2023 AHIP QUESTIONS WITH CORRECT ANSWERS 2025

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2023 AHIP QUESTIONS WITH CORRECT ANSWERS 2025

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25 pages

2024/2025

Institution 2023 AHIP

Course 2023 AHIP

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2023 AHIP QUESTIONS WITH CORRECT ANSWERS 2025

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2023 AHIP QUESTIONS WITH
CORRECT ANSWERS 2025/2026
DavisAisA52AyearsAoldAandAhasArecentlyAbeenAdiagnosedAwithAend-
stageArenalAdiseaseA(ESRD)AandAwillAsoonAbeginAdialysis.AHeAisAwonderingAifAheAcanAobtainAcov
erageAunderAMedicare.AWhatAshouldAyouAtellAhim?A-AcorrectAanswersHeAmayAsign-
upAforAMedicareAatAanyAtimeAhoweverAcoverageAusuallyAbeginsAonAtheAfourthAmonthAafterAdial
ysisAtreatmentsAstart.

JuanAPerez,AwhoAisAturningAageA65AnextAmonth,AintendsAtoAworkAforAseveralAmoreAyearsAatASm
allcap,AIncorporated.ASmallcapAhasAaAworkforceAof15AemployeesAandAoffersAemployer-
sponsoredAhealthcareAcoverage.AJuanAisAaAnaturalizedAcitizenAandAhasAcontributedAtoAtheAMed
icareAsystemAforAoverA20Ayears.AJuanAasksAyouAifAheAwillAbeAentitledAtoAMedicareAandAifAheAenro
llsAhowAthatAwillAimpactAhisAemployer-
sponsoredAhealthcareAcoverage.AHowAwouldAyouArespond?A-
AcorrectAanswersJuanAisAlikelyAtoAbeAeligibleAforAMedicareAonceAheAturnsAageA65AandAifAheAenro

llsAMedicareAwouldAbecomeAtheAprimaryApayorAofAhisAhealthcareAclaimsAandASmallcapAdoesAn
otAhaveAtoAcontinueAtoAofferAhimAcoverageAcomparableAtoAthoseAunderAageA65AunderAitsAempl
oyer-sponsoredAgroupAhealthAplan.

Moy'sAwifeAhasAaAMedicareAAdvantageAplan,AbutAheAwantsAtoAunderstandAwhatAcoverageAMed
icareASupplementalAInsuranceAprovidesAsinceAhisAhealthAcareAneedsAareAdifferentAfromAhisAwif
e'sAneeds.AWhatAcouldAyouAtellAMr.AMoy?A-
AcorrectAanswersMedicareASupplementalAInsuranceAwouldAhelpAcoverAhisAPartAAAandAPartABAd

eductiblesAorAcoinsuranceAinAOriginalAFee-for-
ServiceA(FFS)AMedicareAasAwellAasApossiblyAsomeAservicesAthatAMedicareAdoesAnotAcover.

PeňaAisA66AyearsAold,AhasAcoverageAunderAanAemployerAplan,AandAwillAretireAnextAyear.ASheAhea
rdAsheAmustAenrollAinAPartABAatAtheAbeginningAofAtheAyearAtoAensureAnoAgapAinAcoverage.AWhatA
canAyouAtellAher?A-
AcorrectAanswersSheAmayAenrollAatAanyAtimeAwhileAsheAisAcoveredAunderAherAemployerAplan,Ab

utAsheAwillAhaveAaAspecialAeight-
monthAenrollmentAperiodAafterAtheAlastAmonthAonAherAemployerAplanAthatAdiffersAfromAtheAst
andardAgeneralAenrollmentAperiod,AduringAwhichAsheAmayAenrollAinAMedicareAPartAB.

ChenAwillAbeA65Asoon,AhasAbeenAaAcitizenAforAtwelveAyears,AhasAbeenAemployedAfullAtime,AandA
paidAtaxesAduringAthatAentireAperiod.ASheAisAconcernedAthatAsheAwillAnotAqualifyAforAcoverageA
underApartAAAbecauseAsheAwasAnotAbornAinAtheAUnitedAStates.AWhatAshouldAyouAtellAher?A-
AcorrectAanswersMostAindividualsAwhoAareAcitizensAandAageA65AorAoverAareAcoveredAunderAPar

tAAAbyAvirtueAofAhavingApaidAMedicareAtaxesAwhileAworking,AthoughAsomeAmayAbeAcoveredAasA
aAresultAofApayingAmonthlyApremiums.

,GonzalezAisAenrolledAinAOriginalAMedicareAandAhasAaAMedigapApolicyAasAwell,AbutAitAprovidesAn
oAdrugAcoverage.ASheAwouldAlikeAtoAkeepAtheAcoverageAsheAhasAbutAreplaceAherAexistingAMedig
apAplanAwithAoneAthatAprovidesAdrugAcoverage.AWhatAshouldAyouAtellAher?A-
AcorrectAanswersMrs.AGonzalezAcannotApurchaseAaAMedigapAplanAthatAcoversAdrugs,AbutAsheAc

ouldAkeepAherAMedigapApolicyAandAenrollAinAaAPartADAprescriptionAdrugAplan.

WestAwearsAglassesAandAdenturesAandAhasAenjoyedAconsiderableApainAreliefAfromAarthritisAthr
oughAmassageAtherapy.ASheAisAconcernedAaboutAwhetherAorAnotAMedicareAwillAcoverAtheseAite
msAandAservices.AWhatAshouldAyouAtellAher?A-
AcorrectAanswersMedicareAdoesAnotAcoverAmassageAtherapy,Aor,AinAgeneral,AglassesAorAdenture

s.

PatelAisAinAgoodAhealthAandAisApreparingAaAbudgetAinAanticipationAofAhisAretirementAwhenAheAt
urnsA66.AHeAwantsAtoAunderstandAtheAhealthAcareAcostsAheAmightAbeAexposedAtoAunderAMedic
areAifAheAwereAtoArequireAhospitalizationAasAaAresultAofAanAillness.AInAgeneralAterms,AwhatAcoul
dAyouAtellAhimAaboutAhisAcostsAforAinpatientAhospitalAservices

underAOriginalAMedicare?A-
AcorrectAanswersUnderAOriginalAMedicare,AthereAisAaAsingleAdeductibleAamountAdueAforAtheAfir

stA60AdaysAofAanyAinpatientAhospitalAstay,AafterAwhichAitAconvertsAintoAaAper-
dayAcoinsuranceAamountAthroughAdayA90.AAfterAdayA90,AheAwouldApayAaAdailyAamountAupAtoA6
0AdaysAoverAhisAlifetime,AafterAwhichAheAwouldAbeAresponsibleAforAallAcosts.

HendersonAbelievesAthatAsheAwillAqualifyAforAMedicareACoverageAwhenAsheAturnsA65,AwithoutA
payingAanyApremiums,AbecauseAsheAhasAbeenAworkingAforA40AyearsAandApayingAMedicareAtaxe
s.AWhatAshouldAyouAtellAher?A-
AcorrectAanswersToAobtainAPartABAcoverage,AsheAmustApayAaAstandardAmonthlyApremium,Athou

ghAitAisAhigherAforAindividualsAwithAhigherAincomes.

AlonsoAreceivesAsomeAhelpApayingAforAhisAtwoAgenericAprescriptionAdrugsAfromAhisAemployer's
AretireeAcoverage,AbutAheAwantsAtoAcompareAitAtoAaAPartADAprescriptionAdrugAplan.AHeAasksAyou

AwhatAcostsAheAwouldAgenerallyAexpectAtoAencounterAwhenAenrollingAintoAaAstandardAMedicar

ePartADAprescriptionAdrugAplan.AWhatAshouldAyouAtellAhim?A-
AcorrectAanswersHeAgenerallyAwouldApayAaAmonthlyApremium,AannualAdeductible,AandAper-

prescriptionAcost-sharing.

MooreAplansAtoAretireAwhenAsheAturnsA65AinAaAfewAmonths.ASheAisAinAexcellentAhealthAandAwillA
haveAconsiderableAincomeAwhenAsheAretires.ASheAisAconcernedAthatAherAincomeAwillAmakeAitAi
mpossibleAforAherAtoAqualifyAforAMedicare.AWhatAcouldAyouAtellAherAtoAaddressAherAconcern?A-
AcorrectAanswersMedicareAisAaAprogramAforApeopleAageA65AorAolderAandAthoseAunderAageA65Aw

ithAcertainAdisabilities,Aend-
stageArenalAdisease,AandALouAGehrig'sAdiseaseAsoAsheAwillAbeAeligibleAforAMedicare.

, XiAwillAsoonAturnAageA65AandAhasAcomeAtoAyouAforAadviceAasAtoAwhatAservicesAareAprovidedAun
derAOriginalAMedicare.AWhatAshouldAyouAtellAMr.AXiAthatAbestAdescribesAtheAhealthAcoverageAp
rovidedAtoAMedicareAbeneficiaries?A-
AcorrectAanswersBeneficiariesAunderAOriginalAMedicareAhaveAnoAcost-

sharingAforAmostApreventiveAservicesAwhichAincludeAimmunizationsAsuchAasAannualAfluAshots.

DuarteAisAenrolledAinAOriginalAMedicareAPartsAAAandAB.ASheAhasArecentlyAreviewedAherAMedica
reASummaryANoticeA(MSN)AandAdisagreesAwithAaAdeterminationAthatApartiallyAdeniedAoneAofAh
erAclaimsAforAservices.AWhatAadviceAwouldAyouAgiveAher?A-
AcorrectAanswersMrs.ADuarteAshouldAfileAanAappealAofAthisAinitialAdetermination AwithinA120Ada

ysAofAtheAdateAsheAreceivedAtheAMSNAinAtheAmail.

CapadonaAwouldAlikeAtoApurchaseAaAMedicareAAdvantageA(MA)AplanAandAaAMedigapAplanAtoApi
ckAupAcostsAnotAcoveredAbyAthatAplan.

WhatAshouldAyouAtellAhim?A-
AcorrectAanswersItAisAillegalAforAyouAtoAsellAMr.ACapadonaAaAMedigapAplanAifAheAisAenrolledAinAa

nAMAAplan,AandAbesides,AMedigapAonlyAworksAwithAOriginalAMedicare.

ParkAisAanAelderlyAretiree.AMrs.AParkAhasAaAlowAfixedAincome.AWhatAcouldAyouAtellAMrs.AParkAth
atAmightAbeAofAassistance?A-
AcorrectAanswersSheAshouldAcontactAherAstateAMedicaidAagencyAtoAseeAifAsheAqualifiesAforAoneA

ofAseveralAprogramsAthatAcanAhelpAwithAMedicareAcostsAforAwhichAsheAisAresponsible.

RaineyAisAexperiencingAparanoidAdelusionsAandAhisAphysicianAfeelsAthatAheAshouldAbeAhospitali
zed.AWhatAshouldAyouAtellAMr.ARaineyA(orAhisArepresentative)AaboutAtheAlengthAofAanAinpatient
ApsychiatricAhospitalAstayAthatAMedicareAwillAcover?A-

AcorrectAanswersMedicareAwillAcoverAaAtotalAofA190AdaysAofAinpatientApsychiatricAcareAduringA

Mr.ARainey'sAentireAlifetime.

SchmidtAwouldAlikeAtoAplanAforAretirementAandAhasAaskedAyouAwhatAisAcoveredAunderAOriginalA
Fee-for-ServiceA(FFS)AMedicare?AWhatAcouldAyouAtellAhim?A-
AcorrectAanswersPartAA,AwhichAcoversAhospital,AskilledAnursingAfacility,Ahospice,AandAhomeAhea

lthAservicesAandAPartAB,AwhichAcoversAprofessionalAservicesAsuchAasAthoseAprovidedAbyAaAdocto
rAareAcoveredAunderAOriginalAMedicare.

AgentAJohnAMillerAisAmeetingAwithAJerryASmith,AaAnewAprospect.AJerryAisAcurrentlyAenrolledAinA
MedicareAPartsAAAandAB.AJerryAhasAalsoApurchasedAaAMedicareASupplementA(Medigap)AplanAw
hichAheAhasAhadAforAseveralAyears.AHowever,AtheAplanAdoesAnotAprovideAdrugAbenefits.AHowAw
ouldAyouAadviseAAgentAJohnAMillerAtoAproceed?A-
AcorrectAanswersTellAprospectAJerryASmithAthatAheAshouldAconsiderAaddingAaAstandaloneAPartA

DAprescriptionAdrugAcoverageApolicyAtoAhisApresentAcoverage.

BauerAisA49AyearsAold,AbutAeighteenAmonthsAagoAheAwasAdeclaredAdisabledAbyAtheASocialASecur
ityAAdministrationAandAhasAbeenAreceivingAdisabilityApayments.AHeAisAwonderingAwhetherAheA

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