AHIP Final Exam Study Guide –
Practice Questions with
Verified Answers. GRADED A+.
Latest 2026/2027 Update
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is
being successfully treated for that condition. However, she and her physicians
feel that after her lengthy hospital stay, she will need a month or two of nursing
and rehabilitative care. What should you tell them about Original Medicare's
coverage of care in a skilled nursing facility? - Answer✔✔-Medicare will cover
Mrs. Shield's skilled nursing services provided during the first 20 days of her
stay, after which she would have a copay until she has been in the facility for
100 days.
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief
from arthritis through massage therapy. She is concerned about whether or not
Medicare will cover these items and services. What should you tell her? -
Answer✔✔-Medicare does not cover massage therapy, or, in general, glasses
or dentures.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could
you tell Mrs. Park that might be of assistance? - Answer✔✔-She should contact
her state Medicaid agency to see if she qualifies for one of several programs
that can help with Medicare costs for which she is responsible.
,Mr. Alonso receives some help paying for his two generic prescription drugs
from his employer's retiree coverage, but he wants to compare it to a Part D
prescription drug plan. He asks you what costs he would generally expect to
encounter when enrolling into a standard Medicare Part D prescription drug
plan. What should you tell him? - Answer✔✔-He generally would pay a
monthly premium, annual deductible, and per-prescription cost-sharing.
Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as
well, but it provides no drug coverage. She would like to keep the coverage she
has but replace her existing Medigap plan with one that provides drug
coverage. What should you tell her? - Answer✔✔-Mrs. Gonzalez cannot
purchase a Medigap plan that covers drugs, but she could keep her Medigap
policy and enroll in a Part D prescription drug plan.
Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal
disease (ESRD) and will soon begin dialysis. He is wondering if he can obtain
coverage under Medicare. What should you tell him? - Answer✔✔-He may
sign-up for Medicare at any time however coverage usually begins on the
fourth month after dialysis treatments start.
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently
reviewed her Medicare Summary Notice (MSN) and disagrees with a
determination that partially denied one of her claims for services. What advice
would you give her? - Answer✔✔-Mrs. Duarte should file an appeal of this
initial determination within 120 days of the date she received the MSN in the
mail.
Mrs. Geisler's neighbor told her she should look at her Part D options during
the annual Medicare enrollment period because the features of Part D might
have changed. Mrs. Geisler can't remember what Part D is so she called you to
, ask what her neighbor was talking about. What could you tell her? -
Answer✔✔-Part D covers prescription drugs and she should look at her
premiums, formulary, and cost-sharing among other factors to see if they have
changed.
Mr. Rainey is experiencing paranoid delusions and his physician feels that he
should be hospitalized. What should you tell Mr. Rainey (or his representative)
about the length of an inpatient psychiatric hospital stay that Medicare will
cover? - Answer✔✔-Medicare will cover a total of 190 days of inpatient
psychiatric care during Mr. Rainey's entire lifetime.
Mr. Xi will soon turn age 65 and has come to you for advice as to what services
are provided under Original Medicare. What should you tell Mr. Xi that best
describes the health coverage provided to Medicare beneficiaries? -
Answer✔✔-Beneficiaries under Original Medicare have no cost-sharing for
most preventive services.
Mr. Singh would like drug coverage but does not want to be enrolled in a
Medicare Advantage plan. What should you tell him? - Answer✔✔-Mr. Singh
can enroll in a stand-alone prescription drug plan and continue to be covered
for Part A and Part B services through Original Fee-for-Service Medicare.
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? - Answer✔✔-Most individuals
who are citizens and age 65 or over are covered under Part A by virtue of
having paid Medicare taxes while working, though some may be covered as a
result of paying monthly premiums.
Practice Questions with
Verified Answers. GRADED A+.
Latest 2026/2027 Update
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is
being successfully treated for that condition. However, she and her physicians
feel that after her lengthy hospital stay, she will need a month or two of nursing
and rehabilitative care. What should you tell them about Original Medicare's
coverage of care in a skilled nursing facility? - Answer✔✔-Medicare will cover
Mrs. Shield's skilled nursing services provided during the first 20 days of her
stay, after which she would have a copay until she has been in the facility for
100 days.
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief
from arthritis through massage therapy. She is concerned about whether or not
Medicare will cover these items and services. What should you tell her? -
Answer✔✔-Medicare does not cover massage therapy, or, in general, glasses
or dentures.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could
you tell Mrs. Park that might be of assistance? - Answer✔✔-She should contact
her state Medicaid agency to see if she qualifies for one of several programs
that can help with Medicare costs for which she is responsible.
,Mr. Alonso receives some help paying for his two generic prescription drugs
from his employer's retiree coverage, but he wants to compare it to a Part D
prescription drug plan. He asks you what costs he would generally expect to
encounter when enrolling into a standard Medicare Part D prescription drug
plan. What should you tell him? - Answer✔✔-He generally would pay a
monthly premium, annual deductible, and per-prescription cost-sharing.
Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as
well, but it provides no drug coverage. She would like to keep the coverage she
has but replace her existing Medigap plan with one that provides drug
coverage. What should you tell her? - Answer✔✔-Mrs. Gonzalez cannot
purchase a Medigap plan that covers drugs, but she could keep her Medigap
policy and enroll in a Part D prescription drug plan.
Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal
disease (ESRD) and will soon begin dialysis. He is wondering if he can obtain
coverage under Medicare. What should you tell him? - Answer✔✔-He may
sign-up for Medicare at any time however coverage usually begins on the
fourth month after dialysis treatments start.
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently
reviewed her Medicare Summary Notice (MSN) and disagrees with a
determination that partially denied one of her claims for services. What advice
would you give her? - Answer✔✔-Mrs. Duarte should file an appeal of this
initial determination within 120 days of the date she received the MSN in the
mail.
Mrs. Geisler's neighbor told her she should look at her Part D options during
the annual Medicare enrollment period because the features of Part D might
have changed. Mrs. Geisler can't remember what Part D is so she called you to
, ask what her neighbor was talking about. What could you tell her? -
Answer✔✔-Part D covers prescription drugs and she should look at her
premiums, formulary, and cost-sharing among other factors to see if they have
changed.
Mr. Rainey is experiencing paranoid delusions and his physician feels that he
should be hospitalized. What should you tell Mr. Rainey (or his representative)
about the length of an inpatient psychiatric hospital stay that Medicare will
cover? - Answer✔✔-Medicare will cover a total of 190 days of inpatient
psychiatric care during Mr. Rainey's entire lifetime.
Mr. Xi will soon turn age 65 and has come to you for advice as to what services
are provided under Original Medicare. What should you tell Mr. Xi that best
describes the health coverage provided to Medicare beneficiaries? -
Answer✔✔-Beneficiaries under Original Medicare have no cost-sharing for
most preventive services.
Mr. Singh would like drug coverage but does not want to be enrolled in a
Medicare Advantage plan. What should you tell him? - Answer✔✔-Mr. Singh
can enroll in a stand-alone prescription drug plan and continue to be covered
for Part A and Part B services through Original Fee-for-Service Medicare.
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? - Answer✔✔-Most individuals
who are citizens and age 65 or over are covered under Part A by virtue of
having paid Medicare taxes while working, though some may be covered as a
result of paying monthly premiums.
