AHIP 2026 FINAL EXAM QUESTIONS
WITH VEFIFIED ANSWERS (ALREADY
GRADED A+)
Mrs. Paterson is concerned about the deductibles and co-
payments associated with Original Medicare. What can you tell her about Medigap as an option to addre
ss this concern? - correct answer-
Medigap plans help beneficiaries cover Original Medicare benefits, but they coordinate with Original Me
dicare coverage.
Anita Magri will turn age 65 in August 2023. Anita intends to enroll in Original Medicare Part A and Part B
. She would also like to enroll in a Medicare Supplement (Medigap) plan. Anita's older neighbor Mel has t
old her about the Medigap Plan F in which he is enrolled. It not only provides foreign travel emergency b
enefits but also covers his Medicare Part B deductible. Anita comes to you for advice. What should you te
ll her? -Tcorrect answer-
You are sorry to disappoint Anita, but a Medigap F plan is no longer available to those who turn age 65 af
ter January 1, 2020. Anita might instead consider other Medigap plans that offer foreign travel benefits b
utTdo not cover the Part B deductible.
WhatTimpact, if any, have recent regulatory changes had on Medigap plans? - correct answer-b.
The Part B deductible is no longer covered for individuals newly eligible for Medicare starting January 1,
2020.
Mr. Rainey is experiencing paranoid delusions and his physician feels that he should be hospitalized. Wha
t should you tell Mr. Rainey (or his representative) about the length of an inpatient psychiatric hospital st
ay that Medicare will cover? - correct answer-
Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime.
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is being successfully treate
d for that condition. However, she and her physicians feel that after her lengthy hospital stay, she will nee
d a month or two of nursingTand rehabilitative care. What should you tell them about Original Medicare's
coverage of care in a skilled nursing facility? - correct answer-
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from arthritis through ma
ssage therapy. She is concerned about whether or not Medicare will cover these items and services. Wha
t should you tell her? - correct answer-
Medicare does not cover massage therapy, or, in general, glasses or dentures.
, Ms. Gibson recently lost her employer group health and drug coverage and now she wants to enroll in a
PPO thatTdoes not include drug coverage. What should you tell her about obtaining drug coverage? -
correct answer-She can enroll in the PPO, but she will not be able to purchase a stand-
alone Medicare Part D prescription drug plan.
Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage. What s
hould you tell her? - correct answer-
Mrs. Radford must be entitled to PartTA and enrolled in Part B to enroll in Medicare Advantage.
Mr. Barker enjoys a comfortable retirement income. He recently had surgery and expected that he would
have certain services and items covered by the plan with minimal out-of-pocket costs because his MA-
PD coverage has been very good. However, when he received the bill, he was surprised to see large charg
es in excess of his maximum out-of-
pocket limit that included some services and items he thought would be fully covered. He called you to a
sk what he could do? What could you tell him? - correct answer-
You can offer to review the plans appeal process to help him ask the plan to review the coverage decision
.
Mr. Sanchez has just turned 65 and is entitled to Part A but has not enrolled in Part B because he has cov
erage through an employer plan. If he wants to enroll in a Medicare Advantage plan, what will he have to
do? - correct answer-He will have to enroll in Part B.
Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan's terms and conditio
ns for payment. Mary Rodgers sees Dr. Brennan for treatment. How much may Dr. Brennan charge? -
correct answer-
Mrs. Chou likes a Private Fee-for-
Service (PFFS) plan available in her area that does not include drug coverage. She wants to enroll in the pl
an and enroll in a stand-alone prescription drug plan. What should you tell her? - correct answer-
She could enroll in a PFFS plan and a stand-alone Medicare prescription drug plan.
Mr. Kelly wants to know whether he is eligible to sign up for a Private fee-for-
service (PFFS) plan. What questions would you need to ask to determine his eligibility? - correct answer-
You would need to ask Mr. Kelly if he is enrolled in Part A and Part B and if he lives in the PFFS plan's servi
ce area.
WITH VEFIFIED ANSWERS (ALREADY
GRADED A+)
Mrs. Paterson is concerned about the deductibles and co-
payments associated with Original Medicare. What can you tell her about Medigap as an option to addre
ss this concern? - correct answer-
Medigap plans help beneficiaries cover Original Medicare benefits, but they coordinate with Original Me
dicare coverage.
Anita Magri will turn age 65 in August 2023. Anita intends to enroll in Original Medicare Part A and Part B
. She would also like to enroll in a Medicare Supplement (Medigap) plan. Anita's older neighbor Mel has t
old her about the Medigap Plan F in which he is enrolled. It not only provides foreign travel emergency b
enefits but also covers his Medicare Part B deductible. Anita comes to you for advice. What should you te
ll her? -Tcorrect answer-
You are sorry to disappoint Anita, but a Medigap F plan is no longer available to those who turn age 65 af
ter January 1, 2020. Anita might instead consider other Medigap plans that offer foreign travel benefits b
utTdo not cover the Part B deductible.
WhatTimpact, if any, have recent regulatory changes had on Medigap plans? - correct answer-b.
The Part B deductible is no longer covered for individuals newly eligible for Medicare starting January 1,
2020.
Mr. Rainey is experiencing paranoid delusions and his physician feels that he should be hospitalized. Wha
t should you tell Mr. Rainey (or his representative) about the length of an inpatient psychiatric hospital st
ay that Medicare will cover? - correct answer-
Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime.
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is being successfully treate
d for that condition. However, she and her physicians feel that after her lengthy hospital stay, she will nee
d a month or two of nursingTand rehabilitative care. What should you tell them about Original Medicare's
coverage of care in a skilled nursing facility? - correct answer-
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from arthritis through ma
ssage therapy. She is concerned about whether or not Medicare will cover these items and services. Wha
t should you tell her? - correct answer-
Medicare does not cover massage therapy, or, in general, glasses or dentures.
, Ms. Gibson recently lost her employer group health and drug coverage and now she wants to enroll in a
PPO thatTdoes not include drug coverage. What should you tell her about obtaining drug coverage? -
correct answer-She can enroll in the PPO, but she will not be able to purchase a stand-
alone Medicare Part D prescription drug plan.
Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage. What s
hould you tell her? - correct answer-
Mrs. Radford must be entitled to PartTA and enrolled in Part B to enroll in Medicare Advantage.
Mr. Barker enjoys a comfortable retirement income. He recently had surgery and expected that he would
have certain services and items covered by the plan with minimal out-of-pocket costs because his MA-
PD coverage has been very good. However, when he received the bill, he was surprised to see large charg
es in excess of his maximum out-of-
pocket limit that included some services and items he thought would be fully covered. He called you to a
sk what he could do? What could you tell him? - correct answer-
You can offer to review the plans appeal process to help him ask the plan to review the coverage decision
.
Mr. Sanchez has just turned 65 and is entitled to Part A but has not enrolled in Part B because he has cov
erage through an employer plan. If he wants to enroll in a Medicare Advantage plan, what will he have to
do? - correct answer-He will have to enroll in Part B.
Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan's terms and conditio
ns for payment. Mary Rodgers sees Dr. Brennan for treatment. How much may Dr. Brennan charge? -
correct answer-
Mrs. Chou likes a Private Fee-for-
Service (PFFS) plan available in her area that does not include drug coverage. She wants to enroll in the pl
an and enroll in a stand-alone prescription drug plan. What should you tell her? - correct answer-
She could enroll in a PFFS plan and a stand-alone Medicare prescription drug plan.
Mr. Kelly wants to know whether he is eligible to sign up for a Private fee-for-
service (PFFS) plan. What questions would you need to ask to determine his eligibility? - correct answer-
You would need to ask Mr. Kelly if he is enrolled in Part A and Part B and if he lives in the PFFS plan's servi
ce area.
