AHIP Test Review Questions Verified answers GRADED A+
2026 OVERVIEW OF MEDICARE PROGRAM BASICS: CHOICE,
ELIGIBILTY, AND BENEFITSMODULE 1
QUESTIONS WITH CORRECT
SOLUTIONS GRADED A+
1. Ms. pMoore pplans pto pretire pwhen pshe pturns p65 pin pa pfew pmonths. pShe pis pin pexcellent phealth
pand pwill phave pconsiderable pincome pwhen pshe pretires. pShe pis pconcerned pthat pher pincome pwill pmake
pit pimpossible pfor pher pto pqualify pfor pMedicare. pWhat pcould pyou ptell pher pto paddress pher pconcern?
a. Medicare pis pa pprogram pfor ppeople pof pall pages pwith pspecific pmental phealth pdisabilities. pSince pshe pis
pin pexcellent phealth, pshe pwould pnot pqualify, pbut pshould pinstead plook pinto pher pstate’s pMedicaid pprogram
pif pshe pwants pfurther pcoverage. p Incorrect
b. Eligibility pfor pMedicare pis pbased pon pwhether por pnot pa pperson phas pever pbeen pemployed pby pthe
pfederal pgovernment. pIf pshe por pher phusband pwere pever pemployed pby pthe pfederal pgovernment, pshe
pcan penroll pin pMedicare. p Incorrect
c. Medicare pis pa pprogram pfor ppeople page p65 por polder pand pthose punder page p65 pwith pcertain pdisabilities,
pend- pstage prenal pdisease, pand pLou pGehrig’s pdisease pso pshe pwill pbe peligible pfor pMedicare. p Correct
d. Medicare pis pa pprogram pfor ppeople pwho phave pincomes pand passets pbelow pspecific plimits, pso pyou pwill
phave pto pfind pout pher pexact pfinancial psituation pbefore ptelling pher pwhether pshe pcan pobtain pMedicare
pcoverage. pIncorrect
2. Mrs. pPark pis pan pelderly pretiree. pShe phas pa plow, pfixed pincome. pWhat pcould pyou ptell pMrs. pPark
that pmight pbe pof passistance?
p
a. She pshould pnot psign pup pfor pa pMedigap por pMedicare pAdvantage pplan. p Incorrect
b. She pshould ponly pseek phelp pfrom pprivate porganizations pto pcover pher pMedicare pcosts. p Incorrect
c. She pcan papply pto pthe pMedicare pagency pfor plower ppremiums pand pcost-sharing. p Incorrect
d. She pshould pcontact pher pstate pMedicaid pagency pto psee pif pshe pqualifies pfor pone pof pseveral pprograms
pthat pcan phelp pwith pMedicare pcosts pfor pwhich pshe pis presponsible. p Correct
3. Mr. pWu pis peligible pfor pMedicare. pHe phas plimited pfinancial presources pbut pfailed pto pqualify pfor
pthe pPart pD plow-income psubsidy. pWhere pmight phe pturn pfor phelp pwith phis pprescription pdrug pcosts?
a. Mr. pWu pmay pstill pqualify pfor phelp pin ppaying pfor pPart pD pcosts pthrough pthe plocal pOffice pof pthe pAging.
Incorrect
b. Mr. pWu phas pno palternative pbut pto pliquidate phis premaining passets pand papply pfor pcoverage pthrough
,his pstate’s pMedicaid pprogram. p Incorrect
p
c. Mr. pWu pmay pstill pqualify pfor phelp pin ppaying pPart pD pcosts pthrough phis pState pPharmaceutical
pAssistance pProgram. p Correct
d. Mr. pWu pmay pstill pqualify pfor phelp pin ppaying pfor pPart pD pcosts pthrough pthe pFederal
pPharmaceutical pAssistance pProgram. p Incorrect
, 4. Mr. pSchmidt pwould plike pto pplan pfor pretirement pand phaspasked pyou pwhat pis pcovered
under pOriginal pFee-for-Service p(FFS) pMedicare? p What pcould pyou ptell phim?
p
a. Part pA, pwhich pcovers phospital, pskilled pnursing pfacility, phospice, pand phome phealth pservices pand pPart
pB, pwhich pcovers pprofessional pservices psuch pas pthose pprovided pby pa pdoctor pare pcovered punder
pOriginal pMedicare. p Correct
b. Part pC, pwhich palways pcovers pdental pand pvision pservices, pis pcovered punder pOriginal pMedicare. p Incorrect
c. Part pA, pwhich pcovers plong pterm pcustodial pcare pservices, pis pcovered punder pOriginal pMedicare. p Incorrect
d. Part pD, pwhich pcovers pprescription pdrug pservices, pis pcovered punder pOriginal pMedicare. p Incorrect
5. Mr. pBuck phas pseveral pfamily pmembers pwho pdied pfrom pdifferent pcancers. p He pwants pto
know pif pMedicare pcovers pcancer pscreening. p What pshould pyou ptell phim?
p
a. Medicare pcovers pthe pperiodic pperformance pof pa prange pof pscreening ptests pthat pare pmeant pto
pprovide pearly pdetection pof pdisease. pMr. pBuck pwill pneed pto pcheck pspecific ptests pbefore pobtaining pthem
pto psee pif pthey pwill pbe pcovered. p Correct
b. Medicare pcovers pall pscreening ptests pthat phave pbeen papproved pby pthe pFDA pon pa pfrequency
pdetermined pby pthe ptreating pphysician. p Incorrect
c. Medicare pcovers psome pscreening ptests pthat pmust pbe pperformed pwithin pthe pfirst pyear pafter penrollment.
Beyond pthat ppoint pexpenses pfor pscreening ptests pis pthe presponsibility pof pthe pbeneficiary. p Incorrect
d. Medicare pcovers ptreatments pfor pexisting pdisease, pinjury pand pmalformed plimbs por pbody pparts. pAs
psuch, pit pdoes pnot pcover pany pscreening ptests pand pthese pmust pbe ppaid pfor pby pthe pbeneficiary pout pof
ppocket. pIncorrect
6. Mr. pPatel pis pin pgood phealth pand pis ppreparing pa pbudget pin panticipation pof phis pretirement pwhen
phe pturns p66. pHe pwants pto punderstand pthe phealth pcare pcosts phe pmight pbe pexposed pto punder
pMedicare pif phe pwere pto prequire phospitalization pas pa presult pof pan pillness. pIn pgeneral pterms, pwhat
pcould pyou ptell phim pabout phis pcosts pfor pinpatient phospital pservices punder pOriginal pMedicare?
a. Under pOriginal pMedicare, pthe pinpatient phospital pco-payment pis pa pflat pper-day pamount pthat premains
pthe psame pthroughout pthe pfirst p60 pdays pof pa pbeneficiary’s pstay. pAfter pday p60 pthe pamount pgradually
pincreases puntil pday p90. pAfter p90 pdays phe pwould ppay pthe pfull pamount pof pall pcosts. p Incorrect
b. Under pOriginal pMedicare, pthere pis pa psingle pdeductible pamount pdue pfor pthe pfirst p60 pdays pof pany
pinpatient phospital pstay, pafter pwhich pit pconverts pinto pa pper-day pcoinsurance pamount pthrough pday p90.
pAfter pday p90, phe pwould ppay pa pdaily pamount pup pto p60 pdays pover phis plifetime, pafter pwhich phe pwould
pbe presponsible pfor pall pcosts p Correct
c. Under pOriginal pMedicare, pthe pinpatient phospital pco-payment pis pa ppercentage pof pallowed pcharges.
pThe ppercentage pincreases pafter p60 pdays pand pagain pafter p90 pdays. p Incorrect
, d. Under pOriginal pMedicare, pif pthe pinpatient phospital pservice pis pprovided pby pa pparticipating
pMedicare pprovider, pthe pco-payment pis pwaived. pCo-payments pare ponly pcharged pwhen pa pbeneficiary
popts pto preceive pcare pfrom pa pnon-participating pprovider. p Incorrect
7. Mr. pBauer pis p49 pyears pold, pbut peighteen pmonths pago phe pwas pdeclared pdisabled pby pthe
pSocial pSecurity pAdministration pand phas pbeen preceiving pdisability ppayments. pHe pis pwondering
pwhether phe pcan pobtain pcoverage punder pMedicare. p What pshould pyou ptell phim?
a. Individuals pwho pbecome peligible pfor psuch pdisability ppayments ponly phave pto pwait p12 pmonths pbefore
pthey pcan papply pfor pcoverage punder pMedicare. p Incorrect
b. He pbecame peligible pfor pMedicare pwhen phis pdisability peligibility pdetermination pwas pfirst pmade.
p Incorrect
c. After preceiving psuch pdisability ppayments pfor p24 pmonths phe pwill pbe pautomatically penrolled pin
pMedicare, pregardless pof page. p Correct
d. Individuals preceiving psuch pdisability ppayments pfrom pthe pSocial pSecurity pAdministration pcontinue
pto preceive pthose ppayments, pbut ponly pbecome peligible pfor pMedicare pupon preaching page p65.
p Incorrect
8. Mrs. pRoberts phas pjust preceived pa pnew pMedicare pidentity pcard pin pthe pmail. pShe pis pconcerned
pthat pit pis pa pforgery psince pit pdoes pnot phave pher pSocial pSecurity pnumber pon pit. pWhat pshould pyou ptell
pher?
a. The pcard pis pindeed pa pforgery psince pall pidentity pcards pare pbeing pphased pout pin pfavor pof pa pnew
pelectronic pidentity psystem pdeveloped pby pthe pSocial pSecurity pAdministration. p Incorrect
b. The pcard pshe preceived pis pvalid pbut pshe pshould pkeep pher pold pcard pfor pat pleast ptwo pyears pand
ppresent pit pwhenever pshe preceives phealth pcare. p Incorrect
c. The pcard pshe preceived pis pvalid, pthe pchange phas pbeen pmade pto pprotect pMedicare pbeneficiaries
pfrom pidentity ptheft, pand pshe pshould pnow pdestroy pher pold pcard. p Correct
d. The pcard pis pindeed pa pforgery psince pnewly pissued pMedicare pcards pwill phave pboth pa pbeneficiary’s
pSocial pSecurity pnumber pand pdate pof pbirth pimprinted pon pthem. p Incorrect
9. Mrs. pKelly, page p65, pis pentitled pto pPart pA pbut phas pnot pyet penrolled pin pPart pB. pShe pis
pconsidering penrollment pin pa pMedicare phealth pplan p(Part pC). pWhat pshould pyou padvise pher pto pdo
pbefore pshe pwill pbe pable pto penroll pin pa pMedicare phealth pplan?
a. To penroll pin pa pMedicare phealth pplan, pshe pneed ponly pbe pentitled pto pPart pA, pso pshe pdoes pnot pneed pto
ptake pany pfurther psteps. p Incorrect
b. In porder pto pjoin pa pMedicare phealth pplan, pshe pmust pbe penrolled pin pParts pA, pB, pand pD. p Incorrect
c. Since pshe pis page p65 pshe pmay penroll pin pany pMedicare phealth pplan, pregardless pof pwhether pshe pis
pentitled pto pPart pA por pPart pB pcoverage. p Incorrect
d. In porder pto pjoin pa pMedicare phealth pplan, pshe palso pmust penroll pin pPart pB. p Correct
2026 OVERVIEW OF MEDICARE PROGRAM BASICS: CHOICE,
ELIGIBILTY, AND BENEFITSMODULE 1
QUESTIONS WITH CORRECT
SOLUTIONS GRADED A+
1. Ms. pMoore pplans pto pretire pwhen pshe pturns p65 pin pa pfew pmonths. pShe pis pin pexcellent phealth
pand pwill phave pconsiderable pincome pwhen pshe pretires. pShe pis pconcerned pthat pher pincome pwill pmake
pit pimpossible pfor pher pto pqualify pfor pMedicare. pWhat pcould pyou ptell pher pto paddress pher pconcern?
a. Medicare pis pa pprogram pfor ppeople pof pall pages pwith pspecific pmental phealth pdisabilities. pSince pshe pis
pin pexcellent phealth, pshe pwould pnot pqualify, pbut pshould pinstead plook pinto pher pstate’s pMedicaid pprogram
pif pshe pwants pfurther pcoverage. p Incorrect
b. Eligibility pfor pMedicare pis pbased pon pwhether por pnot pa pperson phas pever pbeen pemployed pby pthe
pfederal pgovernment. pIf pshe por pher phusband pwere pever pemployed pby pthe pfederal pgovernment, pshe
pcan penroll pin pMedicare. p Incorrect
c. Medicare pis pa pprogram pfor ppeople page p65 por polder pand pthose punder page p65 pwith pcertain pdisabilities,
pend- pstage prenal pdisease, pand pLou pGehrig’s pdisease pso pshe pwill pbe peligible pfor pMedicare. p Correct
d. Medicare pis pa pprogram pfor ppeople pwho phave pincomes pand passets pbelow pspecific plimits, pso pyou pwill
phave pto pfind pout pher pexact pfinancial psituation pbefore ptelling pher pwhether pshe pcan pobtain pMedicare
pcoverage. pIncorrect
2. Mrs. pPark pis pan pelderly pretiree. pShe phas pa plow, pfixed pincome. pWhat pcould pyou ptell pMrs. pPark
that pmight pbe pof passistance?
p
a. She pshould pnot psign pup pfor pa pMedigap por pMedicare pAdvantage pplan. p Incorrect
b. She pshould ponly pseek phelp pfrom pprivate porganizations pto pcover pher pMedicare pcosts. p Incorrect
c. She pcan papply pto pthe pMedicare pagency pfor plower ppremiums pand pcost-sharing. p Incorrect
d. She pshould pcontact pher pstate pMedicaid pagency pto psee pif pshe pqualifies pfor pone pof pseveral pprograms
pthat pcan phelp pwith pMedicare pcosts pfor pwhich pshe pis presponsible. p Correct
3. Mr. pWu pis peligible pfor pMedicare. pHe phas plimited pfinancial presources pbut pfailed pto pqualify pfor
pthe pPart pD plow-income psubsidy. pWhere pmight phe pturn pfor phelp pwith phis pprescription pdrug pcosts?
a. Mr. pWu pmay pstill pqualify pfor phelp pin ppaying pfor pPart pD pcosts pthrough pthe plocal pOffice pof pthe pAging.
Incorrect
b. Mr. pWu phas pno palternative pbut pto pliquidate phis premaining passets pand papply pfor pcoverage pthrough
,his pstate’s pMedicaid pprogram. p Incorrect
p
c. Mr. pWu pmay pstill pqualify pfor phelp pin ppaying pPart pD pcosts pthrough phis pState pPharmaceutical
pAssistance pProgram. p Correct
d. Mr. pWu pmay pstill pqualify pfor phelp pin ppaying pfor pPart pD pcosts pthrough pthe pFederal
pPharmaceutical pAssistance pProgram. p Incorrect
, 4. Mr. pSchmidt pwould plike pto pplan pfor pretirement pand phaspasked pyou pwhat pis pcovered
under pOriginal pFee-for-Service p(FFS) pMedicare? p What pcould pyou ptell phim?
p
a. Part pA, pwhich pcovers phospital, pskilled pnursing pfacility, phospice, pand phome phealth pservices pand pPart
pB, pwhich pcovers pprofessional pservices psuch pas pthose pprovided pby pa pdoctor pare pcovered punder
pOriginal pMedicare. p Correct
b. Part pC, pwhich palways pcovers pdental pand pvision pservices, pis pcovered punder pOriginal pMedicare. p Incorrect
c. Part pA, pwhich pcovers plong pterm pcustodial pcare pservices, pis pcovered punder pOriginal pMedicare. p Incorrect
d. Part pD, pwhich pcovers pprescription pdrug pservices, pis pcovered punder pOriginal pMedicare. p Incorrect
5. Mr. pBuck phas pseveral pfamily pmembers pwho pdied pfrom pdifferent pcancers. p He pwants pto
know pif pMedicare pcovers pcancer pscreening. p What pshould pyou ptell phim?
p
a. Medicare pcovers pthe pperiodic pperformance pof pa prange pof pscreening ptests pthat pare pmeant pto
pprovide pearly pdetection pof pdisease. pMr. pBuck pwill pneed pto pcheck pspecific ptests pbefore pobtaining pthem
pto psee pif pthey pwill pbe pcovered. p Correct
b. Medicare pcovers pall pscreening ptests pthat phave pbeen papproved pby pthe pFDA pon pa pfrequency
pdetermined pby pthe ptreating pphysician. p Incorrect
c. Medicare pcovers psome pscreening ptests pthat pmust pbe pperformed pwithin pthe pfirst pyear pafter penrollment.
Beyond pthat ppoint pexpenses pfor pscreening ptests pis pthe presponsibility pof pthe pbeneficiary. p Incorrect
d. Medicare pcovers ptreatments pfor pexisting pdisease, pinjury pand pmalformed plimbs por pbody pparts. pAs
psuch, pit pdoes pnot pcover pany pscreening ptests pand pthese pmust pbe ppaid pfor pby pthe pbeneficiary pout pof
ppocket. pIncorrect
6. Mr. pPatel pis pin pgood phealth pand pis ppreparing pa pbudget pin panticipation pof phis pretirement pwhen
phe pturns p66. pHe pwants pto punderstand pthe phealth pcare pcosts phe pmight pbe pexposed pto punder
pMedicare pif phe pwere pto prequire phospitalization pas pa presult pof pan pillness. pIn pgeneral pterms, pwhat
pcould pyou ptell phim pabout phis pcosts pfor pinpatient phospital pservices punder pOriginal pMedicare?
a. Under pOriginal pMedicare, pthe pinpatient phospital pco-payment pis pa pflat pper-day pamount pthat premains
pthe psame pthroughout pthe pfirst p60 pdays pof pa pbeneficiary’s pstay. pAfter pday p60 pthe pamount pgradually
pincreases puntil pday p90. pAfter p90 pdays phe pwould ppay pthe pfull pamount pof pall pcosts. p Incorrect
b. Under pOriginal pMedicare, pthere pis pa psingle pdeductible pamount pdue pfor pthe pfirst p60 pdays pof pany
pinpatient phospital pstay, pafter pwhich pit pconverts pinto pa pper-day pcoinsurance pamount pthrough pday p90.
pAfter pday p90, phe pwould ppay pa pdaily pamount pup pto p60 pdays pover phis plifetime, pafter pwhich phe pwould
pbe presponsible pfor pall pcosts p Correct
c. Under pOriginal pMedicare, pthe pinpatient phospital pco-payment pis pa ppercentage pof pallowed pcharges.
pThe ppercentage pincreases pafter p60 pdays pand pagain pafter p90 pdays. p Incorrect
, d. Under pOriginal pMedicare, pif pthe pinpatient phospital pservice pis pprovided pby pa pparticipating
pMedicare pprovider, pthe pco-payment pis pwaived. pCo-payments pare ponly pcharged pwhen pa pbeneficiary
popts pto preceive pcare pfrom pa pnon-participating pprovider. p Incorrect
7. Mr. pBauer pis p49 pyears pold, pbut peighteen pmonths pago phe pwas pdeclared pdisabled pby pthe
pSocial pSecurity pAdministration pand phas pbeen preceiving pdisability ppayments. pHe pis pwondering
pwhether phe pcan pobtain pcoverage punder pMedicare. p What pshould pyou ptell phim?
a. Individuals pwho pbecome peligible pfor psuch pdisability ppayments ponly phave pto pwait p12 pmonths pbefore
pthey pcan papply pfor pcoverage punder pMedicare. p Incorrect
b. He pbecame peligible pfor pMedicare pwhen phis pdisability peligibility pdetermination pwas pfirst pmade.
p Incorrect
c. After preceiving psuch pdisability ppayments pfor p24 pmonths phe pwill pbe pautomatically penrolled pin
pMedicare, pregardless pof page. p Correct
d. Individuals preceiving psuch pdisability ppayments pfrom pthe pSocial pSecurity pAdministration pcontinue
pto preceive pthose ppayments, pbut ponly pbecome peligible pfor pMedicare pupon preaching page p65.
p Incorrect
8. Mrs. pRoberts phas pjust preceived pa pnew pMedicare pidentity pcard pin pthe pmail. pShe pis pconcerned
pthat pit pis pa pforgery psince pit pdoes pnot phave pher pSocial pSecurity pnumber pon pit. pWhat pshould pyou ptell
pher?
a. The pcard pis pindeed pa pforgery psince pall pidentity pcards pare pbeing pphased pout pin pfavor pof pa pnew
pelectronic pidentity psystem pdeveloped pby pthe pSocial pSecurity pAdministration. p Incorrect
b. The pcard pshe preceived pis pvalid pbut pshe pshould pkeep pher pold pcard pfor pat pleast ptwo pyears pand
ppresent pit pwhenever pshe preceives phealth pcare. p Incorrect
c. The pcard pshe preceived pis pvalid, pthe pchange phas pbeen pmade pto pprotect pMedicare pbeneficiaries
pfrom pidentity ptheft, pand pshe pshould pnow pdestroy pher pold pcard. p Correct
d. The pcard pis pindeed pa pforgery psince pnewly pissued pMedicare pcards pwill phave pboth pa pbeneficiary’s
pSocial pSecurity pnumber pand pdate pof pbirth pimprinted pon pthem. p Incorrect
9. Mrs. pKelly, page p65, pis pentitled pto pPart pA pbut phas pnot pyet penrolled pin pPart pB. pShe pis
pconsidering penrollment pin pa pMedicare phealth pplan p(Part pC). pWhat pshould pyou padvise pher pto pdo
pbefore pshe pwill pbe pable pto penroll pin pa pMedicare phealth pplan?
a. To penroll pin pa pMedicare phealth pplan, pshe pneed ponly pbe pentitled pto pPart pA, pso pshe pdoes pnot pneed pto
ptake pany pfurther psteps. p Incorrect
b. In porder pto pjoin pa pMedicare phealth pplan, pshe pmust pbe penrolled pin pParts pA, pB, pand pD. p Incorrect
c. Since pshe pis page p65 pshe pmay penroll pin pany pMedicare phealth pplan, pregardless pof pwhether pshe pis
pentitled pto pPart pA por pPart pB pcoverage. p Incorrect
d. In porder pto pjoin pa pMedicare phealth pplan, pshe palso pmust penroll pin pPart pB. p Correct
