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AHIP 2027 FINAL EXAM — MEDICARE CERTIFICATION QUESTIONS
LATEST EDITION 2026 – 2027 VERSION SOLVED QUESTIONS &
ANSWERS
AHIP 2027 Final Exam — Medicare Certification: Questions
SECTION 1: MEDICARE PROGRAM BASICS (Parts A, B, C, D) (Questions 1–45)
1. A client is turning 65 next month and has worked and paid Medicare taxes for
over 10 years. Which parts of Medicare are provided directly by the federal
government?
A) All four parts (A, B, C, and D) are provided directly by the federal government
B) Part A and Part B are provided directly by the federal government; Part C and Part D
are offered by private insurance companies
C) Only Part A is provided directly by the federal government
D) Part A and Part D are provided directly by the federal government
Answer: B
Rationale: Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) are
administered directly by the federal government through CMS. Medicare Part C
(Medicare Advantage) and Part D (Prescription Drug Plans) are offered by private
insurance companies that contract with CMS .
2. Who is eligible for premium-free Medicare Part A?
A) Anyone age 65 or older regardless of work history
B) Individuals age 65 or older who have worked at least 40 quarters (10 years) in
Medicare-covered employment
C) Individuals age 65 or older who have worked at least 20 quarters
D) All U.S. citizens regardless of work history
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Answer: B
Rationale: Medicare Part A is premium-free for individuals age 65 or older who have
worked at least 40 quarters (10 years) in Medicare-covered employment. Individuals
with 30–39 quarters may purchase Part A at a reduced premium .
3. A client has worked 35 quarters in Medicare-covered employment and is turning
65. Which statement is true regarding her Medicare eligibility?
A) She is eligible for premium-free Part A
B) She is not eligible for Medicare because she has not worked enough quarters
C) She can purchase Part A at a reduced premium
D) She must wait until she has 40 quarters to enroll
Answer: C
Rationale: Individuals with 30–39 quarters of Medicare-covered employment are
eligible to purchase Part A at a reduced premium .
4. What is the Initial Enrollment Period (IEP) for Medicare based on age?
A) 3 months before and 3 months after the 65th birthday month
B) 6 months before the 65th birthday month
C) Only the month of the 65th birthday
D) 3 months after the 65th birthday only
Answer: A
Rationale: The IEP is a 7-month window: 3 months before the month of the 65th
birthday, the birthday month itself, and 3 months after .
5. A client turns 65 on June 15, 2027. When does their IEP begin and end?
A) June 1 to June 30, 2027
B) March 1 to September 30, 2027
C) April 1 to July 31, 2027
D) January 1 to December 31, 2027
Answer: B
Rationale: For a June birthday, the IEP runs from March 1 through September 30 (3
months before through 3 months after) .
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6. What is the Medicare Part B late enrollment penalty?
A) A one-time fee of $500
B) A 10% premium increase for each full 12-month period you were eligible but did not
enroll
C) A 5% premium increase for each month you delayed enrollment
D) No penalty exists for late enrollment
Answer: B
Rationale: The Part B late enrollment penalty is a 10% premium increase for each full
12-month period an individual was eligible but did not enroll .
7. A client is 67 and currently has coverage through their employer's group health
plan with 100+ employees. What should you advise regarding Medicare?
A) They must enroll in Part B immediately to avoid penalties
B) They can delay Part B without penalty while covered by the large employer plan
C) They must enroll in Part A but can delay Part B
D) They should drop employer coverage and enroll in Medicare now
Answer: B
Rationale: Individuals covered by an employer group health plan based on current
employment (with 20+ employees) may delay Part B without penalty .
8. Which of the following is NOT covered by Medicare Part A?
A) Inpatient hospital care
B) Skilled nursing facility care (following a hospital stay)
C) Outpatient prescription drugs
D) Hospice care
Answer: C
Rationale: Outpatient prescription drugs are covered under Medicare Part D, not Part A.
Part A covers inpatient hospital care, skilled nursing facility care, hospice, and some
home health care .
9. What is the Annual Election Period (AEP) for Medicare Advantage and Part D
enrollment changes?
A) January 1 through March 31
B) October 15 through December 7
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C) November 1 through December 31
D) April 1 through June 30
Answer: B
Rationale: The AEP runs from October 15 through December 7 each year, during which
beneficiaries can enroll in, change, or drop Medicare Advantage and Part D plans .
10. What is the Medicare Advantage Open Enrollment Period (MA-OEP)?
A) October 15 through December 7
B) January 1 through March 31
C) April 1 through June 30
D) Only during the IEP
Answer: B
Rationale: The MA-OEP runs from January 1 through March 31, during which
beneficiaries enrolled in a Medicare Advantage plan can switch to another MA plan or
return to Original Medicare .
11. A beneficiary is enrolled in Original Medicare (Parts A and B) and wants to add
Part D prescription drug coverage. When can they enroll?
A) Only during the AEP
B) During their IEP, AEP, or a qualifying SEP
C) Only during the GEP
D) Anytime during the year
Answer: B
Rationale: Beneficiaries can enroll in Part D during their IEP, the AEP (October 15–
December 7), or a qualifying Special Enrollment Period .
12. What is the General Enrollment Period (GEP) for Medicare?
A) January 1 through March 31
B) April 1 through June 30
C) October 15 through December 7
D) November 1 through December 31
Answer: B
Rationale: The GEP runs from April 1 through June 30 each year for individuals who did
not enroll in Part A or Part B during their IEP .
AHIP 2027 FINAL EXAM — MEDICARE CERTIFICATION QUESTIONS
LATEST EDITION 2026 – 2027 VERSION SOLVED QUESTIONS &
ANSWERS
AHIP 2027 Final Exam — Medicare Certification: Questions
SECTION 1: MEDICARE PROGRAM BASICS (Parts A, B, C, D) (Questions 1–45)
1. A client is turning 65 next month and has worked and paid Medicare taxes for
over 10 years. Which parts of Medicare are provided directly by the federal
government?
A) All four parts (A, B, C, and D) are provided directly by the federal government
B) Part A and Part B are provided directly by the federal government; Part C and Part D
are offered by private insurance companies
C) Only Part A is provided directly by the federal government
D) Part A and Part D are provided directly by the federal government
Answer: B
Rationale: Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) are
administered directly by the federal government through CMS. Medicare Part C
(Medicare Advantage) and Part D (Prescription Drug Plans) are offered by private
insurance companies that contract with CMS .
2. Who is eligible for premium-free Medicare Part A?
A) Anyone age 65 or older regardless of work history
B) Individuals age 65 or older who have worked at least 40 quarters (10 years) in
Medicare-covered employment
C) Individuals age 65 or older who have worked at least 20 quarters
D) All U.S. citizens regardless of work history
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Answer: B
Rationale: Medicare Part A is premium-free for individuals age 65 or older who have
worked at least 40 quarters (10 years) in Medicare-covered employment. Individuals
with 30–39 quarters may purchase Part A at a reduced premium .
3. A client has worked 35 quarters in Medicare-covered employment and is turning
65. Which statement is true regarding her Medicare eligibility?
A) She is eligible for premium-free Part A
B) She is not eligible for Medicare because she has not worked enough quarters
C) She can purchase Part A at a reduced premium
D) She must wait until she has 40 quarters to enroll
Answer: C
Rationale: Individuals with 30–39 quarters of Medicare-covered employment are
eligible to purchase Part A at a reduced premium .
4. What is the Initial Enrollment Period (IEP) for Medicare based on age?
A) 3 months before and 3 months after the 65th birthday month
B) 6 months before the 65th birthday month
C) Only the month of the 65th birthday
D) 3 months after the 65th birthday only
Answer: A
Rationale: The IEP is a 7-month window: 3 months before the month of the 65th
birthday, the birthday month itself, and 3 months after .
5. A client turns 65 on June 15, 2027. When does their IEP begin and end?
A) June 1 to June 30, 2027
B) March 1 to September 30, 2027
C) April 1 to July 31, 2027
D) January 1 to December 31, 2027
Answer: B
Rationale: For a June birthday, the IEP runs from March 1 through September 30 (3
months before through 3 months after) .
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6. What is the Medicare Part B late enrollment penalty?
A) A one-time fee of $500
B) A 10% premium increase for each full 12-month period you were eligible but did not
enroll
C) A 5% premium increase for each month you delayed enrollment
D) No penalty exists for late enrollment
Answer: B
Rationale: The Part B late enrollment penalty is a 10% premium increase for each full
12-month period an individual was eligible but did not enroll .
7. A client is 67 and currently has coverage through their employer's group health
plan with 100+ employees. What should you advise regarding Medicare?
A) They must enroll in Part B immediately to avoid penalties
B) They can delay Part B without penalty while covered by the large employer plan
C) They must enroll in Part A but can delay Part B
D) They should drop employer coverage and enroll in Medicare now
Answer: B
Rationale: Individuals covered by an employer group health plan based on current
employment (with 20+ employees) may delay Part B without penalty .
8. Which of the following is NOT covered by Medicare Part A?
A) Inpatient hospital care
B) Skilled nursing facility care (following a hospital stay)
C) Outpatient prescription drugs
D) Hospice care
Answer: C
Rationale: Outpatient prescription drugs are covered under Medicare Part D, not Part A.
Part A covers inpatient hospital care, skilled nursing facility care, hospice, and some
home health care .
9. What is the Annual Election Period (AEP) for Medicare Advantage and Part D
enrollment changes?
A) January 1 through March 31
B) October 15 through December 7
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C) November 1 through December 31
D) April 1 through June 30
Answer: B
Rationale: The AEP runs from October 15 through December 7 each year, during which
beneficiaries can enroll in, change, or drop Medicare Advantage and Part D plans .
10. What is the Medicare Advantage Open Enrollment Period (MA-OEP)?
A) October 15 through December 7
B) January 1 through March 31
C) April 1 through June 30
D) Only during the IEP
Answer: B
Rationale: The MA-OEP runs from January 1 through March 31, during which
beneficiaries enrolled in a Medicare Advantage plan can switch to another MA plan or
return to Original Medicare .
11. A beneficiary is enrolled in Original Medicare (Parts A and B) and wants to add
Part D prescription drug coverage. When can they enroll?
A) Only during the AEP
B) During their IEP, AEP, or a qualifying SEP
C) Only during the GEP
D) Anytime during the year
Answer: B
Rationale: Beneficiaries can enroll in Part D during their IEP, the AEP (October 15–
December 7), or a qualifying Special Enrollment Period .
12. What is the General Enrollment Period (GEP) for Medicare?
A) January 1 through March 31
B) April 1 through June 30
C) October 15 through December 7
D) November 1 through December 31
Answer: B
Rationale: The GEP runs from April 1 through June 30 each year for individuals who did
not enroll in Part A or Part B during their IEP .
