AHIP Final Exam 2027 Questions and
Correct Answers | Latest Updated Review
Guide | Verified Practice Questions with
Detailed Rationales | Medicare, Compliance
& Ethics Study Pack Guaranteed Pass
(GRADED A+)
3-SENTENCE DESCRIPTION
Question 1
Which Medicare Part primarily covers inpatient hospital care?
A. Part B
B. Part C
C. Part D
D. Part A
Answer: D. Part A
Rationale: Medicare Part A is hospital insurance and generally
covers inpatient hospital stays, skilled nursing facility care,
hospice care, and certain home health services.
Question 2
Which Medicare Part covers physician services and outpatient
care?
A. Part A
B. Part B
,C. Part C
D. Part D
Answer: B. Part B
Rationale: Medicare Part B provides coverage for outpatient
services, physician visits, preventive care, and durable medical
equipment.
Question 3
What is Medicare Advantage commonly known as?
A. Part A
B. Medigap
C. Part C
D. Medicaid
Answer: C. Part C
Rationale: Medicare Advantage plans are Medicare-approved
private health plans that provide Medicare-covered benefits
under Part C.
Question 4
Which Medicare Part provides prescription drug coverage?
A. Part A
B. Part B
C. Part C
D. Part D
Answer: D. Part D
,Rationale: Medicare Part D provides outpatient prescription
drug benefits through approved private plans.
Question 5
Who administers the Medicare program?
A. Department of Labor
B. CMS
C. State Governments
D. Private Employers
Answer: B. CMS
Rationale: The Centers for Medicare & Medicaid Services
(CMS) administers Medicare and oversees program operations
and regulations.
Question 6
A beneficiary wants help paying Medicare deductibles and
coinsurance. Which type of policy is specifically designed for
this purpose?
A. Medicaid
B. PDP
C. Medigap
D. Employer Coverage
Answer: C. Medigap
Rationale: Medigap policies help cover certain out-of-pocket
costs not paid by Original Medicare.
, Question 7
Which enrollment period allows beneficiaries to review and
change Medicare coverage annually?
A. Initial Enrollment Period
B. Annual Enrollment Period
C. Special Enrollment Period
D. Open Registration Period
Answer: B. Annual Enrollment Period
Rationale: The Annual Enrollment Period (AEP) permits
eligible beneficiaries to make Medicare coverage changes each
year.
Question 8
Fraud in healthcare is best defined as:
A. Unintentional billing mistakes
B. Deliberate deception for unauthorized benefit or payment
C. Administrative inefficiency
D. Poor customer service
Answer: B. Deliberate deception for unauthorized benefit or
payment
Rationale: Fraud involves intentional misrepresentation or
deception to obtain unauthorized payment or benefits.
Question 9
Waste in healthcare generally refers to:
A. Intentional billing scams
B. Abuse of beneficiaries
Correct Answers | Latest Updated Review
Guide | Verified Practice Questions with
Detailed Rationales | Medicare, Compliance
& Ethics Study Pack Guaranteed Pass
(GRADED A+)
3-SENTENCE DESCRIPTION
Question 1
Which Medicare Part primarily covers inpatient hospital care?
A. Part B
B. Part C
C. Part D
D. Part A
Answer: D. Part A
Rationale: Medicare Part A is hospital insurance and generally
covers inpatient hospital stays, skilled nursing facility care,
hospice care, and certain home health services.
Question 2
Which Medicare Part covers physician services and outpatient
care?
A. Part A
B. Part B
,C. Part C
D. Part D
Answer: B. Part B
Rationale: Medicare Part B provides coverage for outpatient
services, physician visits, preventive care, and durable medical
equipment.
Question 3
What is Medicare Advantage commonly known as?
A. Part A
B. Medigap
C. Part C
D. Medicaid
Answer: C. Part C
Rationale: Medicare Advantage plans are Medicare-approved
private health plans that provide Medicare-covered benefits
under Part C.
Question 4
Which Medicare Part provides prescription drug coverage?
A. Part A
B. Part B
C. Part C
D. Part D
Answer: D. Part D
,Rationale: Medicare Part D provides outpatient prescription
drug benefits through approved private plans.
Question 5
Who administers the Medicare program?
A. Department of Labor
B. CMS
C. State Governments
D. Private Employers
Answer: B. CMS
Rationale: The Centers for Medicare & Medicaid Services
(CMS) administers Medicare and oversees program operations
and regulations.
Question 6
A beneficiary wants help paying Medicare deductibles and
coinsurance. Which type of policy is specifically designed for
this purpose?
A. Medicaid
B. PDP
C. Medigap
D. Employer Coverage
Answer: C. Medigap
Rationale: Medigap policies help cover certain out-of-pocket
costs not paid by Original Medicare.
, Question 7
Which enrollment period allows beneficiaries to review and
change Medicare coverage annually?
A. Initial Enrollment Period
B. Annual Enrollment Period
C. Special Enrollment Period
D. Open Registration Period
Answer: B. Annual Enrollment Period
Rationale: The Annual Enrollment Period (AEP) permits
eligible beneficiaries to make Medicare coverage changes each
year.
Question 8
Fraud in healthcare is best defined as:
A. Unintentional billing mistakes
B. Deliberate deception for unauthorized benefit or payment
C. Administrative inefficiency
D. Poor customer service
Answer: B. Deliberate deception for unauthorized benefit or
payment
Rationale: Fraud involves intentional misrepresentation or
deception to obtain unauthorized payment or benefits.
Question 9
Waste in healthcare generally refers to:
A. Intentional billing scams
B. Abuse of beneficiaries
