2026 AHIP Certification Exam – Actual Questions &
Verified Answers (CMS-Aligned Study Guide)
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. Edward suffered from serious kidney disease. As a result, Edward
became eligible for Medicare coverage due to end-stage renal disease
(ESRD). A close relative donated their kidney and Edward successfully
underwent transplant surgery 12 months ago. Edward is now age 50
and asks you if his Medicare coverage will continue, what should you
say? **
A. His Medicare coverage will end 12 months after transplant surgery,
regardless of his age.
B. His Medicare coverage will continue as long as he receives follow-up care
for the transplant.
,C. His Medicare coverage will end 36 months after the transplant unless he
otherwise qualifies.
D. His Medicare coverage ends immediately after transplant surgery.
**Correct Answer: C. His Medicare coverage will end 36 months after
the transplant unless he otherwise qualifies.**
**Expert Rationale:** For individuals eligible for Medicare due to ESRD,
coverage ends 36 months after a successful kidney transplant unless they
qualify for Medicare due to age or disability. Edward’s coverage will
continue for 3 years post-transplant unless he turns 65 or qualifies for
disability.
---
**2. Ms. Henderson believes that she will qualify for Medicare Coverage
when she turns 65, without paying any premiums, because she has
been working for 40 years and paying Medicare taxes. What should you
tell her?**
A. She is not eligible for any Medicare coverage.
B. She will receive Medicare Part A without premiums, but must pay
premiums for Part B.
C. She will not need to pay any premiums for Part A or Part B.
D. She is only eligible for Medicare Part B.
,**Correct Answer: B. She will receive Medicare Part A without
premiums, but must pay premiums for Part B.**
**Expert Rationale:** Individuals with sufficient work credits (generally
40 quarters) receive premium-free Part A at age 65. However, Part B
requires a monthly premium, which is income-adjusted. This often causes
confusion, but Part B premiums are always required unless she qualifies for
Medicaid or other coverage.
---
**3. Ms. Lewis has aggressive cancer and would like to know if
Medicare will cover hospice services in case she needs them. What
should you tell her?**
A. Hospice is not covered under Original Medicare.
B. Hospice is covered under Medicare Part A.
C. Hospice is covered under Medicare Part B.
D. Hospice is only covered if she has a Medicare Advantage plan.
**Correct Answer: B. Hospice is covered under Medicare Part A.**
**Expert Rationale:** Hospice care is a benefit under Part A of Medicare,
available to terminally ill individuals who elect to focus on comfort care
rather than curative treatment. Coverage includes pain relief, symptom
management, and support services.
, ---
**4. Mr. Capadona would like to purchase a Medicare Advantage (MA)
plan and a Medigap plan to pick up costs not covered by that plan. What
should you tell him?**
A. He can enroll in both MA and Medigap plans.
B. Medigap can only be used with Original Medicare, not MA plans.
C. Medigap will cover costs not included by MA plans.
D. He does not need any plan.
**Correct Answer: B. Medigap can only be used with Original Medicare,
not MA plans.**
**Expert Rationale:** Federal law prohibits the sale of Medigap policies to
individuals enrolled in Medicare Advantage, since Medigap supplements
only Original Medicare (Part A and Part B), not Medicare Advantage plans.
---
**5. Mr. Vasquez is in good health and is preparing a budget in
anticipation of his retirement when he turns 66. He wants to
understand the health care costs he might be exposed to under
Medicare if he were to require hospitalization because of an illness. In
Verified Answers (CMS-Aligned Study Guide)
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. Edward suffered from serious kidney disease. As a result, Edward
became eligible for Medicare coverage due to end-stage renal disease
(ESRD). A close relative donated their kidney and Edward successfully
underwent transplant surgery 12 months ago. Edward is now age 50
and asks you if his Medicare coverage will continue, what should you
say? **
A. His Medicare coverage will end 12 months after transplant surgery,
regardless of his age.
B. His Medicare coverage will continue as long as he receives follow-up care
for the transplant.
,C. His Medicare coverage will end 36 months after the transplant unless he
otherwise qualifies.
D. His Medicare coverage ends immediately after transplant surgery.
**Correct Answer: C. His Medicare coverage will end 36 months after
the transplant unless he otherwise qualifies.**
**Expert Rationale:** For individuals eligible for Medicare due to ESRD,
coverage ends 36 months after a successful kidney transplant unless they
qualify for Medicare due to age or disability. Edward’s coverage will
continue for 3 years post-transplant unless he turns 65 or qualifies for
disability.
---
**2. Ms. Henderson believes that she will qualify for Medicare Coverage
when she turns 65, without paying any premiums, because she has
been working for 40 years and paying Medicare taxes. What should you
tell her?**
A. She is not eligible for any Medicare coverage.
B. She will receive Medicare Part A without premiums, but must pay
premiums for Part B.
C. She will not need to pay any premiums for Part A or Part B.
D. She is only eligible for Medicare Part B.
,**Correct Answer: B. She will receive Medicare Part A without
premiums, but must pay premiums for Part B.**
**Expert Rationale:** Individuals with sufficient work credits (generally
40 quarters) receive premium-free Part A at age 65. However, Part B
requires a monthly premium, which is income-adjusted. This often causes
confusion, but Part B premiums are always required unless she qualifies for
Medicaid or other coverage.
---
**3. Ms. Lewis has aggressive cancer and would like to know if
Medicare will cover hospice services in case she needs them. What
should you tell her?**
A. Hospice is not covered under Original Medicare.
B. Hospice is covered under Medicare Part A.
C. Hospice is covered under Medicare Part B.
D. Hospice is only covered if she has a Medicare Advantage plan.
**Correct Answer: B. Hospice is covered under Medicare Part A.**
**Expert Rationale:** Hospice care is a benefit under Part A of Medicare,
available to terminally ill individuals who elect to focus on comfort care
rather than curative treatment. Coverage includes pain relief, symptom
management, and support services.
, ---
**4. Mr. Capadona would like to purchase a Medicare Advantage (MA)
plan and a Medigap plan to pick up costs not covered by that plan. What
should you tell him?**
A. He can enroll in both MA and Medigap plans.
B. Medigap can only be used with Original Medicare, not MA plans.
C. Medigap will cover costs not included by MA plans.
D. He does not need any plan.
**Correct Answer: B. Medigap can only be used with Original Medicare,
not MA plans.**
**Expert Rationale:** Federal law prohibits the sale of Medigap policies to
individuals enrolled in Medicare Advantage, since Medigap supplements
only Original Medicare (Part A and Part B), not Medicare Advantage plans.
---
**5. Mr. Vasquez is in good health and is preparing a budget in
anticipation of his retirement when he turns 66. He wants to
understand the health care costs he might be exposed to under
Medicare if he were to require hospitalization because of an illness. In
