AHIP Final Exam 2027 | 200 Practice Questions and Verified
Answers | Medicare Training Study Guide PDF | A+ Graded
1. Medicare is a federal health insurance program primarily for:
A) Individuals of any age with any income level
B) Individuals aged 65 or older, certain younger people with disabilities, and people with EndStage Renal
Disease (ESRD) or ALS
C) Only lowincome individuals regardless of age
D) Only individuals over age 65 who are retired
Answer: B — Medicare eligibility includes those 65 and older, those under 65 who have received Social
Security Disability Insurance for 24 months, and those of any age with ESRD requiring dialysis or
transplant, or ALS (Lou Gehrig's disease).
2. Medicare Part A primarily covers:
A) Outpatient prescription drugs
B) Inpatient hospital, skilled nursing facility, hospice, and some home health care
C) Routine dental and vision care
D) Physician office visits
Answer: B — Part A is "hospital insurance" covering inpatient stays, skilled nursing facility care (not
custodial care), hospice, and some home health services. Most beneficiaries do not pay a Part A
premium if they or their spouse paid Medicare taxes for 40 quarters.
3. Medicare Part B primarily covers:
A) Inpatient hospital services
,B) Outpatient medical services, physician visits, preventive services, and durable medical equipment
C) Prescription drugs
D) Longterm custodial care
Answer: B — Part B is "medical insurance" covering physician services, outpatient care, preventive
services, and durable medical equipment (DME). Beneficiaries pay a monthly premium for Part B.
4. Which of the following individuals is eligible to enroll in a Medicare Advantage (MA) plan?
A) A 65yearold with Medicare Part A only
B) A 72yearold with Medicare Parts A and B who lives within the plan's service area
C) A 60yearold with employer group coverage only
D) A 68yearold who permanently resides outside the United States
Answer: B — To enroll in an MA plan, a beneficiary must be entitled to Part A, enrolled in Part B, and
reside in the plan's service area.
5. What is the primary goal of Medicare Advantage plans?
A) Replace Original Medicare with private coverage that adds more outofpocket costs
B) Provide Medicarecovered benefits through private insurers that meet CMS standards
C) Eliminate Part D coverage
D) Offer coverage only for hospital services
Answer: B — MA plans deliver Medicare benefits via CMSapproved private insurers, often with
additional benefits like vision, dental, or hearing.
,6. Which of the following services is NOT covered under Medicare Part A?
A) Skilled nursing facility care
B) Hospice care
C) Home health services
D) Outpatient physical therapy
Answer: D — Outpatient physical therapy is covered under Part B, not Part A, which primarily covers
inpatient and facilitybased care.
7. What is the Annual Election Period (AEP) for Medicare Advantage and Part D plans?
A) January 1 – March 31
B) October 15 – December 7
C) April 1 – June 30
D) July 1 – September 30
Answer: B — The Annual Election Period runs from October 15 to December 7 each year, during which
beneficiaries can enroll in, switch, or drop Medicare Advantage and Part D plans.
8. During the Annual Election Period (AEP), beneficiaries can:
A) Only drop their current plan
B) Enroll in, switch, or drop Medicare Advantage and Part D plans
C) Enroll in Medicare Part A for the first time
D) Change their Medigap plan without underwriting
, Answer: B — AEP allows beneficiaries to make changes to their Medicare Advantage and Part D
coverage, including enrolling, switching, or disenrolling.
9. What is the Medicare Open Enrollment Period (OEP) from January 1 to March 31?
A) A period for enrolling in Medicare Part A for the first time
B) A period for Medicare Advantage enrollees to switch to another MA plan or Original Medicare
C) A period for enrolling in Part D only
D) A period for purchasing Medigap without underwriting
Answer: B — The Medicare Open Enrollment Period (January 1 – March 31) allows individuals already
enrolled in a Medicare Advantage plan to switch to another MA plan or return to Original Medicare (and
enroll in a Part D plan if desired).
10. 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) You can sell him a Medigap plan to help with costs not covered under Medicare Advantage
B) It is illegal to sell Mr. Capadona a Medigap plan if he is enrolled in an MA plan, and Medigap only
works with Original Medicare
C) Medigap plans are automatically included with MA plans
D) He should purchase both plans from the same carrier
Answer: B — It is illegal to sell a Medigap plan to someone enrolled in a Medicare Advantage plan.
Medigap plans only coordinate with Original Medicare, not MA plans.
11. Medicare Supplement (Medigap) plans are designed to:
Answers | Medicare Training Study Guide PDF | A+ Graded
1. Medicare is a federal health insurance program primarily for:
A) Individuals of any age with any income level
B) Individuals aged 65 or older, certain younger people with disabilities, and people with EndStage Renal
Disease (ESRD) or ALS
C) Only lowincome individuals regardless of age
D) Only individuals over age 65 who are retired
Answer: B — Medicare eligibility includes those 65 and older, those under 65 who have received Social
Security Disability Insurance for 24 months, and those of any age with ESRD requiring dialysis or
transplant, or ALS (Lou Gehrig's disease).
2. Medicare Part A primarily covers:
A) Outpatient prescription drugs
B) Inpatient hospital, skilled nursing facility, hospice, and some home health care
C) Routine dental and vision care
D) Physician office visits
Answer: B — Part A is "hospital insurance" covering inpatient stays, skilled nursing facility care (not
custodial care), hospice, and some home health services. Most beneficiaries do not pay a Part A
premium if they or their spouse paid Medicare taxes for 40 quarters.
3. Medicare Part B primarily covers:
A) Inpatient hospital services
,B) Outpatient medical services, physician visits, preventive services, and durable medical equipment
C) Prescription drugs
D) Longterm custodial care
Answer: B — Part B is "medical insurance" covering physician services, outpatient care, preventive
services, and durable medical equipment (DME). Beneficiaries pay a monthly premium for Part B.
4. Which of the following individuals is eligible to enroll in a Medicare Advantage (MA) plan?
A) A 65yearold with Medicare Part A only
B) A 72yearold with Medicare Parts A and B who lives within the plan's service area
C) A 60yearold with employer group coverage only
D) A 68yearold who permanently resides outside the United States
Answer: B — To enroll in an MA plan, a beneficiary must be entitled to Part A, enrolled in Part B, and
reside in the plan's service area.
5. What is the primary goal of Medicare Advantage plans?
A) Replace Original Medicare with private coverage that adds more outofpocket costs
B) Provide Medicarecovered benefits through private insurers that meet CMS standards
C) Eliminate Part D coverage
D) Offer coverage only for hospital services
Answer: B — MA plans deliver Medicare benefits via CMSapproved private insurers, often with
additional benefits like vision, dental, or hearing.
,6. Which of the following services is NOT covered under Medicare Part A?
A) Skilled nursing facility care
B) Hospice care
C) Home health services
D) Outpatient physical therapy
Answer: D — Outpatient physical therapy is covered under Part B, not Part A, which primarily covers
inpatient and facilitybased care.
7. What is the Annual Election Period (AEP) for Medicare Advantage and Part D plans?
A) January 1 – March 31
B) October 15 – December 7
C) April 1 – June 30
D) July 1 – September 30
Answer: B — The Annual Election Period runs from October 15 to December 7 each year, during which
beneficiaries can enroll in, switch, or drop Medicare Advantage and Part D plans.
8. During the Annual Election Period (AEP), beneficiaries can:
A) Only drop their current plan
B) Enroll in, switch, or drop Medicare Advantage and Part D plans
C) Enroll in Medicare Part A for the first time
D) Change their Medigap plan without underwriting
, Answer: B — AEP allows beneficiaries to make changes to their Medicare Advantage and Part D
coverage, including enrolling, switching, or disenrolling.
9. What is the Medicare Open Enrollment Period (OEP) from January 1 to March 31?
A) A period for enrolling in Medicare Part A for the first time
B) A period for Medicare Advantage enrollees to switch to another MA plan or Original Medicare
C) A period for enrolling in Part D only
D) A period for purchasing Medigap without underwriting
Answer: B — The Medicare Open Enrollment Period (January 1 – March 31) allows individuals already
enrolled in a Medicare Advantage plan to switch to another MA plan or return to Original Medicare (and
enroll in a Part D plan if desired).
10. 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) You can sell him a Medigap plan to help with costs not covered under Medicare Advantage
B) It is illegal to sell Mr. Capadona a Medigap plan if he is enrolled in an MA plan, and Medigap only
works with Original Medicare
C) Medigap plans are automatically included with MA plans
D) He should purchase both plans from the same carrier
Answer: B — It is illegal to sell a Medigap plan to someone enrolled in a Medicare Advantage plan.
Medigap plans only coordinate with Original Medicare, not MA plans.
11. Medicare Supplement (Medigap) plans are designed to:
