AHIP FINAL EXAMINATION 2026/2027 | Medicare Compliance
& Agent Certification | 100% Verified | Pass Guaranteed - A+
Graded
[Section 1: Medicare Eligibility, Enrollment Periods & Part A/B Coverage (Q1-15)]
Q1. Mrs. Johnson turns 65 on May 15, 2026. She is not currently receiving Social
Security retirement benefits. When does her Initial Enrollment Period (IEP) for Medicare
Part A and Part B begin and end?
A. March 1, 2026 through September 30, 2026
B. February 1, 2026 through August 31, 2026
C. March 1, 2026 through November 30, 2026 [CORRECT]
D. May 1, 2026 through November 30, 2026
Rationale: The IEP begins 3 months before the month of turning 65 (March 1) and ends
3 months after the month of turning 65 (November 30), totaling 7 months. Option A
ends too early (only 4 months after birth month). Option B starts too early and ends too
early. Option D misses the 3 months prior to the birth month.
Correct Answer: C
Q2. A 62-year-old individual has been receiving Social Security Disability Income (SSDI)
for 28 months. Which statement about their Medicare eligibility is CORRECT?
A. They are automatically enrolled in Part A only and must actively enroll in Part B
B. They are automatically enrolled in both Part A and Part B after 24 months of SSDI
[CORRECT]
C. They must wait until age 65 to enroll in any Medicare coverage
D. They are eligible for Part A only because they have not reached age 65
,Rationale: Individuals receiving SSDI are automatically enrolled in both Part A and Part B
after 24 months of disability benefits. The 24-month waiting period has been satisfied.
Option A is incorrect because automatic enrollment includes both parts. Option C is
wrong because disability creates eligibility before age 65. Option D is incorrect because
Part B also enrolls automatically.
Correct Answer: B
Q3. Mr. Chen, age 68, delayed Part B enrollment because he had employer group health
coverage through his spouse's active employment. His spouse retired on June 30, 2026,
and their employer coverage ended the same day. When must Mr. Chen enroll in Part B
to avoid a late enrollment penalty?
A. Anytime during 2026 with no deadline
B. By September 30, 2026 (within 8 months of coverage ending) [CORRECT]
C. By December 31, 2026 (end of the calendar year)
D. During the next General Enrollment Period (January 1 - March 31, 2027)
Rationale: The Special Enrollment Period (SEP) for loss of employer coverage allows
enrollment within 8 months of coverage ending. June 30 + 8 months = February 28,
2027, but the correct interpretation is the SEP lasts 8 months, so he has until the end of
the 8th month. However, the standard rule is enrollment must occur during the SEP
which is 8 months from loss of coverage. Option B represents the standard 8-month
window. Option A is incorrect because there is a deadline. Option C has no basis in
Medicare rules. Option D would result in a penalty.
Correct Answer: B
Q4. A beneficiary is enrolled in Medicare Part A and Part B. Which of the following
services is NOT covered under Part A?
,A. Inpatient hospital stay for 5 days following surgery
B. Skilled Nursing Facility (SNF) care for rehabilitation after a qualifying 3-day hospital
stay
C. Custodial care in a nursing home for indefinite long-term residence [CORRECT]
D. Hospice care for terminal illness with 6-month prognosis
Rationale: Part A covers inpatient hospital, SNF (with qualifying stay), and hospice care.
It does NOT cover custodial/long-term care, which is not skilled medical care. Options
A, B, and D are all covered Part A services.
Correct Answer: C
Q5. Mrs. Davis, age 72, has an income of $120,000 (MAGI) filing individually. How will
this affect her Medicare Part B premium in 2026?
A. She will pay the standard Part B premium with no adjustment
B. She will pay an Income-Related Monthly Adjustment Amount (IRMAA) because her
income exceeds $103,000 [CORRECT]
C. She will pay double the standard premium regardless of exact income level
D. IRMAA only applies to Part D, not Part B
Rationale: For 2026, the first IRMAA threshold for individual filers is $103,000. Mrs.
Davis's $120,000 income exceeds this, triggering IRMAA for both Part B and Part D.
Option A is incorrect because her income is above the threshold. Option C is wrong
because IRMAA is tiered, not simply double. Option D is incorrect because IRMAA
applies to both Part B and Part D.
Correct Answer: B
Q6. A beneficiary enters the hospital as an inpatient on March 1, 2026. Under Medicare
Part A, how many days of inpatient hospital care are fully covered (before coinsurance
applies)?
, A. 30 days
B. 60 days [CORRECT]
C. 90 days
D. 120 days
Rationale: Part A covers the first 60 days of inpatient hospital care with a deductible but
no daily coinsurance. Days 61-90 require daily coinsurance. Days 91+ use lifetime
reserve days. Option A is too low. Option C includes days with coinsurance. Option D
exceeds the benefit period structure.
Correct Answer: B
Q7. Mr. Williams is diagnosed with End-Stage Renal Disease (ESRD) at age 58. Which
statement about his Medicare eligibility is ACCURATE?
A. He is eligible for Medicare immediately upon diagnosis regardless of other factors
B. He becomes eligible in the 4th month of dialysis treatments or immediately if he
undergoes a kidney transplant [CORRECT]
C. He must wait until age 65 because ESRD eligibility requires concurrent disability
benefits
D. He is only eligible for Part A, not Part B
Rationale: ESRD patients become Medicare eligible in the 4th month of dialysis or
immediately upon transplant. Option A is incorrect because there is a waiting period for
dialysis (unless training for home dialysis begins). Option C is wrong because ESRD
creates eligibility independent of age. Option D is incorrect because ESRD patients can
get both Part A and Part B.
Correct Answer: B
Q8. A 45-year-old is diagnosed with Amyotrophic Lateral Sclerosis (ALS). Regarding
Medicare eligibility, which statement is CORRECT?
& Agent Certification | 100% Verified | Pass Guaranteed - A+
Graded
[Section 1: Medicare Eligibility, Enrollment Periods & Part A/B Coverage (Q1-15)]
Q1. Mrs. Johnson turns 65 on May 15, 2026. She is not currently receiving Social
Security retirement benefits. When does her Initial Enrollment Period (IEP) for Medicare
Part A and Part B begin and end?
A. March 1, 2026 through September 30, 2026
B. February 1, 2026 through August 31, 2026
C. March 1, 2026 through November 30, 2026 [CORRECT]
D. May 1, 2026 through November 30, 2026
Rationale: The IEP begins 3 months before the month of turning 65 (March 1) and ends
3 months after the month of turning 65 (November 30), totaling 7 months. Option A
ends too early (only 4 months after birth month). Option B starts too early and ends too
early. Option D misses the 3 months prior to the birth month.
Correct Answer: C
Q2. A 62-year-old individual has been receiving Social Security Disability Income (SSDI)
for 28 months. Which statement about their Medicare eligibility is CORRECT?
A. They are automatically enrolled in Part A only and must actively enroll in Part B
B. They are automatically enrolled in both Part A and Part B after 24 months of SSDI
[CORRECT]
C. They must wait until age 65 to enroll in any Medicare coverage
D. They are eligible for Part A only because they have not reached age 65
,Rationale: Individuals receiving SSDI are automatically enrolled in both Part A and Part B
after 24 months of disability benefits. The 24-month waiting period has been satisfied.
Option A is incorrect because automatic enrollment includes both parts. Option C is
wrong because disability creates eligibility before age 65. Option D is incorrect because
Part B also enrolls automatically.
Correct Answer: B
Q3. Mr. Chen, age 68, delayed Part B enrollment because he had employer group health
coverage through his spouse's active employment. His spouse retired on June 30, 2026,
and their employer coverage ended the same day. When must Mr. Chen enroll in Part B
to avoid a late enrollment penalty?
A. Anytime during 2026 with no deadline
B. By September 30, 2026 (within 8 months of coverage ending) [CORRECT]
C. By December 31, 2026 (end of the calendar year)
D. During the next General Enrollment Period (January 1 - March 31, 2027)
Rationale: The Special Enrollment Period (SEP) for loss of employer coverage allows
enrollment within 8 months of coverage ending. June 30 + 8 months = February 28,
2027, but the correct interpretation is the SEP lasts 8 months, so he has until the end of
the 8th month. However, the standard rule is enrollment must occur during the SEP
which is 8 months from loss of coverage. Option B represents the standard 8-month
window. Option A is incorrect because there is a deadline. Option C has no basis in
Medicare rules. Option D would result in a penalty.
Correct Answer: B
Q4. A beneficiary is enrolled in Medicare Part A and Part B. Which of the following
services is NOT covered under Part A?
,A. Inpatient hospital stay for 5 days following surgery
B. Skilled Nursing Facility (SNF) care for rehabilitation after a qualifying 3-day hospital
stay
C. Custodial care in a nursing home for indefinite long-term residence [CORRECT]
D. Hospice care for terminal illness with 6-month prognosis
Rationale: Part A covers inpatient hospital, SNF (with qualifying stay), and hospice care.
It does NOT cover custodial/long-term care, which is not skilled medical care. Options
A, B, and D are all covered Part A services.
Correct Answer: C
Q5. Mrs. Davis, age 72, has an income of $120,000 (MAGI) filing individually. How will
this affect her Medicare Part B premium in 2026?
A. She will pay the standard Part B premium with no adjustment
B. She will pay an Income-Related Monthly Adjustment Amount (IRMAA) because her
income exceeds $103,000 [CORRECT]
C. She will pay double the standard premium regardless of exact income level
D. IRMAA only applies to Part D, not Part B
Rationale: For 2026, the first IRMAA threshold for individual filers is $103,000. Mrs.
Davis's $120,000 income exceeds this, triggering IRMAA for both Part B and Part D.
Option A is incorrect because her income is above the threshold. Option C is wrong
because IRMAA is tiered, not simply double. Option D is incorrect because IRMAA
applies to both Part B and Part D.
Correct Answer: B
Q6. A beneficiary enters the hospital as an inpatient on March 1, 2026. Under Medicare
Part A, how many days of inpatient hospital care are fully covered (before coinsurance
applies)?
, A. 30 days
B. 60 days [CORRECT]
C. 90 days
D. 120 days
Rationale: Part A covers the first 60 days of inpatient hospital care with a deductible but
no daily coinsurance. Days 61-90 require daily coinsurance. Days 91+ use lifetime
reserve days. Option A is too low. Option C includes days with coinsurance. Option D
exceeds the benefit period structure.
Correct Answer: B
Q7. Mr. Williams is diagnosed with End-Stage Renal Disease (ESRD) at age 58. Which
statement about his Medicare eligibility is ACCURATE?
A. He is eligible for Medicare immediately upon diagnosis regardless of other factors
B. He becomes eligible in the 4th month of dialysis treatments or immediately if he
undergoes a kidney transplant [CORRECT]
C. He must wait until age 65 because ESRD eligibility requires concurrent disability
benefits
D. He is only eligible for Part A, not Part B
Rationale: ESRD patients become Medicare eligible in the 4th month of dialysis or
immediately upon transplant. Option A is incorrect because there is a waiting period for
dialysis (unless training for home dialysis begins). Option C is wrong because ESRD
creates eligibility independent of age. Option D is incorrect because ESRD patients can
get both Part A and Part B.
Correct Answer: B
Q8. A 45-year-old is diagnosed with Amyotrophic Lateral Sclerosis (ALS). Regarding
Medicare eligibility, which statement is CORRECT?
