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AHIP Study Guide 2026-2027 COMPREHENSIVE EXAM QUESTIONS
WITH DETAILED VERIFIED AND 100% CORRECT ANSWERS BRAND
NEW EXAM ALREADY GRADED A+!!
1.
Which of the following individuals is automatically enrolled in Medicare Part A?
A. A 68-year-old who has not paid Medicare taxes.
B. A 66-year-old collecting Social Security retirement benefits.
C. A 63-year-old with no disability.
D. A 60-year-old diagnosed with ESRD.
Answer: B
Rationale: Individuals who begin receiving Social Security retirement benefits are
automatically enrolled in Part A (and Part B unless declined) at age 65.
2.
What is the initial coverage election period (ICEP) for Medicare Advantage?
A. 3 months before, the month of, and 3 months after turning 65.
B. January 1 – March 31 every year.
C. October 15 – December 7 every year.
D. Only the month of turning 65.
Answer: A
Rationale: The ICEP is a 7-month period surrounding eligibility at age 65: 3 months
before, the month of, and 3 months after.
3.
Which part of Medicare covers outpatient prescription drugs?
A. Part A
B. Part B
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C. Part C
D. Part D
Answer: D
Rationale: Medicare Part D covers prescription drugs through stand-alone PDPs or
integrated MA-PD plans.
4.
Which service is not covered by Medicare Part A?
A. Inpatient hospital care
B. Hospice care
C. Skilled nursing facility care
D. Routine dental services
Answer: D
Rationale: Routine dental services are not covered under Part A or Part B.
5.
What is the penalty for delaying Part B enrollment without creditable coverage?
A. 5% for each year delayed.
B. 10% increase in premium for each full 12-month period delayed.
C. 25% increase once.
D. No penalty applies.
Answer: B
Rationale: The Part B late enrollment penalty is 10% for each 12-month period an
individual could have had Part B but did not.
6.
An agent provides a free meal during a marketing event. Which rule applies?
A. Permitted if the meal is modest and under $15.
B. Allowed only if CMS approves.
C. Prohibited by CMS marketing guidelines.
D. Allowed if the agent discloses plan options.
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Answer: C
Rationale: CMS prohibits providing meals at marketing/sales events. Only snacks/light
refreshments are allowed.
7.
Which of the following is considered creditable prescription drug coverage?
A. Most employer or union group health coverage.
B. Stand-alone dental plans.
C. Vision insurance.
D. Supplemental Medigap Plan A.
Answer: A
Rationale: Employer/union coverage often meets or exceeds Part D standards and is
considered creditable.
8.
Which beneficiary is eligible for a Special Enrollment Period (SEP)?
A. Someone moving permanently into a new service area.
B. Someone dissatisfied with their copays.
C. Someone who wants to change plans mid-year without cause.
D. Someone under 65 with no disability.
Answer: A
Rationale: Moving to a new service area triggers an SEP; dissatisfaction with plan cost
does not.
9.
Medicare Part B covers which of the following?
A. Routine hearing aids
B. Physician services
C. Long-term custodial care
D. Cosmetic surgery
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Answer: B
Rationale: Part B covers physician visits, outpatient services, preventive care, and
durable medical equipment.
10.
Which program helps low-income beneficiaries with Part D costs?
A. Medicaid only
B. Medigap Plan F
C. Extra Help (Low-Income Subsidy)
D. PACE
Answer: C
Rationale: Extra Help/LIS reduces Part D premiums, deductibles, and copays for eligible
low-income beneficiaries.
11.
When can a beneficiary use the Medicare Advantage Open Enrollment Period (OEP)?
A. October 15 – December 7
B. January 1 – March 31
C. Anytime during the year
D. Only when turning 65
Answer: B
Rationale: The OEP runs from Jan 1–Mar 31 annually, allowing beneficiaries to switch
MA plans or return to Original Medicare.
12.
What is the role of CMS in Medicare Advantage?
A. Pay claims directly to providers
B. Approve plan marketing and oversee compliance
C. Sell plans directly to beneficiaries
D. Collect Part D premiums only
AHIP Study Guide 2026-2027 COMPREHENSIVE EXAM QUESTIONS
WITH DETAILED VERIFIED AND 100% CORRECT ANSWERS BRAND
NEW EXAM ALREADY GRADED A+!!
1.
Which of the following individuals is automatically enrolled in Medicare Part A?
A. A 68-year-old who has not paid Medicare taxes.
B. A 66-year-old collecting Social Security retirement benefits.
C. A 63-year-old with no disability.
D. A 60-year-old diagnosed with ESRD.
Answer: B
Rationale: Individuals who begin receiving Social Security retirement benefits are
automatically enrolled in Part A (and Part B unless declined) at age 65.
2.
What is the initial coverage election period (ICEP) for Medicare Advantage?
A. 3 months before, the month of, and 3 months after turning 65.
B. January 1 – March 31 every year.
C. October 15 – December 7 every year.
D. Only the month of turning 65.
Answer: A
Rationale: The ICEP is a 7-month period surrounding eligibility at age 65: 3 months
before, the month of, and 3 months after.
3.
Which part of Medicare covers outpatient prescription drugs?
A. Part A
B. Part B
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C. Part C
D. Part D
Answer: D
Rationale: Medicare Part D covers prescription drugs through stand-alone PDPs or
integrated MA-PD plans.
4.
Which service is not covered by Medicare Part A?
A. Inpatient hospital care
B. Hospice care
C. Skilled nursing facility care
D. Routine dental services
Answer: D
Rationale: Routine dental services are not covered under Part A or Part B.
5.
What is the penalty for delaying Part B enrollment without creditable coverage?
A. 5% for each year delayed.
B. 10% increase in premium for each full 12-month period delayed.
C. 25% increase once.
D. No penalty applies.
Answer: B
Rationale: The Part B late enrollment penalty is 10% for each 12-month period an
individual could have had Part B but did not.
6.
An agent provides a free meal during a marketing event. Which rule applies?
A. Permitted if the meal is modest and under $15.
B. Allowed only if CMS approves.
C. Prohibited by CMS marketing guidelines.
D. Allowed if the agent discloses plan options.
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Answer: C
Rationale: CMS prohibits providing meals at marketing/sales events. Only snacks/light
refreshments are allowed.
7.
Which of the following is considered creditable prescription drug coverage?
A. Most employer or union group health coverage.
B. Stand-alone dental plans.
C. Vision insurance.
D. Supplemental Medigap Plan A.
Answer: A
Rationale: Employer/union coverage often meets or exceeds Part D standards and is
considered creditable.
8.
Which beneficiary is eligible for a Special Enrollment Period (SEP)?
A. Someone moving permanently into a new service area.
B. Someone dissatisfied with their copays.
C. Someone who wants to change plans mid-year without cause.
D. Someone under 65 with no disability.
Answer: A
Rationale: Moving to a new service area triggers an SEP; dissatisfaction with plan cost
does not.
9.
Medicare Part B covers which of the following?
A. Routine hearing aids
B. Physician services
C. Long-term custodial care
D. Cosmetic surgery
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Answer: B
Rationale: Part B covers physician visits, outpatient services, preventive care, and
durable medical equipment.
10.
Which program helps low-income beneficiaries with Part D costs?
A. Medicaid only
B. Medigap Plan F
C. Extra Help (Low-Income Subsidy)
D. PACE
Answer: C
Rationale: Extra Help/LIS reduces Part D premiums, deductibles, and copays for eligible
low-income beneficiaries.
11.
When can a beneficiary use the Medicare Advantage Open Enrollment Period (OEP)?
A. October 15 – December 7
B. January 1 – March 31
C. Anytime during the year
D. Only when turning 65
Answer: B
Rationale: The OEP runs from Jan 1–Mar 31 annually, allowing beneficiaries to switch
MA plans or return to Original Medicare.
12.
What is the role of CMS in Medicare Advantage?
A. Pay claims directly to providers
B. Approve plan marketing and oversee compliance
C. Sell plans directly to beneficiaries
D. Collect Part D premiums only
