AHIP
AHIP Final Exam with Accurate Questions & Answers
(Detailed Answers) and Deep Expert Rationales | Latest
(2026/2027) Updated Version
THIS DOCUMENT CONTAINS:
❖AHIP Final Exam
❖Accurate Questions & Answers (Detailed Answers)
❖Deep Expert Rationales
❖Latest (2026/2027) Updated Version
❖100% Guaranteed Pass
,1. 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?
A. Original Medicare will cover 100% of skilled nursing facility care for up to 100 days
without any copayments.
B. 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.
C. Original Medicare only covers skilled nursing facility care if the beneficiary purchases
a standalone Medigap or Part D plan.
D. Original Medicare does not cover post-acute care in a skilled nursing facility under
any circumstances.
Answer: B
Rationale: Under Original Medicare Part A, skilled nursing facility (SNF) care is
covered following a qualifying 3-day inpatient hospital stay. For each benefit period,
Original Medicare pays 100% of covered SNF services for Days 1 through 20. For Days
21 through 100, the beneficiary is responsible for a daily coinsurance/copay amount.
Beyond Day 100, the beneficiary is responsible for all costs.
2. 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?
A. Medicare Part B covers routine dental and vision exams, including glasses and
dentures, but excludes massage therapy.
B. Medicare covers massage therapy under Part B, but excludes glasses and routine
,dentures.
C. Medicare does not cover massage therapy, or, in general, glasses or dentures.
D. Medicare covers all three services as long as they are prescribed by a licensed primary
care physician.
Answer: C
Rationale: Standard Original Medicare (Parts A and B) explicitly excludes routine dental
care (including dentures), routine vision care (including standard eyeglasses, with a
limited exception for post-cataract surgery lenses), and alternative/complementary
therapies such as massage therapy. Beneficiaries seeking coverage for these services
often look to private Medicare Advantage (Part C) plans or pay out-of-pocket.
3. Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could
you tell Mrs. Park that might be of assistance?
A. She should apply directly to the federal government for automatic Medicare Part A
premium waivers.
B. 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.
C. She must forfeit her Original Medicare and enroll exclusively in a commercial group
health plan.
D. She is automatically exempt from all Medicare Part B premiums regardless of her
income level.
Answer: B
Rationale: State Medicaid agencies administer Medicare Savings Programs (MSPs) such
as QMB, SLMB, and QI, which assist low-income Medicare beneficiaries by paying Part
B premiums and, in some cases, deductibles and coinsurance. Advising a low-income
beneficiary to contact their state Medicaid agency is the appropriate action.
4. 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?
A. He will pay a single flat annual fee that eliminates all monthly premiums and co-pays.
B. He generally would pay a monthly premium, annual deductible, and per-prescription
cost-sharing.
C. He is required to pay a 50% coinsurance on all generic drugs regardless of plan design.
D. He will only pay a monthly premium, as Medicare Part D completely eliminates
deductibles and copayments.
Answer: B
Rationale: The standard structure of a Medicare Part D prescription drug plan includes
four primary cost components paid by the enrollee: a monthly premium, an annual
deductible (up to a statutory limit), copayments or coinsurance during initial coverage,
and catastrophic cost-sharing rules established by federal law.
5. 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?
A. She should purchase a new Medigap Plan H, I, or J from her current issuer to obtain
drug coverage.
B. 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.
C. She must terminate her Original Medicare Parts A and B before she can add drug
coverage.
D. Medigap policies are legally required to include full prescription drug benefits at no
AHIP Final Exam with Accurate Questions & Answers
(Detailed Answers) and Deep Expert Rationales | Latest
(2026/2027) Updated Version
THIS DOCUMENT CONTAINS:
❖AHIP Final Exam
❖Accurate Questions & Answers (Detailed Answers)
❖Deep Expert Rationales
❖Latest (2026/2027) Updated Version
❖100% Guaranteed Pass
,1. 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?
A. Original Medicare will cover 100% of skilled nursing facility care for up to 100 days
without any copayments.
B. 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.
C. Original Medicare only covers skilled nursing facility care if the beneficiary purchases
a standalone Medigap or Part D plan.
D. Original Medicare does not cover post-acute care in a skilled nursing facility under
any circumstances.
Answer: B
Rationale: Under Original Medicare Part A, skilled nursing facility (SNF) care is
covered following a qualifying 3-day inpatient hospital stay. For each benefit period,
Original Medicare pays 100% of covered SNF services for Days 1 through 20. For Days
21 through 100, the beneficiary is responsible for a daily coinsurance/copay amount.
Beyond Day 100, the beneficiary is responsible for all costs.
2. 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?
A. Medicare Part B covers routine dental and vision exams, including glasses and
dentures, but excludes massage therapy.
B. Medicare covers massage therapy under Part B, but excludes glasses and routine
,dentures.
C. Medicare does not cover massage therapy, or, in general, glasses or dentures.
D. Medicare covers all three services as long as they are prescribed by a licensed primary
care physician.
Answer: C
Rationale: Standard Original Medicare (Parts A and B) explicitly excludes routine dental
care (including dentures), routine vision care (including standard eyeglasses, with a
limited exception for post-cataract surgery lenses), and alternative/complementary
therapies such as massage therapy. Beneficiaries seeking coverage for these services
often look to private Medicare Advantage (Part C) plans or pay out-of-pocket.
3. Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could
you tell Mrs. Park that might be of assistance?
A. She should apply directly to the federal government for automatic Medicare Part A
premium waivers.
B. 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.
C. She must forfeit her Original Medicare and enroll exclusively in a commercial group
health plan.
D. She is automatically exempt from all Medicare Part B premiums regardless of her
income level.
Answer: B
Rationale: State Medicaid agencies administer Medicare Savings Programs (MSPs) such
as QMB, SLMB, and QI, which assist low-income Medicare beneficiaries by paying Part
B premiums and, in some cases, deductibles and coinsurance. Advising a low-income
beneficiary to contact their state Medicaid agency is the appropriate action.
4. 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?
A. He will pay a single flat annual fee that eliminates all monthly premiums and co-pays.
B. He generally would pay a monthly premium, annual deductible, and per-prescription
cost-sharing.
C. He is required to pay a 50% coinsurance on all generic drugs regardless of plan design.
D. He will only pay a monthly premium, as Medicare Part D completely eliminates
deductibles and copayments.
Answer: B
Rationale: The standard structure of a Medicare Part D prescription drug plan includes
four primary cost components paid by the enrollee: a monthly premium, an annual
deductible (up to a statutory limit), copayments or coinsurance during initial coverage,
and catastrophic cost-sharing rules established by federal law.
5. 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?
A. She should purchase a new Medigap Plan H, I, or J from her current issuer to obtain
drug coverage.
B. 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.
C. She must terminate her Original Medicare Parts A and B before she can add drug
coverage.
D. Medigap policies are legally required to include full prescription drug benefits at no
