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100+ Free AHIP Medicare Practice Questions

Pass your AHIP Medicare Certification exam on the first try — instant access, no signup required.

✓ No registration✓ No credit card✓ No hidden fees✓ Start practicing immediately
Lower first-attempt pass rate than most insurance exams due to the 90% bar Pass Rate
100+ Questions
100% Free
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Question 1
Score: 0/0

Original Medicare consists of which two parts?

A
B
C
D
to track
2026 Statistics

Key Facts: AHIP Medicare Exam

50

Final Exam Questions

AHIP

90%

Passing Score (45/50)

AHIP

3

Attempts Included

AHIP ($125 for 5 more)

$175

Standard Price

Carriers may discount to $125

Annual

Recertification Required

Plan-year specific (2026 opened June 23, 2025)

$2,100

2026 Part D OOP Cap

CMS / IRA redesign

The AHIP Medicare final is 50 questions, 90% to pass (45/45), and 3 attempts for $175 — the highest pass-bar in the Medicare-agent ecosystem. The 2026 plan-year exam opened June 23, 2025. Roughly 700,000 agents recertify annually because almost every carrier requires AHIP (or NABIP) before allowing MA/PDP sales. Plan-year 2026 brings the redesigned Part D benefit: $2,100 out-of-pocket cap, $615 maximum deductible, and the new Medicare Prescription Payment Plan.

Sample AHIP Medicare Practice Questions

Try these sample questions to test your AHIP Medicare exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Original Medicare consists of which two parts?
A.Part A (Hospital) and Part B (Medical)
B.Part A (Hospital) and Part D (Prescription Drug)
C.Part B (Medical) and Part C (Medicare Advantage)
D.Part C (Medicare Advantage) and Part D (Prescription Drug)
Explanation: Original Medicare is the fee-for-service program administered directly by CMS and is made up of Part A (hospital insurance) and Part B (medical insurance). Part C (Medicare Advantage) is a private alternative to Original Medicare, and Part D is the optional outpatient prescription drug benefit delivered through private plans.
2Which scenario qualifies a person under age 65 for Medicare eligibility?
A.Receiving Social Security disability benefits for 24 months
B.Being unemployed for 12 months
C.Earning less than 100% of the Federal Poverty Level
D.Having a household member enrolled in Medicare
Explanation: People under 65 qualify for Medicare after receiving Social Security Disability Insurance (SSDI) for 24 months. They are also eligible immediately upon diagnosis of End-Stage Renal Disease (ESRD) or ALS (Lou Gehrig's disease, no waiting period). Income, household status, and unemployment do not by themselves create Medicare eligibility.
3Most people pay no monthly premium for Medicare Part A. What is the eligibility requirement for premium-free Part A?
A.The beneficiary or their spouse paid Medicare taxes for at least 40 quarters (10 years)
B.The beneficiary's annual income is below $50,000
C.The beneficiary is enrolled in Medicaid
D.The beneficiary has been a U.S. citizen for at least 20 years
Explanation: Premium-free Part A is earned by paying Medicare payroll taxes (FICA) for at least 40 quarters — equivalent to 10 years of work. Eligibility transfers from a spouse, so a non-working spouse also gets premium-free Part A based on the working spouse's record. People with fewer quarters can buy Part A but pay a monthly premium.
4What is the standard monthly Medicare Part B premium for 2026?
A.$185.00
B.$174.70
C.$202.90
D.$233.00
Explanation: The standard Part B premium for 2026 is $202.90 per month, an increase of $17.90 (about 9.7%) from the 2025 standard premium of $185.00. Higher-income beneficiaries pay an Income-Related Monthly Adjustment Amount (IRMAA) on top of the standard premium, ranging up to $689.90 in 2026.
5What is the 2026 annual deductible for Medicare Part B?
A.$240
B.$257
C.$283
D.$0 — there is no Part B deductible
Explanation: The Part B annual deductible for 2026 is $283, up from $257 in 2025. Beneficiaries must meet this deductible before Medicare pays its 80% share of most outpatient services; the beneficiary then pays the remaining 20% coinsurance.
6Once a beneficiary meets the Part B deductible, what is their typical cost share for most Medicare-approved outpatient services?
A.10% coinsurance
B.20% coinsurance
C.50% coinsurance
D.$25 flat copay
Explanation: After meeting the annual Part B deductible, beneficiaries typically owe 20% coinsurance of the Medicare-approved amount for most physician services, outpatient care, and durable medical equipment. Original Medicare has no annual out-of-pocket maximum, which is why many beneficiaries purchase a Medigap policy or enroll in a Medicare Advantage plan.
7Which of the following services is generally NOT covered by Original Medicare?
A.Inpatient hospital stays
B.Routine dental, vision, and hearing exams
C.Outpatient physician visits
D.Skilled nursing facility care after a qualifying hospital stay
Explanation: Original Medicare does not cover routine dental, vision, or hearing exams or related appliances (dentures, eyeglasses, hearing aids). These benefits are commonly bundled into Medicare Advantage (Part C) plans, which is one of the most cited reasons beneficiaries choose MA over Original Medicare.
8How does a Medicare Supplement (Medigap) policy interact with Medicare Advantage?
A.Medigap pays secondary to a Medicare Advantage plan
B.It is illegal for an agent to knowingly sell a Medigap policy to someone enrolled in a Medicare Advantage plan
C.Medigap is required for anyone enrolling in Medicare Advantage
D.Medigap automatically converts to a Part D plan when MA enrollment occurs
Explanation: Federal law prohibits knowingly selling a Medigap policy to someone enrolled in a Medicare Advantage plan, because Medigap is designed to fill gaps in Original Medicare and provides no benefit to MA enrollees. Selling one anyway is an illegal practice that can result in fines and license revocation. Beneficiaries who switch to MA should typically drop their Medigap policy.
9When is the Medigap Open Enrollment Period during which beneficiaries have a guaranteed-issue right to any Medigap policy without medical underwriting?
A.The 6-month period that begins the month they turn 65 and are enrolled in Part B
B.Any time during the AEP (October 15-December 7)
C.The Initial Enrollment Period for Part A
D.The first 90 days after Part A entitlement
Explanation: The federal Medigap Open Enrollment Period is a one-time, 6-month window that begins the first month a beneficiary is age 65 or older AND enrolled in Part B. During this window, any Medigap insurer must sell any policy at the best available rate without medical underwriting. Outside this window, insurers in most states can use underwriting and may decline coverage.
10Which statement about Medicare Part D is correct?
A.Part D is offered only through Original Medicare
B.Part D plans are administered by private insurers under contract with CMS
C.All Medicare beneficiaries are automatically enrolled in Part D
D.Part D covers only generic medications
Explanation: Part D outpatient prescription drug coverage is delivered exclusively through private insurance companies contracted with CMS, either as a stand-alone Prescription Drug Plan (PDP) attached to Original Medicare or as part of a Medicare Advantage Prescription Drug plan (MAPD). Enrollment is voluntary, but a late-enrollment penalty applies if eligible beneficiaries delay without other creditable coverage.

About the AHIP Medicare Exam

Annual certification required by most insurance carriers before agents can legally sell Medicare Advantage and Part D Prescription Drug Plans for the upcoming plan year. Our practice bank includes 100 questions (double the real 50-question exam) so you can drill every CMS rule, plan type, and FWA scenario before sitting the open-book final.

Assessment

5 training modules followed by a 50-question final exam (open book, 2-hour timer, 3 attempts)

Time Limit

2 hours

Passing Score

90%

Exam Fee

$175 (America's Health Insurance Plans (AHIP))

AHIP Medicare Exam Content Outline

20%

Module 1 — Medicare Basics

Parts A, B, C, D; Original Medicare vs. MA; Medigap interaction; eligibility; enrollment periods (IEP, AEP Oct 15-Dec 7, MA OEP Jan 1-Mar 31, SEPs)

20%

Module 2 — Medicare Advantage Plans

Part C plan types: HMO, HMO-POS, PPO, PFFS, MSA, and Special Needs Plans (D-SNP, C-SNP, I-SNP) — provider networks, referrals, MOOP

15%

Module 3 — Part D Prescription Drug Plans

Formularies and tiers, LIS/Extra Help, the redesigned 2026 benefit ($2,100 OOP cap, $615 max deductible), Medicare Prescription Payment Plan

25%

Module 4 — Marketing, Sales & Compliance

CMS marketing rules, Scope of Appointment 48-hour rule, Pre-Enrollment Checklist, prohibited practices (cold calls, unsolicited contact, cross-selling), call recording

20%

Module 5 — Fraud, Waste & Abuse + General Compliance

FWA definitions and reporting, HIPAA, False Claims Act, Anti-Kickback Statute, Stark Law, OIG exclusion list, mandatory annual training

How to Pass the AHIP Medicare Exam

What You Need to Know

  • Passing score: 90%
  • Assessment: 5 training modules followed by a 50-question final exam (open book, 2-hour timer, 3 attempts)
  • Time limit: 2 hours
  • Exam fee: $175

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

AHIP Medicare Study Tips from Top Performers

1Master the enrollment periods cold — IEP (7-month window around 65), AEP (Oct 15-Dec 7), MA OEP (Jan 1-Mar 31, MA-only), and SEPs. CMS-marketing module questions hinge on knowing which period allows which change.
2Memorize the Scope of Appointment 48-hour rule and its exceptions: it does NOT apply in the last 4 days of an enrollment period or when the beneficiary walks into your office and initiates the conversation.
3Know the prohibited marketing practices verbatim: no unsolicited cold calls, no door-to-door, no cross-selling non-health products at the same appointment, no offering gifts over $15 nominal value.
4Drill the four SNP types — D-SNP (dual-eligible), C-SNP (chronic condition), I-SNP (institutional) — and understand model-of-care requirements. SNPs appear in nearly every AHIP exam.
5It is open book — use it. Keep Module 4 (marketing rules) and Module 5 (FWA reporting) tabs open during the final exam. The 90% bar means you cannot afford to guess on a rule you can simply look up.

Frequently Asked Questions

Do I really have to take AHIP every year?

Yes — AHIP certification is plan-year specific. Most carriers require agents to complete AHIP (or the equivalent NABIP course) every year before allowing them to sell Medicare Advantage or Part D plans for the next plan year. The 2026 exam opened June 23, 2025 and must be completed before AEP starts October 15.

How many attempts do I get and what happens if I fail?

Your $175 purchase includes 3 attempts at the 50-question final. If you miss 90% on all three, you can purchase 5 additional attempts (typically about $125). Most carriers will not appoint you to sell MA/PDP until you pass, so do not rush — it is open book and you can use your training notes.

Why do carriers require AHIP if I already have a state insurance license?

A state life and health license authorizes you to sell insurance, but CMS requires that anyone marketing Medicare Advantage or Part D plans complete annual product, marketing, and FWA training. Carriers use AHIP (or NABIP) to satisfy that CMS requirement and document compliance before letting you submit MA/PDP applications.

What is actually covered on the AHIP exam?

Five modules: Module 1 Medicare basics (Parts A-D, eligibility, enrollment periods); Module 2 Medicare Advantage plan types; Module 3 Part D prescription drug plans; Module 4 marketing, sales, and CMS compliance rules; and Module 5 Fraud, Waste, and Abuse plus general compliance (HIPAA, False Claims Act, etc.). Modules 4 and 5 carry the most weight on the final.

Can I take NABIP instead of AHIP?

Many carriers accept NABIP Medicare certification as an alternative to AHIP, but not all. Always check your specific carrier's certification requirements before substituting. Some carriers require AHIP specifically; others accept either. NABIP is sometimes priced lower than the $175 AHIP fee.

What changed for 2026?

The 2026 plan year brings the second year of the IRA-redesigned Part D benefit: the out-of-pocket cap rose from $2,000 to $2,100 (inflation-indexed), the maximum deductible is $615, and the Medicare Prescription Payment Plan (drug-cost smoothing) is fully operational. The standard Part B premium also increased to $202.90/month with a $283 annual deductible. Expect Module 3 questions on the redesign.