AHIP 2026 FINAL EXAM 200 MOST TESTED QUESTIONS WITH ACCURATE ANSWERS

AHIP 2026 FINAL EXAM 200 MOST TESTED QUESTIONS WITH
ACCURATE ANSWERS

1. Describe how Original Medicare differs from Medicare Advantage in terms of co
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verage.


nOriginal Medicare covers only hospital services, while Medicare Advant
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age coversoutpatientservices. n
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Original Medicare requires prior authorization for all services, while Medi
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care Advantage does not. nm nm nm




n m Original Medicare is a fee-for- nm nm nm nm




service plan, while Medicare Advantage is a managed care plan that oft
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en includes additional benefits.
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nOriginal Medicare is available to everyone, while Medicare Advantage is
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only for low-income individuals. n
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2. Plans that may be offered under a Medicare Advantage Plan include:
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n m HMO

n m POS

n m PPO

n m all of the abovenm nm nm




3. Mrs.Gonzalezisenrolled inOriginalMedicareandhasaMedigappolicyas well,
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but it provides no drug coverage. She would like to keep the coverage she has b
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ut replace her existing Medigap plan with one that provides drug coverage.
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What should you tell her?
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n m Mrs. Gonzalez should purchase a K or L Medigap plan.
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,Mrs. Gonzalez cannot purchase a Medigap plan that covers drugs,
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but she could keep her Medigap policy and enroll in a Part D
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, prescription drug plan. nm nm




nMrs. Gonzalez can purchase a Medigap plan that covers drugs, but it lik
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ely won’t offer coverage that is equivalent to that provided under Part
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D.


Medigap is a replacement for Original Medicare and she has been p
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aying for double coverage. She should simply drop her Medigap poli
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cy.

4. If Mrs. Geisler is currently taking multiple medications and finds that her curren
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t Medicare Part D plan does not cover one of her essential drugs, what steps shou
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ld shetakeduringtheenrollmentperiod?
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nShe should continue with her current plan and hope the coverage changes
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next year. nm




n m She should consult her doctor for advice on alternative medications.
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She should compare other Medicare Part D plans to find one that i
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ncludes her essential drug and enroll in that plan.
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n m She should switch to Medicare Advantage instead.
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5. What is the primary purpose of Medicare Part D?
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n m To cover outpatient services
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n m To provide prescription drug coverage
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n m To offer hospital insurance
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n m To provide long-term care insurance
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6. Describe the role of Medicare Part D in providing prescription drug coverage
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for beneficiaries who choose not to enroll in Medicare Advantage plans.
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, Medicare Part D offers standalone prescription drug coverage for
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beneficiaries who opt out of Medicare Advantage plans. nm nm nm nm nm nm nm




n m Medicare Part D is only available to those under 65 years old. nm nm nm nm nm nm nm nm nm nm nm




n m Medicare Part D requires beneficiaries to enroll in both Part A and Part B.
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Medicare Part D is a supplemental insurance that covers all medical expe
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nses.

7. Describe the implications of enrolling in a stand-
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alone Medicare prescription drug plan for someone who is already covered by
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a Medicare Advantage plan that includes drug coverage.
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n m Mr. Block will need to reapply for Medicare Advantage coverage.
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It results in a penalty for Mr. Block but does not affect his Medicare Advan
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tage plan. nm




nm Enrolling in a stand- nm nm nm




alone Medicare prescription drug plan will lead to automatic disenro
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llment from the Medicare Advantage plan. nm nm nm nm nm




nIt allows Mr. Block to have enhanced drug coverage without losing his Me
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dicare Advantage plan. nm nm




8. Mr. Chen is enrolled in his employer's group health plan and will be retiring soo
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n. He would like to know his options since he has decided to drop his retireec
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overageand iseligibleforMedicare.Whatshouldyoutellhim?
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Mr. Chen can disenroll from his employer- nm nm nm nm nm nm nm




sponsored coverage to elect a Medicare Advantage or Part D plan wi nm nm nm nm nm nm nm nm nm nm nm




thin 2 months of his disenrollment.
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n m Mr. Chen can disenroll from the employer-
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sponsored plan and his only option is to choose a Medigap plan. nm nm nm nm nm nm nm nm nm nm nm