2025 AHIP Module 1-Questions with Correct Answers/Verified
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? - ✔✔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? -
✔✔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? - ✔✔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? - ✔✔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? - ✔✔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? - ✔✔Medicare will cover a total
of 190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime.
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? - ✔✔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? -
✔✔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? - ✔✔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? - ✔✔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? - ✔✔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? - ✔✔Medicare will cover a total
of 190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime.
