AHIP Final Exam Actual Exam 2026/2027
| Complete Medicare Certification Test
Bank with Verified Questions & Correct
Answers | Updated for Current CMS
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Medicare Basics & Eligibility
1. Mrs. Lopez is admitted to the hospital as an
inpatient on January 10. She was previously an
inpatient from November 1 through November 25 of
the same year. How many benefit periods has Mrs.
Lopez used?
A. One benefit period
B. Two benefit periods
C. Three benefit periods
D. No benefit periods
Correct Answer: A
Rationale: A benefit period ends when the beneficiary has
been out of the hospital or SNF for 60 consecutive days.
Because Mrs. Lopez was discharged on November 25 and
,readmitted on January 10 – fewer than 60 days apart – she
is still within the same benefit period .
2. A beneficiary turns 65 on August 10, 2026. She is
still actively working at a company with 150 employees
and has had employer group health coverage since age
62. She wants to delay Part B without penalty. She
retires on March 15, 2027, and employer coverage
ends March 31, 2027. What is the last day of her
Special Enrollment Period (SEP) to enroll in Part B
without a late enrollment penalty?
A. August 10, 2027 (12 months after turning 65)
B. September 30, 2027 (6 months after employer coverage
ends)
C. November 30, 2027 (8 months after employer coverage
ends)
D. December 31, 2027
Correct Answer: C
Rationale: The Part B SEP for active employment-based
coverage lasts 8 months after employment ends OR group
health coverage ends, whichever comes first. Coverage
ended March 31, 2027 → plus 8 months = November 30,
2027 .
3. Mr. Diaz continued working with his company and
was insured under his employer's group plan until he
reached age 68. He has heard that there is a premium
,penalty for those who did not sign up for Part B when
first eligible and wants to know how much he will have
to pay.
A. He will pay the standard Part B penalty of 10% per year.
B. Mr. Diaz will not pay any penalty because he had
continuous coverage under his employer's plan.
C. He will pay a penalty based on his income level.
D. He will pay a penalty of 1% per month.
Correct Answer: B
Rationale: Individuals who have continuous creditable
coverage under an employer-sponsored group health plan
are not subject to the Part B late enrollment penalty when
they eventually enroll .
4. Madeline Martinez was widowed several years ago.
Her husband worked for many years and contributed
into the Medicare system. He also left a substantial
estate which provides Madeline with an annual income
of approximately $130,000. What should you tell her
about Medicare eligibility and costs?
A. Madeline will not qualify for Medicare because she has
not worked enough.
B. Madeline will be able to enroll in Medicare Part A
without paying monthly premiums due to her husband's
long work record. She will pay Part B premiums at more
than the standard lowest rate but less than the highest
, rate due to her substantial income.
C. Madeline will have to pay full premiums for both Part A
and Part B.
D. Madeline should apply for Medicaid instead of
Medicare.
Correct Answer: B
Rationale: Madeline qualifies for premium-free Part A
based on her husband's work record. However, her income
of approximately $130,000 will subject her to the Income-
Related Monthly Adjustment Amount (IRMAA), meaning
she will pay higher Part B premiums .
5. Ms. Kumar is concerned that her 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: Eligibility for Medicare is based on age (65+),
certain disabilities, and specific diseases, not income.
| Complete Medicare Certification Test
Bank with Verified Questions & Correct
Answers | Updated for Current CMS
Guidelines | A+ Graded Guaranteed Pass
Medicare Basics & Eligibility
1. Mrs. Lopez is admitted to the hospital as an
inpatient on January 10. She was previously an
inpatient from November 1 through November 25 of
the same year. How many benefit periods has Mrs.
Lopez used?
A. One benefit period
B. Two benefit periods
C. Three benefit periods
D. No benefit periods
Correct Answer: A
Rationale: A benefit period ends when the beneficiary has
been out of the hospital or SNF for 60 consecutive days.
Because Mrs. Lopez was discharged on November 25 and
,readmitted on January 10 – fewer than 60 days apart – she
is still within the same benefit period .
2. A beneficiary turns 65 on August 10, 2026. She is
still actively working at a company with 150 employees
and has had employer group health coverage since age
62. She wants to delay Part B without penalty. She
retires on March 15, 2027, and employer coverage
ends March 31, 2027. What is the last day of her
Special Enrollment Period (SEP) to enroll in Part B
without a late enrollment penalty?
A. August 10, 2027 (12 months after turning 65)
B. September 30, 2027 (6 months after employer coverage
ends)
C. November 30, 2027 (8 months after employer coverage
ends)
D. December 31, 2027
Correct Answer: C
Rationale: The Part B SEP for active employment-based
coverage lasts 8 months after employment ends OR group
health coverage ends, whichever comes first. Coverage
ended March 31, 2027 → plus 8 months = November 30,
2027 .
3. Mr. Diaz continued working with his company and
was insured under his employer's group plan until he
reached age 68. He has heard that there is a premium
,penalty for those who did not sign up for Part B when
first eligible and wants to know how much he will have
to pay.
A. He will pay the standard Part B penalty of 10% per year.
B. Mr. Diaz will not pay any penalty because he had
continuous coverage under his employer's plan.
C. He will pay a penalty based on his income level.
D. He will pay a penalty of 1% per month.
Correct Answer: B
Rationale: Individuals who have continuous creditable
coverage under an employer-sponsored group health plan
are not subject to the Part B late enrollment penalty when
they eventually enroll .
4. Madeline Martinez was widowed several years ago.
Her husband worked for many years and contributed
into the Medicare system. He also left a substantial
estate which provides Madeline with an annual income
of approximately $130,000. What should you tell her
about Medicare eligibility and costs?
A. Madeline will not qualify for Medicare because she has
not worked enough.
B. Madeline will be able to enroll in Medicare Part A
without paying monthly premiums due to her husband's
long work record. She will pay Part B premiums at more
than the standard lowest rate but less than the highest
, rate due to her substantial income.
C. Madeline will have to pay full premiums for both Part A
and Part B.
D. Madeline should apply for Medicaid instead of
Medicare.
Correct Answer: B
Rationale: Madeline qualifies for premium-free Part A
based on her husband's work record. However, her income
of approximately $130,000 will subject her to the Income-
Related Monthly Adjustment Amount (IRMAA), meaning
she will pay higher Part B premiums .
5. Ms. Kumar is concerned that her 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: Eligibility for Medicare is based on age (65+),
certain disabilities, and specific diseases, not income.
