AHIP MEDICARE CERTIFICATION EXAM 2026/2027 – EXAM
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALE | 2027 Q&A | INSTANT
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1. Which Medicare components make up Original Medicare?
A. Part A and Part C
B. Part A and Part B
C. Part B and Part D
D. Part C and Part D
Rationale: Original Medicare consists of Part A, which provides hospital insurance, and Part B,
which provides medical insurance. Part C refers to Medicare Advantage, while Part D provides
prescription drug coverage.
2. What type of services are primarily covered under Medicare Part A?
A. Physician office visits
B. Outpatient diagnostic services
C. Inpatient hospital and skilled nursing facility services
D. Prescription medications obtained from a retail pharmacy
Rationale: Part A is hospital insurance and generally covers eligible inpatient hospital care,
skilled nursing facility care, hospice care, and certain home health services.
3. Medicare Part B primarily provides coverage for which category of care?
A. Physician services and outpatient medical care
B. Long-term custodial nursing home care
C. Most retail prescription medications
D. Private Medicare Advantage benefits
Rationale: Part B covers medically necessary physician services, outpatient care, durable
medical equipment, and many preventive services.
, 4. An individual wants to receive Medicare-covered health benefits through a
private Medicare-approved plan rather than directly through Original Medicare.
Which Medicare option provides this arrangement?
A. Medigap
B. Part D
C. Medicare Supplement Plan
D. Medicare Advantage
Rationale: Medicare Advantage, also known as Part C, consists of private plans that contract
with Medicare to provide Medicare-covered Part A and Part B benefits.
5. Which statement correctly describes Medicare Part D?
A. It replaces Medicare Part B.
B. It provides Medicare prescription drug coverage through Medicare-approved private
plans.
C. It is automatically included in every Medigap policy.
D. It covers inpatient hospital services.
Rationale: Part D provides prescription drug coverage through private plans approved by
Medicare. It is separate from Part A, Part B, and Medigap.
6. A person becomes eligible for Medicare at age 65. What is the general length of
the Initial Enrollment Period for Medicare?
A. 3 months
B. 5 months
C. 7 months
D. 12 months
Rationale: The Initial Enrollment Period generally lasts seven months: three months before the
month the individual turns 65, the birthday month, and three months afterward.
7. A beneficiary is enrolled in Original Medicare and wants additional insurance to
help pay certain Medicare cost-sharing amounts. Which product is designed for
this purpose?
,A. Medicare Advantage
B. Part D
C. Medicaid
D. Medigap
Rationale: Medigap is supplemental insurance sold by private insurers to help pay certain out-
of-pocket costs associated with Original Medicare, such as deductibles, copayments, and
coinsurance.
8. Which requirement generally applies before a beneficiary can enroll in a
Medicare Advantage plan?
A. The beneficiary must have Part D only.
B. The beneficiary must have a Medigap policy.
C. The beneficiary must have both Part A and Part B.
D. The beneficiary must be enrolled in Medicaid.
Rationale: To join a Medicare Advantage plan, an individual generally must have both Medicare
Part A and Part B and live in the plan's service area.
9. A beneficiary has Part A but has not enrolled in Part B. The beneficiary wants to
enroll in a stand-alone Medicare prescription drug plan. Which statement is
correct?
A. The beneficiary must first purchase Medigap.
B. The beneficiary cannot enroll in Part D without Part B.
C. The beneficiary must switch to Medicare Advantage.
D. The beneficiary may generally enroll because Part A alone can satisfy the Medicare
eligibility requirement for Part D.
Rationale: A person generally needs either Part A or Part B to enroll in a stand-alone Medicare
drug plan, provided the other eligibility requirements are met.
10. What is the General Enrollment Period for Medicare Part A and Part B?
A. October 15 through December 7
, B. July 1 through September 30
C. January 1 through March 31
D. April 1 through June 30
Rationale: The Medicare General Enrollment Period occurs each year from January 1 through
March 31. Coverage generally begins the month after enrollment.
11. Which annual period is commonly associated with making changes to Medicare
Advantage and Medicare prescription drug coverage?
A. January 1 through March 31 only
B. October 15 through December 7
C. April 1 through May 31
D. July 15 through August 31
Rationale: The Annual Enrollment Period runs from October 15 through December 7. During
this period, eligible beneficiaries can make specified changes to Medicare Advantage and Part D
coverage.
12. A beneficiary is considering a Medicare Advantage plan. Which feature
distinguishes Medicare Advantage from Original Medicare?
A. Medicare Advantage is administered only by Social Security.
B. Medicare Advantage eliminates all cost-sharing.
C. Medicare Advantage is offered by private organizations that contract with Medicare.
D. Medicare Advantage is a type of Medigap policy.
Rationale: Medicare Advantage plans are offered by private organizations that contract with
Medicare to provide covered Part A and Part B benefits.
13. Which statement about Medigap is accurate?
A. Medigap replaces Part A and Part B.
B. Medigap can be purchased while enrolled in any Medicare Advantage plan.
C. Medigap is the same thing as Part D.
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALE | 2027 Q&A | INSTANT
DOWNLOAD PDF
1. Which Medicare components make up Original Medicare?
A. Part A and Part C
B. Part A and Part B
C. Part B and Part D
D. Part C and Part D
Rationale: Original Medicare consists of Part A, which provides hospital insurance, and Part B,
which provides medical insurance. Part C refers to Medicare Advantage, while Part D provides
prescription drug coverage.
2. What type of services are primarily covered under Medicare Part A?
A. Physician office visits
B. Outpatient diagnostic services
C. Inpatient hospital and skilled nursing facility services
D. Prescription medications obtained from a retail pharmacy
Rationale: Part A is hospital insurance and generally covers eligible inpatient hospital care,
skilled nursing facility care, hospice care, and certain home health services.
3. Medicare Part B primarily provides coverage for which category of care?
A. Physician services and outpatient medical care
B. Long-term custodial nursing home care
C. Most retail prescription medications
D. Private Medicare Advantage benefits
Rationale: Part B covers medically necessary physician services, outpatient care, durable
medical equipment, and many preventive services.
, 4. An individual wants to receive Medicare-covered health benefits through a
private Medicare-approved plan rather than directly through Original Medicare.
Which Medicare option provides this arrangement?
A. Medigap
B. Part D
C. Medicare Supplement Plan
D. Medicare Advantage
Rationale: Medicare Advantage, also known as Part C, consists of private plans that contract
with Medicare to provide Medicare-covered Part A and Part B benefits.
5. Which statement correctly describes Medicare Part D?
A. It replaces Medicare Part B.
B. It provides Medicare prescription drug coverage through Medicare-approved private
plans.
C. It is automatically included in every Medigap policy.
D. It covers inpatient hospital services.
Rationale: Part D provides prescription drug coverage through private plans approved by
Medicare. It is separate from Part A, Part B, and Medigap.
6. A person becomes eligible for Medicare at age 65. What is the general length of
the Initial Enrollment Period for Medicare?
A. 3 months
B. 5 months
C. 7 months
D. 12 months
Rationale: The Initial Enrollment Period generally lasts seven months: three months before the
month the individual turns 65, the birthday month, and three months afterward.
7. A beneficiary is enrolled in Original Medicare and wants additional insurance to
help pay certain Medicare cost-sharing amounts. Which product is designed for
this purpose?
,A. Medicare Advantage
B. Part D
C. Medicaid
D. Medigap
Rationale: Medigap is supplemental insurance sold by private insurers to help pay certain out-
of-pocket costs associated with Original Medicare, such as deductibles, copayments, and
coinsurance.
8. Which requirement generally applies before a beneficiary can enroll in a
Medicare Advantage plan?
A. The beneficiary must have Part D only.
B. The beneficiary must have a Medigap policy.
C. The beneficiary must have both Part A and Part B.
D. The beneficiary must be enrolled in Medicaid.
Rationale: To join a Medicare Advantage plan, an individual generally must have both Medicare
Part A and Part B and live in the plan's service area.
9. A beneficiary has Part A but has not enrolled in Part B. The beneficiary wants to
enroll in a stand-alone Medicare prescription drug plan. Which statement is
correct?
A. The beneficiary must first purchase Medigap.
B. The beneficiary cannot enroll in Part D without Part B.
C. The beneficiary must switch to Medicare Advantage.
D. The beneficiary may generally enroll because Part A alone can satisfy the Medicare
eligibility requirement for Part D.
Rationale: A person generally needs either Part A or Part B to enroll in a stand-alone Medicare
drug plan, provided the other eligibility requirements are met.
10. What is the General Enrollment Period for Medicare Part A and Part B?
A. October 15 through December 7
, B. July 1 through September 30
C. January 1 through March 31
D. April 1 through June 30
Rationale: The Medicare General Enrollment Period occurs each year from January 1 through
March 31. Coverage generally begins the month after enrollment.
11. Which annual period is commonly associated with making changes to Medicare
Advantage and Medicare prescription drug coverage?
A. January 1 through March 31 only
B. October 15 through December 7
C. April 1 through May 31
D. July 15 through August 31
Rationale: The Annual Enrollment Period runs from October 15 through December 7. During
this period, eligible beneficiaries can make specified changes to Medicare Advantage and Part D
coverage.
12. A beneficiary is considering a Medicare Advantage plan. Which feature
distinguishes Medicare Advantage from Original Medicare?
A. Medicare Advantage is administered only by Social Security.
B. Medicare Advantage eliminates all cost-sharing.
C. Medicare Advantage is offered by private organizations that contract with Medicare.
D. Medicare Advantage is a type of Medigap policy.
Rationale: Medicare Advantage plans are offered by private organizations that contract with
Medicare to provide covered Part A and Part B benefits.
13. Which statement about Medigap is accurate?
A. Medigap replaces Part A and Part B.
B. Medigap can be purchased while enrolled in any Medicare Advantage plan.
C. Medigap is the same thing as Part D.
