2026 AHIP
CERTIFICATION EXAM
Actual Questions and Answers
What’s Inside?
Actual AHIP 2026 Certification Exam questions with verified
and explained answers
Fully aligned with the latest CMS & AHIP training modules
Detailed coverage of all exam sections,
Each question includes rationales and key references to reinforce
understanding
Content designed to mirror the official AHIP
testing environment
,**1.Edwardsufferedfromseriouskidneydisease.Asaresult,Edward bec c
n cn
ameeligibleforMedicarecoverageduetoend-
stagerenaldisease (ESRD).A closerelativedonatedtheirkidneyandEd c n c
n q c n c
n
wardsuccessfully underwent transplantsurgery12monthsago.Edwar cn q c n c
n c
n c
n
disnowage50and asks youifhisMedicarecoveragewillcontinue,w hat s c
n c
n cn cn c
n c
n q c n
hould yousay?** cn
A. HisMedicarecoveragewillend12monthsaftertransplantsurgery, r qw cn
egardlessofhisage. n
c n
c n
c
B. HisMedicarecoveragewillcontinueaslongashereceivesfollow-
upcare forthetransplant.
cn cn n
c n
c
C. HisMedicarecoveragewillend36monthsafterthetransplant unlesshe cn
q cn
otherwisequalifies. n
c
D. HisMedicarecoverageendsimmediatelyaftertransplantsurgery.
**CorrectAnswer:C.HisMedicarecoveragewillend36monthsafterthe transp
q
w cn cn
lant unlessheotherwisequalifies.**
q c n c
n c
n
**Expert Rationale:**ForindividualseligibleforMedicareduetoESRD, cover
q c n n
c n
c cn cn cn cn cn cn cn
ageends36monthsafterasuccessfulkidneytransplant unlessthey qualifyforM cn
q c n cn
edicareduetoageordisability.Edward’scoveragewillcontinue for3yearspost-
cn n
c n
c n
c n
c n
c cn cn cn cn cn cn cn
transplant unlessheturns65orqualifiesfordisability. q c n n
c n
c n
c n
c n
c cn cn
---
**2.Ms.Hendersonbelieves that shewillqualifyforMedicareCoverage whens
c
n c
n c n
q c
n c
n cn
heturns65,without payinganypremiums,because c n
q
,shehasbeenworkingfor40yearsandpayingMedicaretaxes.What sho c
n c
n q c n
uldyoutellher?**
c
n
A. SheisnoteligibleforanyMedicarecoverage.
B. ShewillreceiveMedicarePartAwithout premiums,but must pay qw q cn qw q cn c
premiumsforPart B.
n n
c n
c q c n
C. Shewillnot needtopayanypremiumsforPartA cn
q n
c qw c n c n c n orPartB.
D. SheisonlyeligibleforMedicarePart B. cn
q
**CorrectAnswer:B.ShewillreceiveMedicarePartAw ithout premiums,
q
w q
w wq q cn c
but must paypremiumsforPart B.**
n q c n q c n c
n q c n
**Expert Rationale:**Individualswithsufficientwork credits(generally40 quar
q c n n
c cn cn q c n cn cn cn
ters)receivepremium-cn n
c
freePart A at age65.However,Part Brequiresa monthlypremium,whichisinco
cn q qw q c n n
c n
c n
c q c n cn cn cn cn cn cn cn
me-
adjusted.Thisoftencauses confusion,but PartB premiumsarealwaysrequired
n
c n
c n
c c n cn qw
unlessshequalifiesforMedicaidorother coverage. cn n
c cn cn cn
---
**3. Ms. Lewishasaggressivecancerandwouldliketoknowif Medicare w
cn cn cn cn
illcoverhospiceservicesincasesheneedsthem.What should youtell he c n
q cn cn
r?**
A. HospiceisnotcoveredunderOriginalMedicare. q
B. HospiceiscoveredunderMedicarePartA . qw c n c n
C. HospiceiscoveredunderMedicarePartB.
, D. HospiceisonlycoveredifshehasaMedicareAdvantageplan.
**CorrectAnswer:B.HospiceiscoveredunderMedicarePartA.**
q
w
**Expert Rationale:**Hospicecareisa benefit under PartAo fMedicare,
cn
q cn
q cn
q qw c n c n
availabletoterminallyillindividualswhoelecttofocusoncomfort carerather tha
n
c n
c n
c cn cn cn cn cn c n
q cn cn
ncurativetreatment.Coverageincludespainrelief,symptom management,an
cn n
c n
c n
c cn cn cn cn cn
dsupport services.
cn q c n
---
**4.Mr.CapadonawouldliketopurchaseaMedicareAdvantage(MA)plan c
n cn
andaMedigapplantopick upcosts notcoveredbythat plan.
c
n c n
q c
n c n
q
Whatshouldyoutellhim?**
A. HecanenrollinbothMAa ndMedigapplans. qw c n c n
B. MedigapcanonlybeusedwithOriginalMedicare,notMAp lans. qw
C. MedigapwillcovercostsnotincludedbyMAplans.
D. Hedoesnot needanyplan. c n
q
**CorrectAnswer:B.MedigapcanonlybeusedwithOriginalMedicare, no
q
w cn c
n c
n cn
t MA plans.**
q cn q cn
**Expert Rationale:**FederallawprohibitsthesaleofMedigappoliciesto individua
q cn cn cn
lsenrolledinMedicareAdvantage,sinceMedigapsupplementsonly
cn n
c n
c cn cn cn cn
OriginalMedicare( PartAa ndPartB),not MedicareAdvantageplans.
cn n
c qw c n c n n
c cn cn cn
q cn
CERTIFICATION EXAM
Actual Questions and Answers
What’s Inside?
Actual AHIP 2026 Certification Exam questions with verified
and explained answers
Fully aligned with the latest CMS & AHIP training modules
Detailed coverage of all exam sections,
Each question includes rationales and key references to reinforce
understanding
Content designed to mirror the official AHIP
testing environment
,**1.Edwardsufferedfromseriouskidneydisease.Asaresult,Edward bec c
n cn
ameeligibleforMedicarecoverageduetoend-
stagerenaldisease (ESRD).A closerelativedonatedtheirkidneyandEd c n c
n q c n c
n
wardsuccessfully underwent transplantsurgery12monthsago.Edwar cn q c n c
n c
n c
n
disnowage50and asks youifhisMedicarecoveragewillcontinue,w hat s c
n c
n cn cn c
n c
n q c n
hould yousay?** cn
A. HisMedicarecoveragewillend12monthsaftertransplantsurgery, r qw cn
egardlessofhisage. n
c n
c n
c
B. HisMedicarecoveragewillcontinueaslongashereceivesfollow-
upcare forthetransplant.
cn cn n
c n
c
C. HisMedicarecoveragewillend36monthsafterthetransplant unlesshe cn
q cn
otherwisequalifies. n
c
D. HisMedicarecoverageendsimmediatelyaftertransplantsurgery.
**CorrectAnswer:C.HisMedicarecoveragewillend36monthsafterthe transp
q
w cn cn
lant unlessheotherwisequalifies.**
q c n c
n c
n
**Expert Rationale:**ForindividualseligibleforMedicareduetoESRD, cover
q c n n
c n
c cn cn cn cn cn cn cn
ageends36monthsafterasuccessfulkidneytransplant unlessthey qualifyforM cn
q c n cn
edicareduetoageordisability.Edward’scoveragewillcontinue for3yearspost-
cn n
c n
c n
c n
c n
c cn cn cn cn cn cn cn
transplant unlessheturns65orqualifiesfordisability. q c n n
c n
c n
c n
c n
c cn cn
---
**2.Ms.Hendersonbelieves that shewillqualifyforMedicareCoverage whens
c
n c
n c n
q c
n c
n cn
heturns65,without payinganypremiums,because c n
q
,shehasbeenworkingfor40yearsandpayingMedicaretaxes.What sho c
n c
n q c n
uldyoutellher?**
c
n
A. SheisnoteligibleforanyMedicarecoverage.
B. ShewillreceiveMedicarePartAwithout premiums,but must pay qw q cn qw q cn c
premiumsforPart B.
n n
c n
c q c n
C. Shewillnot needtopayanypremiumsforPartA cn
q n
c qw c n c n c n orPartB.
D. SheisonlyeligibleforMedicarePart B. cn
q
**CorrectAnswer:B.ShewillreceiveMedicarePartAw ithout premiums,
q
w q
w wq q cn c
but must paypremiumsforPart B.**
n q c n q c n c
n q c n
**Expert Rationale:**Individualswithsufficientwork credits(generally40 quar
q c n n
c cn cn q c n cn cn cn
ters)receivepremium-cn n
c
freePart A at age65.However,Part Brequiresa monthlypremium,whichisinco
cn q qw q c n n
c n
c n
c q c n cn cn cn cn cn cn cn
me-
adjusted.Thisoftencauses confusion,but PartB premiumsarealwaysrequired
n
c n
c n
c c n cn qw
unlessshequalifiesforMedicaidorother coverage. cn n
c cn cn cn
---
**3. Ms. Lewishasaggressivecancerandwouldliketoknowif Medicare w
cn cn cn cn
illcoverhospiceservicesincasesheneedsthem.What should youtell he c n
q cn cn
r?**
A. HospiceisnotcoveredunderOriginalMedicare. q
B. HospiceiscoveredunderMedicarePartA . qw c n c n
C. HospiceiscoveredunderMedicarePartB.
, D. HospiceisonlycoveredifshehasaMedicareAdvantageplan.
**CorrectAnswer:B.HospiceiscoveredunderMedicarePartA.**
q
w
**Expert Rationale:**Hospicecareisa benefit under PartAo fMedicare,
cn
q cn
q cn
q qw c n c n
availabletoterminallyillindividualswhoelecttofocusoncomfort carerather tha
n
c n
c n
c cn cn cn cn cn c n
q cn cn
ncurativetreatment.Coverageincludespainrelief,symptom management,an
cn n
c n
c n
c cn cn cn cn cn
dsupport services.
cn q c n
---
**4.Mr.CapadonawouldliketopurchaseaMedicareAdvantage(MA)plan c
n cn
andaMedigapplantopick upcosts notcoveredbythat plan.
c
n c n
q c
n c n
q
Whatshouldyoutellhim?**
A. HecanenrollinbothMAa ndMedigapplans. qw c n c n
B. MedigapcanonlybeusedwithOriginalMedicare,notMAp lans. qw
C. MedigapwillcovercostsnotincludedbyMAplans.
D. Hedoesnot needanyplan. c n
q
**CorrectAnswer:B.MedigapcanonlybeusedwithOriginalMedicare, no
q
w cn c
n c
n cn
t MA plans.**
q cn q cn
**Expert Rationale:**FederallawprohibitsthesaleofMedigappoliciesto individua
q cn cn cn
lsenrolledinMedicareAdvantage,sinceMedigapsupplementsonly
cn n
c n
c cn cn cn cn
OriginalMedicare( PartAa ndPartB),not MedicareAdvantageplans.
cn n
c qw c n c n n
c cn cn cn
q cn