2027 AHIP Final Exam – Medicare
Certification – Actual Questions &
Answers (AHIP) Guarantee Pass (Updated
Pdf)
SECTION 1: MEDICARE BASICS – PARTS A & B
Question 1:
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full
time, and paid taxes during that entire period. Which of the following is true regarding
her Medicare eligibility?
A) She is eligible for premium-free Part A
B) She must pay a premium for Part A
C) She is not eligible for Medicare
D) She is only eligible for Part B
Correct Answer: A) She is eligible for premium-free Part A
Rationale: Individuals who are age 65 or older and have been a U.S. citizen or
permanent resident for at least five years, and who have worked and paid Medicare
taxes for at least 10 years (40 quarters), are eligible for premium-free Part A .
,Question 2:
Which part of Medicare covers inpatient hospital stays, care in a skilled nursing facility,
hospice care, and some home health care?
A) Part A
B) Part B
C) Part C
D) Part D
Correct Answer: A) Part A
Rationale: Medicare Part A specifically covers institutional and inpatient care services,
such as hospital stays, skilled nursing facility care, hospice, and some home health
services .
Question 3:
To be entitled to Medicare Part A without paying a monthly premium, how many
quarters of coverage must an individual or their spouse earn through payroll taxes?
A) 20 quarters
B) 30 quarters
C) 40 quarters
D) 50 quarters
Correct Answer: C) 40 quarters
Rationale: Individuals who have worked at least 40 quarters (10 years) in Medicare-
covered employment do not have to pay a premium for Part A .
Question 4:
Medicare Part B covers which of the following services?
A) Inpatient surgery
B) Outpatient physician services and preventive care
C) Long-term custodial care in a nursing home
D) Routine cosmetic procedures
,Correct Answer: B) Outpatient physician services and preventive care
Rationale: Part B covers medically necessary outpatient services, doctor visits, durable
medical equipment, and preventive care. It does not cover inpatient surgery, long-term
custodial care, or routine cosmetic procedures .
Question 5:
What is the standard monthly premium for Medicare Part B based upon?
A) The beneficiary's zip code
B) The beneficiary's modified adjusted gross income (MAGI)
C) The beneficiary's health status and pre-existing conditions
D) The number of years the beneficiary has been retired
Correct Answer: B) The beneficiary's modified adjusted gross income (MAGI)
Rationale: Higher-income beneficiaries pay a higher Part B premium based on their
Modified Adjusted Gross Income, known as the Income-Related Monthly Adjustment
Amount (IRMAA) .
Question 6:
What percentage of the Medicare-approved amount does a beneficiary typically pay for
Part B covered services after meeting their annual deductible?
A) 10%
B) 20%
C) 30%
D) 50%
Correct Answer: B) 20%
Rationale: Under Original Medicare Part B, the beneficiary is responsible for a 20%
coinsurance after the annual deductible is satisfied .
, Question 7:
Mrs. Ellis received a letter that she was automatically enrolled in Medicare Part B after
retirement. She wants to understand what this means. What should you tell her?
A) Medicare Part B covers only hospital services
B) Part B primarily covers physician services. She will be paying a monthly premium and,
except for many preventive and screening tests, generally will have 20% co-payments
for these services, in addition to an annual deductible
C) Part B is free for everyone
D) Part B is optional and requires no payment
Correct Answer: B) Part B primarily covers physician services. She will be paying a
monthly premium and, except for many preventive and screening tests, generally
will have 20% co-payments for these services, in addition to an annual deductible
Rationale: Part B covers physician and outpatient services. Beneficiaries pay a monthly
premium and a 20% coinsurance after the deductible is met. Preventive services may be
covered at no cost-sharing .
Question 8:
What is the primary difference between Medicare Part A and Part B?
A) Part A covers prescription drugs; Part B covers hospital care
B) Part A covers hospital care; Part B covers medical services
C) Part A is voluntary; Part B is mandatory
D) Part A has no deductible; Part B has a deductible
Correct Answer: B) Part A covers hospital care; Part B covers medical services
Rationale: Medicare Part A covers hospital inpatient care, skilled nursing facility care,
hospice, and some home health care. Medicare Part B covers outpatient medical
services, including physician visits, preventive services, and durable medical equipment .
Question 9:
A client asks about enrolling in Medicare Part B. What is the Initial Enrollment Period
(IEP) for Medicare?
Certification – Actual Questions &
Answers (AHIP) Guarantee Pass (Updated
Pdf)
SECTION 1: MEDICARE BASICS – PARTS A & B
Question 1:
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full
time, and paid taxes during that entire period. Which of the following is true regarding
her Medicare eligibility?
A) She is eligible for premium-free Part A
B) She must pay a premium for Part A
C) She is not eligible for Medicare
D) She is only eligible for Part B
Correct Answer: A) She is eligible for premium-free Part A
Rationale: Individuals who are age 65 or older and have been a U.S. citizen or
permanent resident for at least five years, and who have worked and paid Medicare
taxes for at least 10 years (40 quarters), are eligible for premium-free Part A .
,Question 2:
Which part of Medicare covers inpatient hospital stays, care in a skilled nursing facility,
hospice care, and some home health care?
A) Part A
B) Part B
C) Part C
D) Part D
Correct Answer: A) Part A
Rationale: Medicare Part A specifically covers institutional and inpatient care services,
such as hospital stays, skilled nursing facility care, hospice, and some home health
services .
Question 3:
To be entitled to Medicare Part A without paying a monthly premium, how many
quarters of coverage must an individual or their spouse earn through payroll taxes?
A) 20 quarters
B) 30 quarters
C) 40 quarters
D) 50 quarters
Correct Answer: C) 40 quarters
Rationale: Individuals who have worked at least 40 quarters (10 years) in Medicare-
covered employment do not have to pay a premium for Part A .
Question 4:
Medicare Part B covers which of the following services?
A) Inpatient surgery
B) Outpatient physician services and preventive care
C) Long-term custodial care in a nursing home
D) Routine cosmetic procedures
,Correct Answer: B) Outpatient physician services and preventive care
Rationale: Part B covers medically necessary outpatient services, doctor visits, durable
medical equipment, and preventive care. It does not cover inpatient surgery, long-term
custodial care, or routine cosmetic procedures .
Question 5:
What is the standard monthly premium for Medicare Part B based upon?
A) The beneficiary's zip code
B) The beneficiary's modified adjusted gross income (MAGI)
C) The beneficiary's health status and pre-existing conditions
D) The number of years the beneficiary has been retired
Correct Answer: B) The beneficiary's modified adjusted gross income (MAGI)
Rationale: Higher-income beneficiaries pay a higher Part B premium based on their
Modified Adjusted Gross Income, known as the Income-Related Monthly Adjustment
Amount (IRMAA) .
Question 6:
What percentage of the Medicare-approved amount does a beneficiary typically pay for
Part B covered services after meeting their annual deductible?
A) 10%
B) 20%
C) 30%
D) 50%
Correct Answer: B) 20%
Rationale: Under Original Medicare Part B, the beneficiary is responsible for a 20%
coinsurance after the annual deductible is satisfied .
, Question 7:
Mrs. Ellis received a letter that she was automatically enrolled in Medicare Part B after
retirement. She wants to understand what this means. What should you tell her?
A) Medicare Part B covers only hospital services
B) Part B primarily covers physician services. She will be paying a monthly premium and,
except for many preventive and screening tests, generally will have 20% co-payments
for these services, in addition to an annual deductible
C) Part B is free for everyone
D) Part B is optional and requires no payment
Correct Answer: B) Part B primarily covers physician services. She will be paying a
monthly premium and, except for many preventive and screening tests, generally
will have 20% co-payments for these services, in addition to an annual deductible
Rationale: Part B covers physician and outpatient services. Beneficiaries pay a monthly
premium and a 20% coinsurance after the deductible is met. Preventive services may be
covered at no cost-sharing .
Question 8:
What is the primary difference between Medicare Part A and Part B?
A) Part A covers prescription drugs; Part B covers hospital care
B) Part A covers hospital care; Part B covers medical services
C) Part A is voluntary; Part B is mandatory
D) Part A has no deductible; Part B has a deductible
Correct Answer: B) Part A covers hospital care; Part B covers medical services
Rationale: Medicare Part A covers hospital inpatient care, skilled nursing facility care,
hospice, and some home health care. Medicare Part B covers outpatient medical
services, including physician visits, preventive services, and durable medical equipment .
Question 9:
A client asks about enrolling in Medicare Part B. What is the Initial Enrollment Period
(IEP) for Medicare?
