AHIP Final Exam (Latest 2025/2026
Update) Questions with Verified Answers
|100% Correct |Already Graded A
Module 1: Medicare Basics & Eligibility (Questions 1-20)
1. Mr. Capadona would like to purchase a Medicare Advantage (MA) plan
and a Medigap plan to pick up costs not covered by that plan. What should
you tell him?
A. He can enroll in both as long as he pays two separate premiums
B. He should enroll in Medigap first, then MA
C. It is illegal for you to sell Mr. Capadona a Medigap plan if he is enrolled in an
MA plan, and besides, Medigap only works with Original Medicare
D. He can use Medigap to cover MA deductibles
Correct ,,,answer,,,: C
Rationale: It is illegal to sell a Medigap policy to someone enrolled in a Medicare
Advantage plan. Medigap plans only coordinate with Original Medicare (Parts A
and B), not with Medicare Advantage plans .
2. Mrs. West is a 67-year-old newly eligible Medicare beneficiary. When is her
Initial Enrollment Period (IEP)?
A. 3 months before, the month of, and 3 months after her 65th birthday
B. Only during her birth month
,C. 6 months before and 6 months after turning 65
D. Only during the Annual Election Period (AEP)
Correct ,,,answer,,,: A
*Rationale: The Initial Enrollment Period (IEP) is a 7-month window: the 3
months before the month of turning 65, the birthday month itself, and the 3 months
after .*
3. Mr. Hernandez is turning 65 next month and is still working. He has
employer group health coverage. Which statement is true?
A. He must enroll in Medicare Part B immediately or face a lifetime penalty
B. He can delay Part B without penalty if he has creditable employer coverage
C. He cannot delay Part B under any circumstances
D. He must drop his employer coverage to enroll in Medicare
Correct ,,,answer,,,: B
Rationale: Beneficiaries with creditable employer group health coverage can delay
enrolling in Part B without incurring a late enrollment penalty. A Special
Enrollment Period (SEP) allows enrollment later without penalty .
4. What does Medicare Part A cover?
A. Outpatient services, doctor visits, and preventive care
B. Inpatient hospital stays, skilled nursing facility care, hospice, and some home
health
C. Prescription drugs only
D. Dental and vision services
,Correct ,,,answer,,,: B
Rationale: Part A is often called "hospital insurance." It covers inpatient hospital
stays, skilled nursing facility (SNF) care, hospice, and limited home health
services. Part B covers outpatient services .
5. What does Medicare Part B cover?
A. Hospital inpatient stays
B. Prescription medications
C. Outpatient services, physician visits, preventive care, and durable medical
equipment
D. Long-term custodial care
Correct ,,,answer,,,: C
Rationale: Part B covers medically necessary outpatient services, including doctor
visits, preventive screenings, ambulance services, durable medical equipment
(DME), and some home health .
6. Mr. Garcia is concerned about the Medicare Part B late enrollment penalty.
How is this penalty calculated?
A. 10% of the standard Part B premium for each full 12-month period he was
eligible but not enrolled
B. A flat $50 per month fee
C. 5% of the standard premium for each year delayed
D. No penalty exists for Part B
Correct ,,,answer,,,: A
, *Rationale: The Part B late enrollment penalty is 10% of the standard premium for
each full 12-month period the beneficiary was eligible for Part B but did not enroll,
unless they qualify for a Special Enrollment Period .*
7. Mr. Chen is eligible for Medicare but has limited financial resources. He
did NOT qualify for the Part D Low-Income Subsidy (LIS). Where might he
turn for help with prescription drug costs?
A. He has no other options
B. He may still qualify for help through his State Pharmaceutical Assistance
Program (SPAP)
C. He can ask his doctor to write prescriptions for free samples only
D. He can enroll in a Medigap plan to cover drug costs
Correct ,,,answer,,,: B
Rationale: State Pharmaceutical Assistance Programs (SPAPs) provide additional
help with prescription drug costs for eligible residents, even if they do not qualify
for the federal Low-Income Subsidy (LIS/Extra Help) .
8. Mr. O'Donnell is not satisfied with his Original Medicare coverage. He is
considering a Medicare Advantage Plan. What should you tell him about MA
plans?
A. MA plans only cover hospital services, not doctor visits
B. MA plans must cover all Part A and Part B services, except hospice (still
covered by Part A)
C. MA plans are more expensive than Original Medicare in all cases
D. MA plans do not have out-of-pocket maximums
Update) Questions with Verified Answers
|100% Correct |Already Graded A
Module 1: Medicare Basics & Eligibility (Questions 1-20)
1. Mr. Capadona would like to purchase a Medicare Advantage (MA) plan
and a Medigap plan to pick up costs not covered by that plan. What should
you tell him?
A. He can enroll in both as long as he pays two separate premiums
B. He should enroll in Medigap first, then MA
C. It is illegal for you to sell Mr. Capadona a Medigap plan if he is enrolled in an
MA plan, and besides, Medigap only works with Original Medicare
D. He can use Medigap to cover MA deductibles
Correct ,,,answer,,,: C
Rationale: It is illegal to sell a Medigap policy to someone enrolled in a Medicare
Advantage plan. Medigap plans only coordinate with Original Medicare (Parts A
and B), not with Medicare Advantage plans .
2. Mrs. West is a 67-year-old newly eligible Medicare beneficiary. When is her
Initial Enrollment Period (IEP)?
A. 3 months before, the month of, and 3 months after her 65th birthday
B. Only during her birth month
,C. 6 months before and 6 months after turning 65
D. Only during the Annual Election Period (AEP)
Correct ,,,answer,,,: A
*Rationale: The Initial Enrollment Period (IEP) is a 7-month window: the 3
months before the month of turning 65, the birthday month itself, and the 3 months
after .*
3. Mr. Hernandez is turning 65 next month and is still working. He has
employer group health coverage. Which statement is true?
A. He must enroll in Medicare Part B immediately or face a lifetime penalty
B. He can delay Part B without penalty if he has creditable employer coverage
C. He cannot delay Part B under any circumstances
D. He must drop his employer coverage to enroll in Medicare
Correct ,,,answer,,,: B
Rationale: Beneficiaries with creditable employer group health coverage can delay
enrolling in Part B without incurring a late enrollment penalty. A Special
Enrollment Period (SEP) allows enrollment later without penalty .
4. What does Medicare Part A cover?
A. Outpatient services, doctor visits, and preventive care
B. Inpatient hospital stays, skilled nursing facility care, hospice, and some home
health
C. Prescription drugs only
D. Dental and vision services
,Correct ,,,answer,,,: B
Rationale: Part A is often called "hospital insurance." It covers inpatient hospital
stays, skilled nursing facility (SNF) care, hospice, and limited home health
services. Part B covers outpatient services .
5. What does Medicare Part B cover?
A. Hospital inpatient stays
B. Prescription medications
C. Outpatient services, physician visits, preventive care, and durable medical
equipment
D. Long-term custodial care
Correct ,,,answer,,,: C
Rationale: Part B covers medically necessary outpatient services, including doctor
visits, preventive screenings, ambulance services, durable medical equipment
(DME), and some home health .
6. Mr. Garcia is concerned about the Medicare Part B late enrollment penalty.
How is this penalty calculated?
A. 10% of the standard Part B premium for each full 12-month period he was
eligible but not enrolled
B. A flat $50 per month fee
C. 5% of the standard premium for each year delayed
D. No penalty exists for Part B
Correct ,,,answer,,,: A
, *Rationale: The Part B late enrollment penalty is 10% of the standard premium for
each full 12-month period the beneficiary was eligible for Part B but did not enroll,
unless they qualify for a Special Enrollment Period .*
7. Mr. Chen is eligible for Medicare but has limited financial resources. He
did NOT qualify for the Part D Low-Income Subsidy (LIS). Where might he
turn for help with prescription drug costs?
A. He has no other options
B. He may still qualify for help through his State Pharmaceutical Assistance
Program (SPAP)
C. He can ask his doctor to write prescriptions for free samples only
D. He can enroll in a Medigap plan to cover drug costs
Correct ,,,answer,,,: B
Rationale: State Pharmaceutical Assistance Programs (SPAPs) provide additional
help with prescription drug costs for eligible residents, even if they do not qualify
for the federal Low-Income Subsidy (LIS/Extra Help) .
8. Mr. O'Donnell is not satisfied with his Original Medicare coverage. He is
considering a Medicare Advantage Plan. What should you tell him about MA
plans?
A. MA plans only cover hospital services, not doctor visits
B. MA plans must cover all Part A and Part B services, except hospice (still
covered by Part A)
C. MA plans are more expensive than Original Medicare in all cases
D. MA plans do not have out-of-pocket maximums
