AHIP – FINAL EXAM 2026 WITH 100% ACCURATE ANSWERS.
AHIP FINAL EXAM 2026 – QUESTIONS WITH ANSWERS & RATIONALES
Section 1: Medicare Basics & Eligibility (Questions 1–25)
1. Edward suffered from serious kidney disease. As a result, Edward became
eligible for Medicare coverage due to end-stage renal disease (ESRD). A close
relative donated their kidney and Edward successfully underwent transplant
surgery 12 months ago. Edward is now age 50 and asks you if his Medicare
coverage will continue. What should you say?
A) His Medicare coverage will end 12 months after transplant surgery, regardless
of his age.
B) His Medicare coverage will continue as long as he receives follow-up care for
the transplant.
C) His Medicare coverage will end 36 months after the transplant unless he
otherwise qualifies.
D) His Medicare coverage ends immediately after transplant surgery.
Answer: C
,Rationale: For individuals eligible for Medicare due to ESRD, coverage ends 36
months after a successful kidney transplant unless they qualify for Medicare due
to age (65+) or disability. Edward's coverage will continue for 3 years post-
transplant.
2. Which part of Medicare covers inpatient hospital care, skilled nursing facility
care, and hospice?
A) Part A
B) Part B
C) Part C
D) Part D
Answer: A
Rationale: Part A is hospital insurance. It covers inpatient hospital stays, skilled
nursing facility care (not custodial or long-term care), hospice, and some home
health care.
3. What is the primary source of funding for Medicare Part A?
A) Income taxes
,B) Payroll taxes (FICA)
C) Beneficiary premiums
D) State general funds
Answer: B
Rationale: Part A is primarily funded by the FICA payroll tax paid by employees
and employers. Part B and Part D are funded by general revenues and beneficiary
premiums.
4. How many quarters of Medicare-covered employment must an individual have
to qualify for premium-free Part A?
A) 20 quarters
B) 30 quarters
C) 40 quarters
D) 50 quarters
Answer: C
, Rationale: 40 quarters (10 years) of covered employment grants premium-free
Part A. Individuals with 30-39 quarters pay a reduced premium; those with fewer
than 30 quarters pay the full premium.
5. Ms. Kumar plans to retire when she turns 65 in a few months. She is in
excellent health and will have considerable income when she retires. She is
concerned that her income will make it impossible for her to qualify for Medicare.
What could you tell her?
A) Ms. Kumar's high income will disqualify her from Medicare coverage.
B) Medicare is a program for people age 65 or older and those under age 65 with
certain disabilities, ESRD, and ALS, so she will be eligible for Medicare.
C) Only those with low income are eligible for Medicare.
D) Ms. Kumar needs to apply for Medicaid, not Medicare.
Answer: B
Rationale: Medicare eligibility is based on age (65+) or qualifying disabilities, not
income. While high income may affect premium amounts (IRMAA), it does not
affect eligibility.
AHIP FINAL EXAM 2026 – QUESTIONS WITH ANSWERS & RATIONALES
Section 1: Medicare Basics & Eligibility (Questions 1–25)
1. Edward suffered from serious kidney disease. As a result, Edward became
eligible for Medicare coverage due to end-stage renal disease (ESRD). A close
relative donated their kidney and Edward successfully underwent transplant
surgery 12 months ago. Edward is now age 50 and asks you if his Medicare
coverage will continue. What should you say?
A) His Medicare coverage will end 12 months after transplant surgery, regardless
of his age.
B) His Medicare coverage will continue as long as he receives follow-up care for
the transplant.
C) His Medicare coverage will end 36 months after the transplant unless he
otherwise qualifies.
D) His Medicare coverage ends immediately after transplant surgery.
Answer: C
,Rationale: For individuals eligible for Medicare due to ESRD, coverage ends 36
months after a successful kidney transplant unless they qualify for Medicare due
to age (65+) or disability. Edward's coverage will continue for 3 years post-
transplant.
2. Which part of Medicare covers inpatient hospital care, skilled nursing facility
care, and hospice?
A) Part A
B) Part B
C) Part C
D) Part D
Answer: A
Rationale: Part A is hospital insurance. It covers inpatient hospital stays, skilled
nursing facility care (not custodial or long-term care), hospice, and some home
health care.
3. What is the primary source of funding for Medicare Part A?
A) Income taxes
,B) Payroll taxes (FICA)
C) Beneficiary premiums
D) State general funds
Answer: B
Rationale: Part A is primarily funded by the FICA payroll tax paid by employees
and employers. Part B and Part D are funded by general revenues and beneficiary
premiums.
4. How many quarters of Medicare-covered employment must an individual have
to qualify for premium-free Part A?
A) 20 quarters
B) 30 quarters
C) 40 quarters
D) 50 quarters
Answer: C
, Rationale: 40 quarters (10 years) of covered employment grants premium-free
Part A. Individuals with 30-39 quarters pay a reduced premium; those with fewer
than 30 quarters pay the full premium.
5. Ms. Kumar plans to retire when she turns 65 in a few months. She is in
excellent health and will have considerable income when she retires. She is
concerned that her income will make it impossible for her to qualify for Medicare.
What could you tell her?
A) Ms. Kumar's high income will disqualify her from Medicare coverage.
B) Medicare is a program for people age 65 or older and those under age 65 with
certain disabilities, ESRD, and ALS, so she will be eligible for Medicare.
C) Only those with low income are eligible for Medicare.
D) Ms. Kumar needs to apply for Medicaid, not Medicare.
Answer: B
Rationale: Medicare eligibility is based on age (65+) or qualifying disabilities, not
income. While high income may affect premium amounts (IRMAA), it does not
affect eligibility.
