AHIP FINAL EXAM, PRACTICE EXAM AND STUDY GUIDE
LATEST 2025/2026 ACTUAL EXAM 135 QUESTIONS WITH
CORRECT ANSWERS 100% VERIFIED GRADED A+
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C
Terms in this set (105)
Mrs. Shields is covered by Original Medicare will cover Mrs. Shield's skilled nursing services
Medicare. She sustained a hip fracture and provided during the first 20 days of her stay, after which she
is being successfully treated for that would have a copay until she has been in the facility for
condition. 100 days.
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?
Mrs. West wears glasses and dentures and Medicare does not cover massage therapy, or, in general,
has enjoyed considerable pain relief from glasses or dentures.
arthritis through massage therapy. She is
concerned about whether or not
Medicare will cover these items and
services. What
should you tell her?
Mrs. Park is an elderly retiree. Mrs. Park has She should contact her state Medicaid agency to see if she
a low fixed income. What could you tell Mrs. qualifies for one of several programs that can help with
Park that might be of assistance? Medicare costs for which she is responsible.
,Mr. Alonso receives some help paying for He generally would pay a monthly premium, annual
his two generic prescription drugs from his deductible, and per-prescription cost-sharing.
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?
Mrs. Gonzalez is enrolled in Original Mrs. Gonzalez cannot purchase a Medigap plan that
Medicare and has a Medigap policy as covers drugs, but she could keep her Medigap policy and
well, but it provides no drug coverage. enroll in a Part D prescription drug plan.
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?
Mr. Davis is 52 years old and has He may sign-up for Medicare at any time however coverage
recently been diagnosed with end-stage usually begins on the fourth month after dialysis treatments
renal disease (ESRD) and will soon begin start.
dialysis. He is wondering if he can obtain
coverage under Medicare. What should
you tell him?
Mrs. Duarte is enrolled in Original Medicare Mrs. Duarte should file an appeal of this initial
Parts A and B. She has recently reviewed her determination within 120 days of the date she received the
Medicare Summary Notice (MSN) and MSN in the mail.
disagrees with a determination that partially
denied one of her claims for services. What
advice would you give her?
Mrs. Geisler's neighbor told her she Part D covers prescription drugs and she should look at her
should look at her Part D options during premiums, formulary, and cost-sharing among other factors to
the annual Medicare enrollment period see if they have changed.
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?
Mr. Rainey is experiencing paranoid Medicare will cover a total of 190 days of inpatient
delusions and his physician feels that he psychiatric care during Mr. Rainey's entire lifetime.
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?
Mr. Xi will soon turn age 65 and has come to Beneficiaries under Original Medicare have no cost-sharing
you for advice as to what services are for most preventive services.
provided under Original Medicare. What
should you tell Mr. Xi that best describes the
health coverage provided to Medicare
beneficiaries?
, Mr. Singh would like drug coverage but Mr. Singh can enroll in a stand-alone prescription drug plan
does not want to be enrolled in a and continue to be covered for Part A and Part B
Medicare Advantage plan. What should you services
tell him? through Original Fee-for-Service Medicare.
Mrs. Chen will be 65 soon, has been a Most individuals who are citizens and age 65 or over are
citizen for twelve years, has been employed covered under Part A by virtue of having paid Medicare taxes
full time, and paid taxes during that while working, though some may be covered as a result of
entire period. She is concerned that she paying monthly premiums.
will not
qualify for coverage under part A
because she was not born in the United
States. What should you tell her?
Mrs. Quinn recently turned 66 and decided Part B primarily covers physician services. She will be paying a
after many years of work to retire and begin monthly premium and, except for many preventive and
receiving Social Security benefits. Shortly screening tests, generally will have 20% co-payments for
thereafter Mrs. Quinn received a letter these services, in addition to an annual deductible.
informing her that she had been
automatically enrolled in Medicare Part B.
She wants to understand what this means.
What should you tell Mrs. Quinn?
Mr. Patel is in good health and is preparing Under Original Medicare, there is a single deductible amount
a budget in anticipation of his retirement due for the first 60 days of any inpatient hospital stay,
when he turns 66. He wants to after which it converts into a per-day coinsurance amount
understand the health care costs he through day 90. After day 90, he would pay a daily
might be exposed to under Medicare if amount up to 60
he were to require days over his lifetime, after which he would be responsible for
hospitalization because of an illness. all costs.
In general terms, what could you tell
him about his costs for inpatient
hospital
services under Original Medicare?
What impact, if any, have recent regulatory The Part B deductible is no longer covered for individuals
changes had on Medigap plans? newly eligible for Medicare starting January 1, 2020.
Mrs. Paterson is concerned about the Medigap plans do not cover Original Medicare benefits, but
deductibles and co-payments associated they coordinate with Original Medicare coverage.
with Original Medicare. What can you tell
her about Medigap as an option to address
this concern?
Mrs. Turner is comparing her employer's Original Medicare covers ambulance services.
retiree insurance to Original Medicare and
would like to know which of the following
services Original Medicare will cover if the
appropriate criteria are met. What could you
tell her?
Ms. Brooks has aggressive cancer and Medicare covers hospice services, and they will be available
would like to know if Medicare will cover for her.
hospice services in case she needs them.
What should you tell her?
LATEST 2025/2026 ACTUAL EXAM 135 QUESTIONS WITH
CORRECT ANSWERS 100% VERIFIED GRADED A+
Students also studied
Flashcard sets Study guides
C
Terms in this set (105)
Mrs. Shields is covered by Original Medicare will cover Mrs. Shield's skilled nursing services
Medicare. She sustained a hip fracture and provided during the first 20 days of her stay, after which she
is being successfully treated for that would have a copay until she has been in the facility for
condition. 100 days.
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?
Mrs. West wears glasses and dentures and Medicare does not cover massage therapy, or, in general,
has enjoyed considerable pain relief from glasses or dentures.
arthritis through massage therapy. She is
concerned about whether or not
Medicare will cover these items and
services. What
should you tell her?
Mrs. Park is an elderly retiree. Mrs. Park has She should contact her state Medicaid agency to see if she
a low fixed income. What could you tell Mrs. qualifies for one of several programs that can help with
Park that might be of assistance? Medicare costs for which she is responsible.
,Mr. Alonso receives some help paying for He generally would pay a monthly premium, annual
his two generic prescription drugs from his deductible, and per-prescription cost-sharing.
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?
Mrs. Gonzalez is enrolled in Original Mrs. Gonzalez cannot purchase a Medigap plan that
Medicare and has a Medigap policy as covers drugs, but she could keep her Medigap policy and
well, but it provides no drug coverage. enroll in a Part D prescription drug plan.
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?
Mr. Davis is 52 years old and has He may sign-up for Medicare at any time however coverage
recently been diagnosed with end-stage usually begins on the fourth month after dialysis treatments
renal disease (ESRD) and will soon begin start.
dialysis. He is wondering if he can obtain
coverage under Medicare. What should
you tell him?
Mrs. Duarte is enrolled in Original Medicare Mrs. Duarte should file an appeal of this initial
Parts A and B. She has recently reviewed her determination within 120 days of the date she received the
Medicare Summary Notice (MSN) and MSN in the mail.
disagrees with a determination that partially
denied one of her claims for services. What
advice would you give her?
Mrs. Geisler's neighbor told her she Part D covers prescription drugs and she should look at her
should look at her Part D options during premiums, formulary, and cost-sharing among other factors to
the annual Medicare enrollment period see if they have changed.
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?
Mr. Rainey is experiencing paranoid Medicare will cover a total of 190 days of inpatient
delusions and his physician feels that he psychiatric care during Mr. Rainey's entire lifetime.
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?
Mr. Xi will soon turn age 65 and has come to Beneficiaries under Original Medicare have no cost-sharing
you for advice as to what services are for most preventive services.
provided under Original Medicare. What
should you tell Mr. Xi that best describes the
health coverage provided to Medicare
beneficiaries?
, Mr. Singh would like drug coverage but Mr. Singh can enroll in a stand-alone prescription drug plan
does not want to be enrolled in a and continue to be covered for Part A and Part B
Medicare Advantage plan. What should you services
tell him? through Original Fee-for-Service Medicare.
Mrs. Chen will be 65 soon, has been a Most individuals who are citizens and age 65 or over are
citizen for twelve years, has been employed covered under Part A by virtue of having paid Medicare taxes
full time, and paid taxes during that while working, though some may be covered as a result of
entire period. She is concerned that she paying monthly premiums.
will not
qualify for coverage under part A
because she was not born in the United
States. What should you tell her?
Mrs. Quinn recently turned 66 and decided Part B primarily covers physician services. She will be paying a
after many years of work to retire and begin monthly premium and, except for many preventive and
receiving Social Security benefits. Shortly screening tests, generally will have 20% co-payments for
thereafter Mrs. Quinn received a letter these services, in addition to an annual deductible.
informing her that she had been
automatically enrolled in Medicare Part B.
She wants to understand what this means.
What should you tell Mrs. Quinn?
Mr. Patel is in good health and is preparing Under Original Medicare, there is a single deductible amount
a budget in anticipation of his retirement due for the first 60 days of any inpatient hospital stay,
when he turns 66. He wants to after which it converts into a per-day coinsurance amount
understand the health care costs he through day 90. After day 90, he would pay a daily
might be exposed to under Medicare if amount up to 60
he were to require days over his lifetime, after which he would be responsible for
hospitalization because of an illness. all costs.
In general terms, what could you tell
him about his costs for inpatient
hospital
services under Original Medicare?
What impact, if any, have recent regulatory The Part B deductible is no longer covered for individuals
changes had on Medigap plans? newly eligible for Medicare starting January 1, 2020.
Mrs. Paterson is concerned about the Medigap plans do not cover Original Medicare benefits, but
deductibles and co-payments associated they coordinate with Original Medicare coverage.
with Original Medicare. What can you tell
her about Medigap as an option to address
this concern?
Mrs. Turner is comparing her employer's Original Medicare covers ambulance services.
retiree insurance to Original Medicare and
would like to know which of the following
services Original Medicare will cover if the
appropriate criteria are met. What could you
tell her?
Ms. Brooks has aggressive cancer and Medicare covers hospice services, and they will be available
would like to know if Medicare will cover for her.
hospice services in case she needs them.
What should you tell her?
