantage plans are the only option for additional coverage
C. She cannot purchase additional coverage
D. She must wait until she turns 70 to get extra coverage
, Correct Answer: A
Rationale: Medigap (Medicare Supplement Insurance) policies help pay
some of the health care costs that Original Medicare doesn't cover, such as
copayments, coinsurance, and deductibles. These plans are designed
specifically to fill the "gaps" in Original Medicare coverage and are sold by
private insurance companies .
Question 6
What is the Medicare Part A inpatient hospital deductible for 2026?
A. $500
B. $1,676
C. $2,000
D. $240
Correct Answer: B
Rationale: The Medicare Part A inpatient hospital deductible is $1,676 for
2026. This is the amount the beneficiary pays for each benefit period before
Medicare begins to pay. The Part B annual deductible is $240 for 2026 .
Question 7
The Part D coverage gap (donut hole) in 2026:
A. Is no longer applicable
B. Requires beneficiaries to pay 25% of drug costs for brand-name and
generic drugs
Questions with Rationales – Complete
Study Guide
Question 1
Mrs. West wears glasses and dentures and has enjoyed considerable pain
relief from arthritis through acupuncture. She is concerned about whether
Medicare will cover these items and services. What should you tell her?
A. Medicare covers acupuncture, glasses, and dentures
B. Medicare covers acupuncture only
C. Medicare covers glasses and dentures only
D. Medicare does not cover acupuncture, or, in general, glasses or dentures
Correct Answer: D
Rationale: Original Medicare does not cover acupuncture, or, in general,
glasses or dentures. While some Medicare Advantage plans may offer
supplemental benefits that cover these items, Original Medicare Parts A
and B do not cover routine vision, dental, or acupuncture services. This is a
key distinction when explaining Medicare coverage to beneficiaries .
Question 2
Mr. Capadona would like to purchase a Medicare Advantage (MA) plan. He
,is 67 years old and has been enrolled in Original Medicare Parts A and B.
Which enrollment period is he in if he wants to join an MA plan?
A. Initial Enrollment Period (IEP)
B. Annual Enrollment Period (AEP)
C. Special Enrollment Period (SEP)
D. Medicare Advantage Open Enrollment Period (MA OEP)
Correct Answer: B
Rationale: The Annual Enrollment Period (AEP) runs from October 15 to
December 7 each year. During this period, beneficiaries enrolled in Original
Medicare can join a Medicare Advantage plan. Since Mr. Capadona is
already enrolled in Parts A and B, the AEP is the appropriate enrollment
period. IEP is for when a beneficiary first becomes eligible for Medicare, SEP
requires a qualifying event, and MA OEP is for beneficiaries already enrolled
in MA plans .
Question 3
Which of the following is true about Medicare Part A?
A. It covers outpatient medical services and doctor visits
B. It covers inpatient hospital care, skilled nursing facility care, hospice, and
some home health services
C. It covers prescription drugs only
D. It covers vision, dental, and hearing services exclusively
Correct Answer: B
Rationale: Medicare Part A is hospital insurance that covers inpatient
hospital stays, skilled nursing facility care, hospice care, and limited home
,health services. Outpatient services are covered under Part B, and
prescription drugs are covered under Part D. Part A does not cover routine
vision, dental, or hearing .
Question 4
What is the standard monthly premium for Medicare Part B for 2026?
A. $0 (premium-free)
B. $174.70 per month
C. $278.50 per month
D. $500.00 per month
Correct Answer: B
Rationale: The standard monthly premium for Medicare Part B is $174.70
for 2026. Higher-income beneficiaries may pay more due to Income-
Related Monthly Adjustment Amount (IRMAA). Part A is premium-free for
most beneficiaries who worked at least 40 quarters .
Question 5
Mrs. Park is an elderly retiree who has Medicare Part A and Part B. She is
concerned about costs because she has heard there are some gaps in her
coverage. What can you tell her?
A. Medigap plans cover the gaps in Original Medicare coverage
B. Medicare Advantage plans are the only option for additional coverage
C. She cannot purchase additional coverage
D. She must wait until she turns 70 to get extra coverage
, Correct Answer: A
Rationale: Medigap (Medicare Supplement Insurance) policies help pay
some of the health care costs that Original Medicare doesn't cover, such as
copayments, coinsurance, and deductibles. These plans are designed
specifically to fill the "gaps" in Original Medicare coverage and are sold by
private insurance companies .
Question 6
What is the Medicare Part A inpatient hospital deductible for 2026?
A. $500
B. $1,676
C. $2,000
D. $240
Correct Answer: B
Rationale: The Medicare Part A inpatient hospital deductible is $1,676 for
2026. This is the amount the beneficiary pays for each benefit period before
Medicare begins to pay. The Part B annual deductible is $240 for 2026 .
Question 7
The Part D coverage gap (donut hole) in 2026:
A. Is no longer applicable
B. Requires beneficiaries to pay 25% of drug costs for brand-name and
generic drugs
