AHIP Exam 2026/2027 Actual
Exam Medicare Training Plans
Compliance and Enrollment
Strategies Complete Questions &
Answers - Pass Guaranteed - A+
Graded
Medicare Basics & Eligibility
Q1: A beneficiary calls and asks what services are covered under Medicare Part A.
Which of the following correctly describes Part A coverage?
A. Physician services, outpatient care, and preventive services.
B. Inpatient hospital care, skilled nursing facility care, hospice care, and some home
health services.
C. Prescription drug coverage and durable medical equipment.
D. Routine vision, dental, and hearing exams.
Correct Answer: B
Rationale: Medicare Part A is known as Hospital Insurance and primarily covers
inpatient care in hospitals, skilled nursing facilities, hospice, and limited home health,
whereas Part B covers outpatient and physician services.
Q2: Mr. Henderson is 64 years old and asks when he can first apply for Medicare. What
is the correct advice regarding his Initial Enrollment Period (IEP)?
A. He can apply 3 months before his 65th birthday, the month of, and 3 months after.
B. He must wait until his 65th birthday to apply.
C. He can only apply during the Annual Election Period (AEP).
D. He cannot apply until he is fully retired.
Correct Answer: A
,Rationale: The Initial Enrollment Period (IEP) is a 7-month window that starts 3 months
before the month of eligibility (usually the 65th birthday), includes the month of eligibility,
and ends 3 months after.
Q3: Which of the following beneficiaries qualifies for Medicare based on End-Stage
Renal Disease (ESRD)?
A. A 45-year-old who requires dialysis for the rest of their life or a kidney transplant.
B. A 60-year-old with controlled high blood pressure.
C. A 50-year-old with Type 2 diabetes who is currently working.
D. A 70-year-old with mild kidney stones.
Correct Answer: A
Rationale: Regardless of age, a beneficiary qualifies for Medicare if they have
End-Stage Renal Disease requiring regular dialysis or a kidney transplant.
Q4: Mrs. Lee turned 65 last month but did not enroll in Medicare Part B because she
has creditable coverage from her husband's employer. She decides to drop her
employer coverage and enroll in Part B. What will happen regarding the Part B Late
Enrollment Penalty?
A. She will pay a 10% penalty for every year she could have had Part B but didn't.
B. She will not pay a penalty because she had creditable coverage.
C. She will pay a flat fee of $50.
D. She can only enroll during the AEP.
Correct Answer: B
Rationale: As long as a beneficiary is covered by creditable employer group health plan,
the Part B Late Enrollment Penalty (LEP) is deferred; dropping that coverage triggers a
Special Enrollment Period (SEP) without a penalty.
Q5: In 2026, what is the standard annual deductible for Medicare Part B?
A. $240.00
B. $164.90
C. $233.00
D. $198.00
Correct Answer: B
Rationale: The standard Part B annual deductible is $164.90 (as of 2026 standards),
though this amount is subject to annual inflation adjustments.
Q6: Mr. Davis has both Medicare Part A and Part B. He requires a routine cataract
surgery. Which part of Medicare covers the physician performing the surgery?
A. Medicare Part A
, B. Medicare Part B
C. Medicare Part D
D. Medicare Part C only
Correct Answer: B
Rationale: Medicare Part B covers medically necessary physician services, including
surgeries performed in an outpatient setting, even if Part A covers the inpatient facility if
applicable.
Q7: A beneficiary asks who pays the monthly premium for Medicare Part A. How should
you respond?
A. The beneficiary pays a standard monthly premium of $174.70.
B. The beneficiary pays a monthly premium based on income (IRMAA) if they have a
higher income.
C. Most beneficiaries do not pay a premium because they paid taxes while working.
D. Medicare Part A has no premium.
Correct Answer: C
Rationale: Most people get premium-free Part A because they or their spouse paid
Medicare taxes for at least 40 quarters (10 years); only those with fewer quarters pay a
premium.
Q8: Which of the following individuals qualifies for Medicare due to disability?
A. A 25-year-old who has been disabled for 12 months.
B. A 30-year-old who just broke their leg yesterday.
C. A 50-year-old who has been receiving Social Security Disability Insurance (SSDI)
checks for 25 months.
D. A 40-year-old who is unemployed but not disabled.
Correct Answer: C
Rationale: To qualify for Medicare based on disability, an individual must be entitled to
Social Security Disability Insurance (SSDI) for 24 months.
Q9: Mr. Thompson is still working past age 65 and has creditable coverage from his
employer (with fewer than 20 employees). He signs up for Medicare Part A only. Does
he face a Late Enrollment Penalty for Part B?
A. Yes, because he did not take Part B at 65.
B. No, because his employer group plan is creditable.
C. Yes, unless he retires within 6 months.
D. No, penalties do not apply to working individuals.
Correct Answer: A
Exam Medicare Training Plans
Compliance and Enrollment
Strategies Complete Questions &
Answers - Pass Guaranteed - A+
Graded
Medicare Basics & Eligibility
Q1: A beneficiary calls and asks what services are covered under Medicare Part A.
Which of the following correctly describes Part A coverage?
A. Physician services, outpatient care, and preventive services.
B. Inpatient hospital care, skilled nursing facility care, hospice care, and some home
health services.
C. Prescription drug coverage and durable medical equipment.
D. Routine vision, dental, and hearing exams.
Correct Answer: B
Rationale: Medicare Part A is known as Hospital Insurance and primarily covers
inpatient care in hospitals, skilled nursing facilities, hospice, and limited home health,
whereas Part B covers outpatient and physician services.
Q2: Mr. Henderson is 64 years old and asks when he can first apply for Medicare. What
is the correct advice regarding his Initial Enrollment Period (IEP)?
A. He can apply 3 months before his 65th birthday, the month of, and 3 months after.
B. He must wait until his 65th birthday to apply.
C. He can only apply during the Annual Election Period (AEP).
D. He cannot apply until he is fully retired.
Correct Answer: A
,Rationale: The Initial Enrollment Period (IEP) is a 7-month window that starts 3 months
before the month of eligibility (usually the 65th birthday), includes the month of eligibility,
and ends 3 months after.
Q3: Which of the following beneficiaries qualifies for Medicare based on End-Stage
Renal Disease (ESRD)?
A. A 45-year-old who requires dialysis for the rest of their life or a kidney transplant.
B. A 60-year-old with controlled high blood pressure.
C. A 50-year-old with Type 2 diabetes who is currently working.
D. A 70-year-old with mild kidney stones.
Correct Answer: A
Rationale: Regardless of age, a beneficiary qualifies for Medicare if they have
End-Stage Renal Disease requiring regular dialysis or a kidney transplant.
Q4: Mrs. Lee turned 65 last month but did not enroll in Medicare Part B because she
has creditable coverage from her husband's employer. She decides to drop her
employer coverage and enroll in Part B. What will happen regarding the Part B Late
Enrollment Penalty?
A. She will pay a 10% penalty for every year she could have had Part B but didn't.
B. She will not pay a penalty because she had creditable coverage.
C. She will pay a flat fee of $50.
D. She can only enroll during the AEP.
Correct Answer: B
Rationale: As long as a beneficiary is covered by creditable employer group health plan,
the Part B Late Enrollment Penalty (LEP) is deferred; dropping that coverage triggers a
Special Enrollment Period (SEP) without a penalty.
Q5: In 2026, what is the standard annual deductible for Medicare Part B?
A. $240.00
B. $164.90
C. $233.00
D. $198.00
Correct Answer: B
Rationale: The standard Part B annual deductible is $164.90 (as of 2026 standards),
though this amount is subject to annual inflation adjustments.
Q6: Mr. Davis has both Medicare Part A and Part B. He requires a routine cataract
surgery. Which part of Medicare covers the physician performing the surgery?
A. Medicare Part A
, B. Medicare Part B
C. Medicare Part D
D. Medicare Part C only
Correct Answer: B
Rationale: Medicare Part B covers medically necessary physician services, including
surgeries performed in an outpatient setting, even if Part A covers the inpatient facility if
applicable.
Q7: A beneficiary asks who pays the monthly premium for Medicare Part A. How should
you respond?
A. The beneficiary pays a standard monthly premium of $174.70.
B. The beneficiary pays a monthly premium based on income (IRMAA) if they have a
higher income.
C. Most beneficiaries do not pay a premium because they paid taxes while working.
D. Medicare Part A has no premium.
Correct Answer: C
Rationale: Most people get premium-free Part A because they or their spouse paid
Medicare taxes for at least 40 quarters (10 years); only those with fewer quarters pay a
premium.
Q8: Which of the following individuals qualifies for Medicare due to disability?
A. A 25-year-old who has been disabled for 12 months.
B. A 30-year-old who just broke their leg yesterday.
C. A 50-year-old who has been receiving Social Security Disability Insurance (SSDI)
checks for 25 months.
D. A 40-year-old who is unemployed but not disabled.
Correct Answer: C
Rationale: To qualify for Medicare based on disability, an individual must be entitled to
Social Security Disability Insurance (SSDI) for 24 months.
Q9: Mr. Thompson is still working past age 65 and has creditable coverage from his
employer (with fewer than 20 employees). He signs up for Medicare Part A only. Does
he face a Late Enrollment Penalty for Part B?
A. Yes, because he did not take Part B at 65.
B. No, because his employer group plan is creditable.
C. Yes, unless he retires within 6 months.
D. No, penalties do not apply to working individuals.
Correct Answer: A
