1|Page
MEDICARE AHIP STUDY GUIDE 2026-2027 | 200+
PRACTICE QUESTIONS & RATIONALES |
MEDICARE ADVANTAGE | PART D |
ENROLLMENT | CERTIFICATION PREP | HIGH-
YIELD
## Table of Contents
1. **Medicare Basics & Eligibility** (Q1–Q25)
2. **Medicare Part A (Hospital Insurance)** (Q26–Q40)
3. **Medicare Part B (Medical Insurance)** (Q41–Q55)
4. **Medicare Part C (Medicare Advantage)** (Q56–Q80)
5. **Medicare Part D (Prescription Drug Coverage)** (Q81–Q105)
6. **Medigap (Supplemental Insurance)** (Q106–Q115)
7. **Enrollment Periods & Penalties** (Q116–Q140)
8. **Marketing & Compliance Rules** (Q141–Q160)
9. **Low-Income Subsidy (LIS / Extra Help)** (Q161–Q170)
10. **Appeals & Grievances** (Q171–Q180)
11. **High-Yield Scenario-Based Questions** (Q181–Q200)
---
,2|Page
# Section 1: Medicare Basics & Eligibility (Q1–Q25)
**Q1.** A person is generally eligible for Medicare if they are age:
A. 65 or older
B. 62 or older
C. 60 or older
D. 70 or older
**Correct Answer: A – 65 or older**
*Rationale: Most people become eligible for Medicare at age 65.
Younger individuals may qualify based on disability or End-Stage Renal
Disease (ESRD).*
**Q2.** Which of the following individuals is automatically eligible for
Medicare without paying a premium for Part A?
A. A 65-year-old who worked at least 40 quarters (10 years) in
Medicare-covered employment
B. A 65-year-old who never worked
C. A 60-year-old with no disability
D. A 70-year-old who worked 20 quarters
,3|Page
**Correct Answer: A – A 65-year-old who worked at least 40 quarters in
Medicare-covered employment**
*Rationale: Premium-free Part A is available to individuals who have
paid Medicare taxes for at least 40 quarters (10 years).*
**Q3.** A person under age 65 may qualify for Medicare based on
disability after receiving Social Security Disability Insurance (SSDI) for:
A. 24 months
B. 12 months
C. 6 months
D. 36 months
**Correct Answer: A – 24 months**
*Rationale: Individuals under 65 qualify for Medicare after receiving
SSDI for 24 months.*
**Q4.** Which condition qualifies a person for Medicare regardless of
age?
A. End-Stage Renal Disease (ESRD)
B. Hypertension
C. Diabetes
D. COPD
, 4|Page
**Correct Answer: A – End-Stage Renal Disease (ESRD)**
*Rationale: ESRD is one of the conditions that qualifies an individual
for Medicare regardless of age.*
**Q5.** The Initial Enrollment Period (IEP) for Medicare begins:
A. 3 months before the month of the 65th birthday and ends 3 months
after
B. 6 months before the 65th birthday
C. Only during the month of the 65th birthday
D. 1 year before the 65th birthday
**Correct Answer: A – 3 months before the month of the 65th birthday
and ends 3 months after**
*Rationale: The IEP is a 7-month window: the 3 months before, the
month of, and the 3 months after the 65th birthday.*
**Q6.** If a person does not enroll in Medicare Part B during their
Initial Enrollment Period, they may face:
A. A late enrollment penalty
B. Automatic enrollment the next year
C. No penalty
D. Loss of Social Security benefits
MEDICARE AHIP STUDY GUIDE 2026-2027 | 200+
PRACTICE QUESTIONS & RATIONALES |
MEDICARE ADVANTAGE | PART D |
ENROLLMENT | CERTIFICATION PREP | HIGH-
YIELD
## Table of Contents
1. **Medicare Basics & Eligibility** (Q1–Q25)
2. **Medicare Part A (Hospital Insurance)** (Q26–Q40)
3. **Medicare Part B (Medical Insurance)** (Q41–Q55)
4. **Medicare Part C (Medicare Advantage)** (Q56–Q80)
5. **Medicare Part D (Prescription Drug Coverage)** (Q81–Q105)
6. **Medigap (Supplemental Insurance)** (Q106–Q115)
7. **Enrollment Periods & Penalties** (Q116–Q140)
8. **Marketing & Compliance Rules** (Q141–Q160)
9. **Low-Income Subsidy (LIS / Extra Help)** (Q161–Q170)
10. **Appeals & Grievances** (Q171–Q180)
11. **High-Yield Scenario-Based Questions** (Q181–Q200)
---
,2|Page
# Section 1: Medicare Basics & Eligibility (Q1–Q25)
**Q1.** A person is generally eligible for Medicare if they are age:
A. 65 or older
B. 62 or older
C. 60 or older
D. 70 or older
**Correct Answer: A – 65 or older**
*Rationale: Most people become eligible for Medicare at age 65.
Younger individuals may qualify based on disability or End-Stage Renal
Disease (ESRD).*
**Q2.** Which of the following individuals is automatically eligible for
Medicare without paying a premium for Part A?
A. A 65-year-old who worked at least 40 quarters (10 years) in
Medicare-covered employment
B. A 65-year-old who never worked
C. A 60-year-old with no disability
D. A 70-year-old who worked 20 quarters
,3|Page
**Correct Answer: A – A 65-year-old who worked at least 40 quarters in
Medicare-covered employment**
*Rationale: Premium-free Part A is available to individuals who have
paid Medicare taxes for at least 40 quarters (10 years).*
**Q3.** A person under age 65 may qualify for Medicare based on
disability after receiving Social Security Disability Insurance (SSDI) for:
A. 24 months
B. 12 months
C. 6 months
D. 36 months
**Correct Answer: A – 24 months**
*Rationale: Individuals under 65 qualify for Medicare after receiving
SSDI for 24 months.*
**Q4.** Which condition qualifies a person for Medicare regardless of
age?
A. End-Stage Renal Disease (ESRD)
B. Hypertension
C. Diabetes
D. COPD
, 4|Page
**Correct Answer: A – End-Stage Renal Disease (ESRD)**
*Rationale: ESRD is one of the conditions that qualifies an individual
for Medicare regardless of age.*
**Q5.** The Initial Enrollment Period (IEP) for Medicare begins:
A. 3 months before the month of the 65th birthday and ends 3 months
after
B. 6 months before the 65th birthday
C. Only during the month of the 65th birthday
D. 1 year before the 65th birthday
**Correct Answer: A – 3 months before the month of the 65th birthday
and ends 3 months after**
*Rationale: The IEP is a 7-month window: the 3 months before, the
month of, and the 3 months after the 65th birthday.*
**Q6.** If a person does not enroll in Medicare Part B during their
Initial Enrollment Period, they may face:
A. A late enrollment penalty
B. Automatic enrollment the next year
C. No penalty
D. Loss of Social Security benefits
