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AHIP FINAL EXAM: ACTUAL MEDICARE TRAINING EXAM
LATEST VERSION QUESTIONS AND ANSWERS 2026 EDITION
AHIP FINAL EXAM: ACTUAL MEDICARE TRAINING EXAM
QUESTIONS 1-50: MEDICARE PROGRAM BASICS & ELIGIBILITY
1. Mrs. Chen, a 65-year-old citizen who has been a U.S. resident for 12 years, is
concerned that she won't qualify for Medicare Part A coverage because she wasn't
born in the United States. What should you tell her?
A. She is ineligible for Medicare Part A because she is not a natural-born citizen
B. She is not eligible because she has not been a U.S. resident for at least 15 years
C. Most individuals who are citizens and over age 65 are covered under Part A by virtue
of having paid Medicare taxes while working, though some may be covered as a result of
paying monthly premiums
D. She must first enroll in a Medicare Advantage plan before she can qualify for Part A
Correct Answer: C
Rationale: Medicare Part A eligibility is based on age, citizenship, and work history, not
country of birth. Most individuals over 65 who are citizens and have paid Medicare taxes
for at least 10 years (40 quarters) qualify for premium-free Part A. Those who do not
have sufficient work history may still be eligible for Part A but may need to pay a monthly
premium. Birthplace does not determine eligibility; citizenship and residency status are
the key factors .
2. Mr. Singh would like prescription drug coverage but does not want to be enrolled
in a Medicare Advantage plan. What should you tell him?
A. He must switch to a Medicare Advantage Prescription Drug plan for coverage
B. Drug coverage is only available through Medigap
C. He cannot get drug coverage under Original Medicare
D. Mr. Singh can enroll in a stand-alone prescription drug plan and continue to be
covered for Part A and Part B services through Original Fee-for-Service Medicare
Correct Answer: D
Rationale: Beneficiaries who wish to remain in Original Medicare (Parts A and B) can
enroll in a stand-alone Medicare Prescription Drug Plan (PDP) to obtain Part D
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prescription drug coverage. This allows them to keep their Original Medicare coverage
while adding drug benefits. Medigap plans do not typically include prescription drug
coverage. Medicare Advantage is not the only option for drug coverage .
3. Mr. Bauer, a 49-year-old individual with a disability, has been receiving Social
Security Disability Insurance (SSDI) for 24 months. Is he eligible for Medicare?
A. No, Medicare is only available to individuals age 65 and older
B. Yes, individuals with disabilities who receive SSDI are eligible after 24 months of
receiving disability benefits
C. No, he must wait until age 65 to enroll in Medicare
D. Yes, but only if he also has End-Stage Renal Disease (ESRD)
Correct Answer: B
Rationale: Medicare eligibility extends beyond age 65 to include individuals under 65
who have been receiving Social Security Disability Insurance (SSDI) benefits for at least
24 months. ESRD and ALS (Lou Gehrig's disease) also qualify individuals for Medicare
regardless of age. Mr. Bauer's 24 months of SSDI benefits make him eligible for
Medicare even at age 49 .
4. Mrs. Kumar is concerned that her high income will make her ineligible for
Medicare at age 65. What could you tell her?
A. High income makes one ineligible for Medicare
B. Only low-income individuals qualify for Medicare
C. Medicare is a program for people age 65 or older and those under age 65 with certain
disabilities, ESRD, and ALS, so she will be eligible for Medicare
D. She should apply for Medicaid instead
Correct Answer: C
Rationale: Medicare is not a means-tested program. Eligibility is based on age (65 or
older), disability status, or specific medical conditions, not income level. While high-
income beneficiaries may pay higher monthly premiums (Income-Related Monthly
Adjustment Amount - IRMAA), they are not excluded from Medicare coverage. Medicaid,
on the other hand, is income-based .
5. Mr. Johnson will turn 65 on March 15. He is currently covered under his
employer's group health plan and wants to continue working. When can he enroll in
Medicare Part B without penalty?
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A. He must enroll by March 15 or face a late enrollment penalty
B. He can delay enrollment without penalty as long as he has creditable employer
coverage, and his Special Enrollment Period (SEP) allows enrollment within 8 months of
losing that coverage
C. He can only enroll during the Annual Enrollment Period (AEP) from October 15 to
December 7
D. He cannot delay Part B enrollment; he must enroll at age 65
Correct Answer: B
Rationale: Individuals who continue working past age 65 and have creditable employer-
sponsored health insurance can delay Medicare Part B enrollment without incurring a
late enrollment penalty. The Special Enrollment Period (SEP) allows them to enroll in
Part B within 8 months of losing their employer coverage or ceasing employment,
whichever comes first. This is a critical protection for working seniors who do not wish
to pay Part B premiums while already covered .
6. Mrs. Geisler's neighbor told her to look at her Part D options during the Annual
Enrollment Period. What are the dates of the Annual Enrollment Period (AEP)?
A. January 1 – March 31
B. October 15 – December 7
C. April 1 – June 30
D. December 8 – December 31
Correct Answer: B
Rationale: The Medicare Annual Enrollment Period (AEP) runs from October 15 to
December 7 each year. During this time, beneficiaries can enroll in, switch, or drop
Medicare Advantage and Part D prescription drug plans. Changes made during AEP take
effect on January 1 of the following year. This is the primary enrollment period for
beneficiaries who want to review and change their coverage .
7. Mr. Capadona would like to purchase a Medicare Advantage (MA) plan and a
Medigap plan to pick up costs not covered by that plan. What should you tell him?
A. It is legal to sell him both plans as long as he understands the coverage
B. He can purchase both as long as they are from the same insurance company
C. It is illegal for you to sell Mr. Capadona a Medigap plan if he is enrolled in an MA plan,
and besides, Medigap only works with Original Medicare
D. He can purchase a Medigap plan but only for prescription drug coverage
Correct Answer: C
AHIP FINAL EXAM: ACTUAL MEDICARE TRAINING EXAM
LATEST VERSION QUESTIONS AND ANSWERS 2026 EDITION
AHIP FINAL EXAM: ACTUAL MEDICARE TRAINING EXAM
QUESTIONS 1-50: MEDICARE PROGRAM BASICS & ELIGIBILITY
1. Mrs. Chen, a 65-year-old citizen who has been a U.S. resident for 12 years, is
concerned that she won't qualify for Medicare Part A coverage because she wasn't
born in the United States. What should you tell her?
A. She is ineligible for Medicare Part A because she is not a natural-born citizen
B. She is not eligible because she has not been a U.S. resident for at least 15 years
C. Most individuals who are citizens and over age 65 are covered under Part A by virtue
of having paid Medicare taxes while working, though some may be covered as a result of
paying monthly premiums
D. She must first enroll in a Medicare Advantage plan before she can qualify for Part A
Correct Answer: C
Rationale: Medicare Part A eligibility is based on age, citizenship, and work history, not
country of birth. Most individuals over 65 who are citizens and have paid Medicare taxes
for at least 10 years (40 quarters) qualify for premium-free Part A. Those who do not
have sufficient work history may still be eligible for Part A but may need to pay a monthly
premium. Birthplace does not determine eligibility; citizenship and residency status are
the key factors .
2. Mr. Singh would like prescription drug coverage but does not want to be enrolled
in a Medicare Advantage plan. What should you tell him?
A. He must switch to a Medicare Advantage Prescription Drug plan for coverage
B. Drug coverage is only available through Medigap
C. He cannot get drug coverage under Original Medicare
D. Mr. Singh can enroll in a stand-alone prescription drug plan and continue to be
covered for Part A and Part B services through Original Fee-for-Service Medicare
Correct Answer: D
Rationale: Beneficiaries who wish to remain in Original Medicare (Parts A and B) can
enroll in a stand-alone Medicare Prescription Drug Plan (PDP) to obtain Part D
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prescription drug coverage. This allows them to keep their Original Medicare coverage
while adding drug benefits. Medigap plans do not typically include prescription drug
coverage. Medicare Advantage is not the only option for drug coverage .
3. Mr. Bauer, a 49-year-old individual with a disability, has been receiving Social
Security Disability Insurance (SSDI) for 24 months. Is he eligible for Medicare?
A. No, Medicare is only available to individuals age 65 and older
B. Yes, individuals with disabilities who receive SSDI are eligible after 24 months of
receiving disability benefits
C. No, he must wait until age 65 to enroll in Medicare
D. Yes, but only if he also has End-Stage Renal Disease (ESRD)
Correct Answer: B
Rationale: Medicare eligibility extends beyond age 65 to include individuals under 65
who have been receiving Social Security Disability Insurance (SSDI) benefits for at least
24 months. ESRD and ALS (Lou Gehrig's disease) also qualify individuals for Medicare
regardless of age. Mr. Bauer's 24 months of SSDI benefits make him eligible for
Medicare even at age 49 .
4. Mrs. Kumar is concerned that her high income will make her ineligible for
Medicare at age 65. What could you tell her?
A. High income makes one ineligible for Medicare
B. Only low-income individuals qualify for Medicare
C. Medicare is a program for people age 65 or older and those under age 65 with certain
disabilities, ESRD, and ALS, so she will be eligible for Medicare
D. She should apply for Medicaid instead
Correct Answer: C
Rationale: Medicare is not a means-tested program. Eligibility is based on age (65 or
older), disability status, or specific medical conditions, not income level. While high-
income beneficiaries may pay higher monthly premiums (Income-Related Monthly
Adjustment Amount - IRMAA), they are not excluded from Medicare coverage. Medicaid,
on the other hand, is income-based .
5. Mr. Johnson will turn 65 on March 15. He is currently covered under his
employer's group health plan and wants to continue working. When can he enroll in
Medicare Part B without penalty?
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A. He must enroll by March 15 or face a late enrollment penalty
B. He can delay enrollment without penalty as long as he has creditable employer
coverage, and his Special Enrollment Period (SEP) allows enrollment within 8 months of
losing that coverage
C. He can only enroll during the Annual Enrollment Period (AEP) from October 15 to
December 7
D. He cannot delay Part B enrollment; he must enroll at age 65
Correct Answer: B
Rationale: Individuals who continue working past age 65 and have creditable employer-
sponsored health insurance can delay Medicare Part B enrollment without incurring a
late enrollment penalty. The Special Enrollment Period (SEP) allows them to enroll in
Part B within 8 months of losing their employer coverage or ceasing employment,
whichever comes first. This is a critical protection for working seniors who do not wish
to pay Part B premiums while already covered .
6. Mrs. Geisler's neighbor told her to look at her Part D options during the Annual
Enrollment Period. What are the dates of the Annual Enrollment Period (AEP)?
A. January 1 – March 31
B. October 15 – December 7
C. April 1 – June 30
D. December 8 – December 31
Correct Answer: B
Rationale: The Medicare Annual Enrollment Period (AEP) runs from October 15 to
December 7 each year. During this time, beneficiaries can enroll in, switch, or drop
Medicare Advantage and Part D prescription drug plans. Changes made during AEP take
effect on January 1 of the following year. This is the primary enrollment period for
beneficiaries who want to review and change their coverage .
7. Mr. Capadona would like to purchase a Medicare Advantage (MA) plan and a
Medigap plan to pick up costs not covered by that plan. What should you tell him?
A. It is legal to sell him both plans as long as he understands the coverage
B. He can purchase both as long as they are from the same insurance company
C. It is illegal for you to sell Mr. Capadona a Medigap plan if he is enrolled in an MA plan,
and besides, Medigap only works with Original Medicare
D. He can purchase a Medigap plan but only for prescription drug coverage
Correct Answer: C
