2026 AHIP MODULE 1 PRACTICE EXAM
1. Regarding Premium-free Part A, Which response best applies?
A. Part A is automatically free only for federal employees
B. Most people qualify for premium-free Part A after about 40 quarters of Medicare-covered work
C. Part A is free only after age 70
D. Everyone pays the same Part A premium
Correct Answer: B. Most people qualify for premium-free Part A after about 40 quarters of Medicare-covered
work
Rationale: Premium-free Part A is generally tied to sufficient Medicare-covered work, commonly 40 quarters,
either through the individual or a qualifying spouse.
2. A beneficiary is comparing several Medicare statements involving Part B late enrollment penalty. Which
statement should be selected as the accurate one?
A. 1% for each month
B. A one-time $100 fee
C. 20% regardless of delay
D. Generally 10% for each full 12-month period the person could have had Part B but did not, absent an exception
Correct Answer: D. Generally 10% for each full 12-month period the person could have had Part B but did not,
absent an exception
Rationale: The Part B late enrollment penalty is generally 10% for each full 12-month period of delayed
enrollment without an applicable exception and usually lasts as long as Part B coverage.
3. Alicia is reviewing Medicare coverage during a scheduled phone consultation and asks about SNF days
21-100. Which action or explanation is most appropriate?
A. $217 per day in 2026 after qualifying requirements are met
B. $283 per day
C. $0 per day
D. $434 per day
Correct Answer: A. $217 per day in 2026 after qualifying requirements are met
Rationale: For 2026, Medicare SNF coinsurance for days 21-100 is $217 per day when the stay otherwise
qualifies.
4. During a compliance review, an agent must give an accurate explanation of Routine long-term custodial
care without overstating or omitting a key rule. Which explanation should the agent use?
A. Part A covers unlimited custodial care
B. Medigap converts custodial care into a Medicare benefit
C. Original Medicare generally does not cover long-term custodial care when that is the only care needed
D. Part B covers custodial care after the deductible
Correct Answer: C. Original Medicare generally does not cover long-term custodial care when that is the only
care needed
Rationale: Medicare covers qualifying skilled care under specific conditions but generally does not cover
long-term custodial care by itself.
5. Regarding General Part B cost sharing, Which statement best resolves the question?
A. The beneficiary always pays 50%
B. Original Medicare always pays 100%
C. After the deductible, Original Medicare commonly pays 80% of the Medicare-approved amount and the
beneficiary pays 20%
D. Part B uses the Part A benefit-period deductible
Correct Answer: C. After the deductible, Original Medicare commonly pays 80% of the Medicare-approved
amount and the beneficiary pays 20%
Rationale: For many Part B services, after the annual deductible, Medicare generally pays 80% of the approved
amount and the beneficiary pays 20%.
6. A beneficiary is comparing several Medicare statements involving Premium-free
Part A. Which statement should be selected as the accurate one?
A. Most people qualify for premium-free Part A after about 40 quarters of Medicare-covered work
,B. Part A is automatically free only for federal employees
C. Everyone pays the same Part A premium
D. Part A is free only after age 70
Correct Answer: A. Most people qualify for premium-free Part A after about 40 quarters of Medicare-covered
work
Rationale: Premium-free Part A is generally tied to sufficient Medicare-covered work, commonly 40 quarters,
either through the individual or a qualifying spouse.
7. Edward is reviewing Medicare coverage while comparing next-year coverage and asks about Original
Medicare provider choice. Which option best reflects Medicare rules?
A. A referral is always required for specialists
B. The beneficiary must choose an HMO network
C. Coverage is limited to one county
D. A beneficiary can generally see any doctor or hospital that accepts Medicare
Correct Answer: D. A beneficiary can generally see any doctor or hospital that accepts Medicare
Rationale: Original Medicare generally permits use of any Medicare-participating provider nationwide, subject to
provider acceptance and coverage rules.
8. During a compliance review, an agent must give an accurate explanation of Initial Enrollment Period
without overstating or omitting a key rule. Which explanation should the agent use?
A. Only January 1-March 31
B. Generally a 7-month window centered on the month a person first becomes eligible around age 65
C. A 12-month period beginning at retirement
D. Only October 15-December 7
Correct Answer: B. Generally a 7-month window centered on the month a person first becomes eligible around
age 65
Rationale: The Medicare Initial Enrollment Period generally spans 3 months before, the month of, and 3 months
after the month of initial age-based eligibility.
9. Regarding Purpose of Medigap, How should this situation be interpreted?
A. It helps pay certain out-of-pocket costs in Original Medicare
B. It is a Medicare Advantage network plan
C. It replaces Medicare Part A and Part B
D. It is a stand-alone Part D plan
Correct Answer: A. It helps pay certain out-of-pocket costs in Original Medicare
Rationale: Medigap supplements Original Medicare by helping with certain deductibles, coinsurance, and
copayments depending on the standardized plan.
10. A beneficiary is comparing several Medicare statements involving Current employment coverage.
Which statement should be selected as the accurate one?
A. Retiree coverage always creates the same Part B SEP
B. A person may be able to delay Part B without penalty while covered by qualifying current-employment group
health coverage
C. COBRA always counts as current-employment coverage
D. Part B can never be delayed
Correct Answer: B. A person may be able to delay Part B without penalty while covered by qualifying
current-employment group health coverage
Rationale: Qualifying group health coverage based on current employment can support a Part B Special
Enrollment Period; COBRA and retiree coverage are treated differently.
11. George is reviewing Medicare coverage while reviewing Medicare choices with a licensed agent and
asks about 2026 Part B deductible. Which statement is most accurate?
A. $1,736 per benefit period
B. $217 for the year
C. $615 for the year
D. $283 for the year
Correct Answer: D. $283 for the year
Rationale: The 2026 Part B annual deductible is $283 before Original Medicare begins paying for most Part B
services subject to the deductible.
, 12. A beneficiary is comparing several Medicare statements involving 2026 Part A deductible. Which
statement should be selected as the accurate one?
A. $2,100 per year
B. $615 per year
C. $1,736 per benefit period
D. $283 per year
Correct Answer: C. $1,736 per benefit period
Rationale: For 2026, the Original Medicare Part A inpatient hospital deductible is $1,736 for each benefit period.
13. Regarding Medicare Savings Programs, Which conclusion is correct?
A. They are available only to people under 65
B. They pay only dental expenses
C. They replace Medicare with Medicaid-only coverage
D. State Medicare Savings Programs can help eligible people with limited income/resources pay certain Medicare
premiums and cost sharing
Correct Answer: D. State Medicare Savings Programs can help eligible people with limited income/resources
pay certain Medicare premiums and cost sharing
Rationale: Medicare Savings Programs are state-administered programs that can help qualifying beneficiaries
with Medicare premiums and, in some categories, other cost sharing.
14. During a compliance review, an agent must give an accurate explanation of 2026 standard Part B
premium without overstating or omitting a key rule. Which explanation should the agent use?
A. $174.70 per month
B. $565 per month
C. $202.90 per month for the standard premium
D. $283 per month
Correct Answer: C. $202.90 per month for the standard premium
Rationale: The standard Part B premium for 2026 is $202.90 per month, though higher-income beneficiaries may
pay more.
15. Olivia is reviewing Medicare coverage during a scheduled phone consultation and asks about Purpose
of Medigap. Which action or explanation is most appropriate?
A. It replaces Medicare Part A and Part B
B. It helps pay certain out-of-pocket costs in Original Medicare
C. It is a Medicare Advantage network plan
D. It is a stand-alone Part D plan
Correct Answer: B. It helps pay certain out-of-pocket costs in Original Medicare
Rationale: Medigap supplements Original Medicare by helping with certain deductibles, coinsurance, and
copayments depending on the standardized plan.
16. During a compliance review, an agent must give an accurate explanation of Hospice election without
overstating or omitting a key rule. Which explanation should the agent use?
A. A beneficiary with terminal illness who elects the Medicare hospice benefit receives palliative rather than
curative treatment for the terminal condition under the hospice benefit
B. Hospice is limited to 10 days
C. Hospice is available only through Part B
D. Hospice requires giving up all Medicare coverage
Correct Answer: A. A beneficiary with terminal illness who elects the Medicare hospice benefit receives
palliative rather than curative treatment for the terminal condition under the hospice benefit
Rationale: Medicare hospice focuses on comfort and symptom management for a terminal illness when
eligibility and election requirements are met.
17. Regarding 2026 Part B deductible, Which statement best resolves the question?
A. $217 for the year
B. $283 for the year
C. $1,736 per benefit period
D. $615 for the year
Correct Answer: B. $283 for the year
1. Regarding Premium-free Part A, Which response best applies?
A. Part A is automatically free only for federal employees
B. Most people qualify for premium-free Part A after about 40 quarters of Medicare-covered work
C. Part A is free only after age 70
D. Everyone pays the same Part A premium
Correct Answer: B. Most people qualify for premium-free Part A after about 40 quarters of Medicare-covered
work
Rationale: Premium-free Part A is generally tied to sufficient Medicare-covered work, commonly 40 quarters,
either through the individual or a qualifying spouse.
2. A beneficiary is comparing several Medicare statements involving Part B late enrollment penalty. Which
statement should be selected as the accurate one?
A. 1% for each month
B. A one-time $100 fee
C. 20% regardless of delay
D. Generally 10% for each full 12-month period the person could have had Part B but did not, absent an exception
Correct Answer: D. Generally 10% for each full 12-month period the person could have had Part B but did not,
absent an exception
Rationale: The Part B late enrollment penalty is generally 10% for each full 12-month period of delayed
enrollment without an applicable exception and usually lasts as long as Part B coverage.
3. Alicia is reviewing Medicare coverage during a scheduled phone consultation and asks about SNF days
21-100. Which action or explanation is most appropriate?
A. $217 per day in 2026 after qualifying requirements are met
B. $283 per day
C. $0 per day
D. $434 per day
Correct Answer: A. $217 per day in 2026 after qualifying requirements are met
Rationale: For 2026, Medicare SNF coinsurance for days 21-100 is $217 per day when the stay otherwise
qualifies.
4. During a compliance review, an agent must give an accurate explanation of Routine long-term custodial
care without overstating or omitting a key rule. Which explanation should the agent use?
A. Part A covers unlimited custodial care
B. Medigap converts custodial care into a Medicare benefit
C. Original Medicare generally does not cover long-term custodial care when that is the only care needed
D. Part B covers custodial care after the deductible
Correct Answer: C. Original Medicare generally does not cover long-term custodial care when that is the only
care needed
Rationale: Medicare covers qualifying skilled care under specific conditions but generally does not cover
long-term custodial care by itself.
5. Regarding General Part B cost sharing, Which statement best resolves the question?
A. The beneficiary always pays 50%
B. Original Medicare always pays 100%
C. After the deductible, Original Medicare commonly pays 80% of the Medicare-approved amount and the
beneficiary pays 20%
D. Part B uses the Part A benefit-period deductible
Correct Answer: C. After the deductible, Original Medicare commonly pays 80% of the Medicare-approved
amount and the beneficiary pays 20%
Rationale: For many Part B services, after the annual deductible, Medicare generally pays 80% of the approved
amount and the beneficiary pays 20%.
6. A beneficiary is comparing several Medicare statements involving Premium-free
Part A. Which statement should be selected as the accurate one?
A. Most people qualify for premium-free Part A after about 40 quarters of Medicare-covered work
,B. Part A is automatically free only for federal employees
C. Everyone pays the same Part A premium
D. Part A is free only after age 70
Correct Answer: A. Most people qualify for premium-free Part A after about 40 quarters of Medicare-covered
work
Rationale: Premium-free Part A is generally tied to sufficient Medicare-covered work, commonly 40 quarters,
either through the individual or a qualifying spouse.
7. Edward is reviewing Medicare coverage while comparing next-year coverage and asks about Original
Medicare provider choice. Which option best reflects Medicare rules?
A. A referral is always required for specialists
B. The beneficiary must choose an HMO network
C. Coverage is limited to one county
D. A beneficiary can generally see any doctor or hospital that accepts Medicare
Correct Answer: D. A beneficiary can generally see any doctor or hospital that accepts Medicare
Rationale: Original Medicare generally permits use of any Medicare-participating provider nationwide, subject to
provider acceptance and coverage rules.
8. During a compliance review, an agent must give an accurate explanation of Initial Enrollment Period
without overstating or omitting a key rule. Which explanation should the agent use?
A. Only January 1-March 31
B. Generally a 7-month window centered on the month a person first becomes eligible around age 65
C. A 12-month period beginning at retirement
D. Only October 15-December 7
Correct Answer: B. Generally a 7-month window centered on the month a person first becomes eligible around
age 65
Rationale: The Medicare Initial Enrollment Period generally spans 3 months before, the month of, and 3 months
after the month of initial age-based eligibility.
9. Regarding Purpose of Medigap, How should this situation be interpreted?
A. It helps pay certain out-of-pocket costs in Original Medicare
B. It is a Medicare Advantage network plan
C. It replaces Medicare Part A and Part B
D. It is a stand-alone Part D plan
Correct Answer: A. It helps pay certain out-of-pocket costs in Original Medicare
Rationale: Medigap supplements Original Medicare by helping with certain deductibles, coinsurance, and
copayments depending on the standardized plan.
10. A beneficiary is comparing several Medicare statements involving Current employment coverage.
Which statement should be selected as the accurate one?
A. Retiree coverage always creates the same Part B SEP
B. A person may be able to delay Part B without penalty while covered by qualifying current-employment group
health coverage
C. COBRA always counts as current-employment coverage
D. Part B can never be delayed
Correct Answer: B. A person may be able to delay Part B without penalty while covered by qualifying
current-employment group health coverage
Rationale: Qualifying group health coverage based on current employment can support a Part B Special
Enrollment Period; COBRA and retiree coverage are treated differently.
11. George is reviewing Medicare coverage while reviewing Medicare choices with a licensed agent and
asks about 2026 Part B deductible. Which statement is most accurate?
A. $1,736 per benefit period
B. $217 for the year
C. $615 for the year
D. $283 for the year
Correct Answer: D. $283 for the year
Rationale: The 2026 Part B annual deductible is $283 before Original Medicare begins paying for most Part B
services subject to the deductible.
, 12. A beneficiary is comparing several Medicare statements involving 2026 Part A deductible. Which
statement should be selected as the accurate one?
A. $2,100 per year
B. $615 per year
C. $1,736 per benefit period
D. $283 per year
Correct Answer: C. $1,736 per benefit period
Rationale: For 2026, the Original Medicare Part A inpatient hospital deductible is $1,736 for each benefit period.
13. Regarding Medicare Savings Programs, Which conclusion is correct?
A. They are available only to people under 65
B. They pay only dental expenses
C. They replace Medicare with Medicaid-only coverage
D. State Medicare Savings Programs can help eligible people with limited income/resources pay certain Medicare
premiums and cost sharing
Correct Answer: D. State Medicare Savings Programs can help eligible people with limited income/resources
pay certain Medicare premiums and cost sharing
Rationale: Medicare Savings Programs are state-administered programs that can help qualifying beneficiaries
with Medicare premiums and, in some categories, other cost sharing.
14. During a compliance review, an agent must give an accurate explanation of 2026 standard Part B
premium without overstating or omitting a key rule. Which explanation should the agent use?
A. $174.70 per month
B. $565 per month
C. $202.90 per month for the standard premium
D. $283 per month
Correct Answer: C. $202.90 per month for the standard premium
Rationale: The standard Part B premium for 2026 is $202.90 per month, though higher-income beneficiaries may
pay more.
15. Olivia is reviewing Medicare coverage during a scheduled phone consultation and asks about Purpose
of Medigap. Which action or explanation is most appropriate?
A. It replaces Medicare Part A and Part B
B. It helps pay certain out-of-pocket costs in Original Medicare
C. It is a Medicare Advantage network plan
D. It is a stand-alone Part D plan
Correct Answer: B. It helps pay certain out-of-pocket costs in Original Medicare
Rationale: Medigap supplements Original Medicare by helping with certain deductibles, coinsurance, and
copayments depending on the standardized plan.
16. During a compliance review, an agent must give an accurate explanation of Hospice election without
overstating or omitting a key rule. Which explanation should the agent use?
A. A beneficiary with terminal illness who elects the Medicare hospice benefit receives palliative rather than
curative treatment for the terminal condition under the hospice benefit
B. Hospice is limited to 10 days
C. Hospice is available only through Part B
D. Hospice requires giving up all Medicare coverage
Correct Answer: A. A beneficiary with terminal illness who elects the Medicare hospice benefit receives
palliative rather than curative treatment for the terminal condition under the hospice benefit
Rationale: Medicare hospice focuses on comfort and symptom management for a terminal illness when
eligibility and election requirements are met.
17. Regarding 2026 Part B deductible, Which statement best resolves the question?
A. $217 for the year
B. $283 for the year
C. $1,736 per benefit period
D. $615 for the year
Correct Answer: B. $283 for the year
