MEDICARE AHIP FINAL EXAM– QUESTIONS AND
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1. Which part of the Medicare program specifically covers inpatient hospital stays, skilled
nursing facility care, hospice care, and some home health care services?
A. Part A
B. Part B
C. Part C
D. Part D
Answer: A
Medicare Part A functions as hospital insurance, primarily covering inpatient care in
hospitals, skilled nursing facilities, hospice, and select home health services.
2. A Medicare beneficiary asks an agent which component covers outpatient medical
services, doctor visits, clinical research, and durable medical equipment. What should the
agent reply?
A. Medicare Part A
B. Medicare Part B
C. Medicare Part C
D. Medicare Part D
Answer: B
Medicare Part B is medical insurance that covers physician services, outpatient care, medical
supplies, and preventive services.
3. An agent is explaining alternative delivery systems to a client who wants all-in-one
coverage through a private insurance company approved by Medicare. Which part is being
described?
A. Original Medicare
B. Medicare Part B
C. Medicare Part C (Medicare Advantage)
D. Medicare Part D
Answer: C
,Medicare Part C, known as Medicare Advantage, allows private insurers approved by
Medicare to provide all Part A and Part B benefits, often including prescription coverage.
4. A client currently enrolled in Original Medicare needs standalone coverage exclusively
for outpatient prescription drugs. Which program must the agent recommend?
A. Medicare Part C
B. Medicare Part D
C. Medigap Plan F
D. Medicaid Expansion
Answer: B
Medicare Part D provides outpatient prescription drug coverage through private insurance
plans approved by Medicare.
5. Which entity administers the federal Medicare program, establishing national policies,
regulations, and quality standards for healthcare delivery?
A. Social Security Administration (SSA)
B. Centers for Medicare & Medicaid Services (CMS)
C. Department of Labor (DOL)
D. National Association of Insurance Commissioners (NAIC)
Answer: B
CMS is the federal agency within the Department of Health and Human Services that
administers Medicare, Medicaid, and related quality initiatives.
6. A client turns 65 and qualifies for Medicare based on age. What is the standard duration
of the Initial Enrollment Period (IEP) surrounding their birth month?
A. Three months
B. Six months
C. Seven months
D. Twelve months
Answer: C
The Initial Enrollment Period spans seven months total: the three months before the birth
month, the birth month itself, and the three months following it.
7. A Medicare beneficiary misses their Initial Enrollment Period and must wait until the
General Enrollment Period (GEP). During what months does the GEP occur each year?
A. January 1 through March 31
, B. April 1 through June 30
C. October 15 through December 7
D. July 1 through September 30
Answer: A
The General Enrollment Period runs annually from January 1 through March 31, with
coverage effective the first of the month following enrollment.
8. An agent is reviewing the Annual Election Period (AEP) dates with a prospective
enrollee. What are the exact dates for the AEP each year?
A. January 1 to February 14
B. April 1 to June 30
C. October 15 to December 7
D. November 1 to January 15
Answer: C
The Annual Election Period runs from October 15 through December 7, allowing
beneficiaries to change their Medicare health and prescription drug plans for the upcoming
year.
9. During which timeframe can Medicare Advantage enrollees switch to another Medicare
Advantage plan or disenroll and return to Original Medicare?
A. Medicare Advantage Open Enrollment Period (OEP)
B. General Enrollment Period (GEP)
C. Initial Coverage Election Period (ICEP)
D. Special Enrollment Period (SEP) only
Answer: A
The Medicare Advantage Open Enrollment Period runs from January 1 through March 31,
allowing individuals enrolled in a Medicare Advantage plan to make a single plan change or
return to Original Medicare.
10. Which of the following events would trigger a Special Enrollment Period (SEP)
allowing a beneficiary to change plans outside standard windows?
A. Dissatisfaction with current plan premium increases
B. Moving out of the plan's designated service area
C. Wanting a plan with a different corporate logo
D. Forgetting to review plan documents during AEP
Answer: B
ANSWERS | VERIFIED AND WELL DETAILED ANSWERS |
PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM
UPDATE | EXAM PREP | STUDY GUIDE | PRACTICE TEST
1. Which part of the Medicare program specifically covers inpatient hospital stays, skilled
nursing facility care, hospice care, and some home health care services?
A. Part A
B. Part B
C. Part C
D. Part D
Answer: A
Medicare Part A functions as hospital insurance, primarily covering inpatient care in
hospitals, skilled nursing facilities, hospice, and select home health services.
2. A Medicare beneficiary asks an agent which component covers outpatient medical
services, doctor visits, clinical research, and durable medical equipment. What should the
agent reply?
A. Medicare Part A
B. Medicare Part B
C. Medicare Part C
D. Medicare Part D
Answer: B
Medicare Part B is medical insurance that covers physician services, outpatient care, medical
supplies, and preventive services.
3. An agent is explaining alternative delivery systems to a client who wants all-in-one
coverage through a private insurance company approved by Medicare. Which part is being
described?
A. Original Medicare
B. Medicare Part B
C. Medicare Part C (Medicare Advantage)
D. Medicare Part D
Answer: C
,Medicare Part C, known as Medicare Advantage, allows private insurers approved by
Medicare to provide all Part A and Part B benefits, often including prescription coverage.
4. A client currently enrolled in Original Medicare needs standalone coverage exclusively
for outpatient prescription drugs. Which program must the agent recommend?
A. Medicare Part C
B. Medicare Part D
C. Medigap Plan F
D. Medicaid Expansion
Answer: B
Medicare Part D provides outpatient prescription drug coverage through private insurance
plans approved by Medicare.
5. Which entity administers the federal Medicare program, establishing national policies,
regulations, and quality standards for healthcare delivery?
A. Social Security Administration (SSA)
B. Centers for Medicare & Medicaid Services (CMS)
C. Department of Labor (DOL)
D. National Association of Insurance Commissioners (NAIC)
Answer: B
CMS is the federal agency within the Department of Health and Human Services that
administers Medicare, Medicaid, and related quality initiatives.
6. A client turns 65 and qualifies for Medicare based on age. What is the standard duration
of the Initial Enrollment Period (IEP) surrounding their birth month?
A. Three months
B. Six months
C. Seven months
D. Twelve months
Answer: C
The Initial Enrollment Period spans seven months total: the three months before the birth
month, the birth month itself, and the three months following it.
7. A Medicare beneficiary misses their Initial Enrollment Period and must wait until the
General Enrollment Period (GEP). During what months does the GEP occur each year?
A. January 1 through March 31
, B. April 1 through June 30
C. October 15 through December 7
D. July 1 through September 30
Answer: A
The General Enrollment Period runs annually from January 1 through March 31, with
coverage effective the first of the month following enrollment.
8. An agent is reviewing the Annual Election Period (AEP) dates with a prospective
enrollee. What are the exact dates for the AEP each year?
A. January 1 to February 14
B. April 1 to June 30
C. October 15 to December 7
D. November 1 to January 15
Answer: C
The Annual Election Period runs from October 15 through December 7, allowing
beneficiaries to change their Medicare health and prescription drug plans for the upcoming
year.
9. During which timeframe can Medicare Advantage enrollees switch to another Medicare
Advantage plan or disenroll and return to Original Medicare?
A. Medicare Advantage Open Enrollment Period (OEP)
B. General Enrollment Period (GEP)
C. Initial Coverage Election Period (ICEP)
D. Special Enrollment Period (SEP) only
Answer: A
The Medicare Advantage Open Enrollment Period runs from January 1 through March 31,
allowing individuals enrolled in a Medicare Advantage plan to make a single plan change or
return to Original Medicare.
10. Which of the following events would trigger a Special Enrollment Period (SEP)
allowing a beneficiary to change plans outside standard windows?
A. Dissatisfaction with current plan premium increases
B. Moving out of the plan's designated service area
C. Wanting a plan with a different corporate logo
D. Forgetting to review plan documents during AEP
Answer: B
