AHIP Final Exam 2025-2026 100% Verified Questions & Accurate Answers –
Pass With Confidence
Part 1: Medicare Basics & Eligibility (Questions 1-40)
1. A Medicare beneficiary's Initial Enrollment Period (IEP) generally lasts how
many months?
A. Four months
B. Six months
C. Seven months
D. Nine months
Answer: C. Seven months
Rationale: The Initial Enrollment Period spans seven months — beginning three
months before the month of eligibility, including the eligibility month, and ending
three months after. This ensures ample time to enroll without penalty .
2. Which of the following individuals is eligible for Medicare?
A. A 40-year-old with no disabilities
,B. A 63-year-old with no qualifying conditions
C. A 67-year-old U.S. citizen who has worked 10 years in covered employment
D. A 55-year-old with private insurance
Answer: C. A 67-year-old U.S. citizen who has worked 10 years in covered
employment
Rationale: Eligibility generally requires age 65 or older and sufficient work credits
(40 quarters), or certain disabilities or ESRD (end-stage renal disease). Only the
67-year-old meets standard age and work credit criteria .
3. Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been
employed full time, and paid taxes during that entire period. She is concerned
that she will not qualify for coverage under Part A because she was not born in
the United States. What should you tell her?
A. She will not qualify for Part A because citizenship requires 15 years
B. She cannot receive Part A because she was not born in the US
C. Most individuals who are citizens and age 65 or over are covered under Part A
by virtue of having paid Medicare taxes while working
D. She must purchase Part A at a reduced monthly premium
,Answer: C. Most individuals who are citizens and age 65 or over are covered
under Part A by virtue of having paid Medicare taxes while working
Rationale: Citizenship and work history (paying Medicare taxes) qualify individuals
for premium-free Part A, regardless of country of birth. Mrs. Chen meets both
criteria .
4. Mrs. Quinn recently turned 66 and decided to retire and begin receiving Social
Security benefits. Shortly thereafter, she received a letter informing her that she
had been automatically enrolled in Medicare Part B. She wants to understand
what this means. What should you tell Mrs. Quinn?
A. Part B covers hospital stays and she has no monthly premium
B. Part B primarily covers physician services, she will pay a monthly premium, and
generally will have 20% co-payments plus an annual deductible
C. Part B covers prescription drugs and requires no cost-sharing
D. Part B is optional and she can decline with no future penalty
Answer: B. Part B primarily covers physician services, she will pay a monthly
premium, and generally will have 20% co-payments plus an annual deductible
, Rationale: Part B covers physician services, outpatient care, and preventive
services. Beneficiaries pay a standard monthly premium, an annual deductible,
and typically 20% coinsurance for most covered services .
5. Mr. Xi will soon turn age 65 and wants to know what services are provided
under Original Medicare. What best describes the health coverage provided to
Medicare beneficiaries?
A. Beneficiaries pay 50% coinsurance for all services
B. Beneficiaries under Original Medicare have no cost-sharing for most preventive
services
C. Beneficiaries must pay a deductible for all preventive services
D. Preventive services are not covered under Original Medicare
Answer: B. Beneficiaries under Original Medicare have no cost-sharing for most
preventive services
Rationale: Original Medicare covers many preventive services (e.g., annual
wellness visit, mammograms, cardiovascular screenings) with no cost-sharing (no
deductible or coinsurance) when obtained from a participating provider .
Pass With Confidence
Part 1: Medicare Basics & Eligibility (Questions 1-40)
1. A Medicare beneficiary's Initial Enrollment Period (IEP) generally lasts how
many months?
A. Four months
B. Six months
C. Seven months
D. Nine months
Answer: C. Seven months
Rationale: The Initial Enrollment Period spans seven months — beginning three
months before the month of eligibility, including the eligibility month, and ending
three months after. This ensures ample time to enroll without penalty .
2. Which of the following individuals is eligible for Medicare?
A. A 40-year-old with no disabilities
,B. A 63-year-old with no qualifying conditions
C. A 67-year-old U.S. citizen who has worked 10 years in covered employment
D. A 55-year-old with private insurance
Answer: C. A 67-year-old U.S. citizen who has worked 10 years in covered
employment
Rationale: Eligibility generally requires age 65 or older and sufficient work credits
(40 quarters), or certain disabilities or ESRD (end-stage renal disease). Only the
67-year-old meets standard age and work credit criteria .
3. Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been
employed full time, and paid taxes during that entire period. She is concerned
that she will not qualify for coverage under Part A because she was not born in
the United States. What should you tell her?
A. She will not qualify for Part A because citizenship requires 15 years
B. She cannot receive Part A because she was not born in the US
C. Most individuals who are citizens and age 65 or over are covered under Part A
by virtue of having paid Medicare taxes while working
D. She must purchase Part A at a reduced monthly premium
,Answer: C. Most individuals who are citizens and age 65 or over are covered
under Part A by virtue of having paid Medicare taxes while working
Rationale: Citizenship and work history (paying Medicare taxes) qualify individuals
for premium-free Part A, regardless of country of birth. Mrs. Chen meets both
criteria .
4. Mrs. Quinn recently turned 66 and decided to retire and begin receiving Social
Security benefits. Shortly thereafter, she received a letter informing her that she
had been automatically enrolled in Medicare Part B. She wants to understand
what this means. What should you tell Mrs. Quinn?
A. Part B covers hospital stays and she has no monthly premium
B. Part B primarily covers physician services, she will pay a monthly premium, and
generally will have 20% co-payments plus an annual deductible
C. Part B covers prescription drugs and requires no cost-sharing
D. Part B is optional and she can decline with no future penalty
Answer: B. Part B primarily covers physician services, she will pay a monthly
premium, and generally will have 20% co-payments plus an annual deductible
, Rationale: Part B covers physician services, outpatient care, and preventive
services. Beneficiaries pay a standard monthly premium, an annual deductible,
and typically 20% coinsurance for most covered services .
5. Mr. Xi will soon turn age 65 and wants to know what services are provided
under Original Medicare. What best describes the health coverage provided to
Medicare beneficiaries?
A. Beneficiaries pay 50% coinsurance for all services
B. Beneficiaries under Original Medicare have no cost-sharing for most preventive
services
C. Beneficiaries must pay a deductible for all preventive services
D. Preventive services are not covered under Original Medicare
Answer: B. Beneficiaries under Original Medicare have no cost-sharing for most
preventive services
Rationale: Original Medicare covers many preventive services (e.g., annual
wellness visit, mammograms, cardiovascular screenings) with no cost-sharing (no
deductible or coinsurance) when obtained from a participating provider .
