AHIP 2027 Final Exam (PDF) | (2026) Medicare
Certification
1.
Which Medicare part primarily provides hospital insurance?
,A. Part B
B. Part C
C. Part A
D. Part D
Rationale: Medicare Part A is Hospital Insurance and generally covers
inpatient hospital care, skilled nursing facility care under qualifying
circumstances, hospice, and certain home health services.
2.
Which Medicare part primarily covers physician and outpatient
medical services?
A. Part A
B. Part B
C. Part C
D. Part D
Rationale: Part B is Medical Insurance and covers physician services,
outpatient care, durable medical equipment, and other medically
necessary services.
3.
Medicare Part C is another name for:
A. Medigap
B. Medicare Supplement Insurance
C. Medicare Advantage
D. Medicaid
Rationale: Medicare Advantage is formally Medicare Part C.
4.
Which Medicare part provides outpatient prescription drug
coverage?
,A. Part A
B. Part B
C. Part C only
D. Part D
Rationale: Part D provides prescription drug coverage through
Medicare-approved private plans.
5.
A person enrolled in Original Medicare generally receives coverage
through:
A. A state Medicaid agency
B. The federal Medicare program
C. A Medicare Advantage insurer
D. A Medigap insurer
Rationale: Original Medicare is the traditional fee-for-service
Medicare program administered by the federal government.
6.
Which statement about Medicare Advantage is correct?
A. It is administered only by state governments.
B. It replaces Medicaid.
C. It is offered by private organizations that contract with Medicare.
D. It is available only to people with Medicaid.
Rationale: Medicare Advantage plans are offered by Medicare-
contracted private organizations.
7.
A beneficiary who chooses Original Medicare may generally add
which product to help pay certain Medicare cost-sharing?
A. Medicaid only
B. Medigap
, C. Medicare Advantage
D. PACE only
Rationale: Medigap policies supplement Original Medicare by helping
pay certain deductibles, coinsurance, and other covered cost-sharing.
8.
Which statement best describes Medicare eligibility based on age?
A. Everyone automatically qualifies at age 55.
B. Everyone qualifies at age 60.
C. Most people become eligible at age 65 if they meet applicable
citizenship or residency requirements.
D. Eligibility begins at age 70.
Rationale: Age 65 is the principal age-based Medicare eligibility
point, subject to applicable requirements.
9.
A person younger than 65 may qualify for Medicare because of:
A. Income alone
B. Certain disabilities or qualifying medical conditions
C. Employment alone
D. Home ownership
Rationale: Medicare can cover certain people under 65 who meet
disability-related or other statutory eligibility requirements.
10.
Which program is jointly funded by federal and state governments
and is generally based on financial and/or categorical eligibility?
A. Medicare
B. Medigap
C. Medicaid
D. Part D
Certification
1.
Which Medicare part primarily provides hospital insurance?
,A. Part B
B. Part C
C. Part A
D. Part D
Rationale: Medicare Part A is Hospital Insurance and generally covers
inpatient hospital care, skilled nursing facility care under qualifying
circumstances, hospice, and certain home health services.
2.
Which Medicare part primarily covers physician and outpatient
medical services?
A. Part A
B. Part B
C. Part C
D. Part D
Rationale: Part B is Medical Insurance and covers physician services,
outpatient care, durable medical equipment, and other medically
necessary services.
3.
Medicare Part C is another name for:
A. Medigap
B. Medicare Supplement Insurance
C. Medicare Advantage
D. Medicaid
Rationale: Medicare Advantage is formally Medicare Part C.
4.
Which Medicare part provides outpatient prescription drug
coverage?
,A. Part A
B. Part B
C. Part C only
D. Part D
Rationale: Part D provides prescription drug coverage through
Medicare-approved private plans.
5.
A person enrolled in Original Medicare generally receives coverage
through:
A. A state Medicaid agency
B. The federal Medicare program
C. A Medicare Advantage insurer
D. A Medigap insurer
Rationale: Original Medicare is the traditional fee-for-service
Medicare program administered by the federal government.
6.
Which statement about Medicare Advantage is correct?
A. It is administered only by state governments.
B. It replaces Medicaid.
C. It is offered by private organizations that contract with Medicare.
D. It is available only to people with Medicaid.
Rationale: Medicare Advantage plans are offered by Medicare-
contracted private organizations.
7.
A beneficiary who chooses Original Medicare may generally add
which product to help pay certain Medicare cost-sharing?
A. Medicaid only
B. Medigap
, C. Medicare Advantage
D. PACE only
Rationale: Medigap policies supplement Original Medicare by helping
pay certain deductibles, coinsurance, and other covered cost-sharing.
8.
Which statement best describes Medicare eligibility based on age?
A. Everyone automatically qualifies at age 55.
B. Everyone qualifies at age 60.
C. Most people become eligible at age 65 if they meet applicable
citizenship or residency requirements.
D. Eligibility begins at age 70.
Rationale: Age 65 is the principal age-based Medicare eligibility
point, subject to applicable requirements.
9.
A person younger than 65 may qualify for Medicare because of:
A. Income alone
B. Certain disabilities or qualifying medical conditions
C. Employment alone
D. Home ownership
Rationale: Medicare can cover certain people under 65 who meet
disability-related or other statutory eligibility requirements.
10.
Which program is jointly funded by federal and state governments
and is generally based on financial and/or categorical eligibility?
A. Medicare
B. Medigap
C. Medicaid
D. Part D
