2025/2026 AHIP Final Exam Questions and Verified Answers, 100% Guarantee Pass

1. Mr. Xi will soon turn age 65 and hascome to youfor advice asto what services are provided under
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk




jk Original Medicare. What should you tell Mr. Xi that best describes the health coverage provided to
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk




jk Medicare beneficiaries? jk




a.Beneficiaries under Original Medicare have no cost-sharing for most preventive services which
jk jk jk jk jk jk jk jk jk jk jk jk




include immunizations such as annual flu hots.
j k j k j k j k j k jk




a. MedicarePart A generally covers medically necessary physicianand other healthcare professional
jk jk jk jk jk jk jk jk jk jk jk jk




jk services.

b. Benefitscovered by Medicare Parts A and B include routine dental care, hearing aids, and routine eye care.
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk




c. MedicarePartB generallyprovides prescriptiondrug coverage. jk jk jk jk jk jk jk




2. Mr. Buck has several family members who died from different cancers. Hewants to know if
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk




jk Medicare covers cancer screening. What should you tell him? jk jk jk jk jk jk jk jk




a. MedicarecoversallscreeningteststhathavebeenapprovedbytheFDAonafrequencydetermined by
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk




jk the treating physician.
jk jk




b. Medicare covers treatments for existing disease,injury, and malformed limbs or body parts. As
jk jk jk jk jk jk jk jk jk jk jk jk jk




jk such,it doesnotcoverany screening testsandthese mustbe paidfor bythebeneficiary out-of-
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk




jk pocket.
c. Medicare covers some screening tests that must be performed within the first year after
jk jk jk jk jk jk jk jk jk jk jk jk jk




jk enrollment. Beyondthatpointexpensesfor screening tests arethe responsibility ofthe jk jk jk jk jk jk jk jk jk jk jk jk

, beneficiary.


d. j k j k j k




q j k u j k q j k u




Source: Module 1, j k j k j k j k j k Slide j k j k - j k j k Medicare j k j k Part j k j k B j k j k Benefits j k j k - j k j k Preventive j k j k Services
and Screenings
j k j k jk




3. Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original Fee-
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk




jk for- Service (FFS) Medicare? What could you tell him?
jk jk jk jk jk jk jk jk




a. Part C, whichalwayscovers dentalandvision services, iscoveredunderOriginal Medicare.
qu qu jk jk jk qu qu




b. jk




which covers professional services such as those provided by a doctor are
q
jk j k u j k q
jk j k u j k q
jk j k u j k q
jk j k u j k q
jk j k u j k q
jk j k u j k q
jk j k u j k q
jk j k u j k q
jk j k u j k q
jk j k u j k q
jk j k u j k q
jk j k u




covered
q j k u j k




q j Medic k. u j k q
jk j k u

,q j are k u j k




c. Part A, whichcoverslong-term custodialcareservices, is coveredunderOriginal Medicare.
qu qu qu qu qu




d. Part D,whichcoversprescriptiondrug services, iscoveredunderOriginalMedicare.
qu jk jk qu qu jk




Source: Module 1, Slide - Overview of Medicare Benefits and Coverage -
j k j k j k j k j k j k j k j k j k j k j k




Parts A, B, C, and Slide - Overview of Different Ways to Get Medicare
j k j k j k jk j k j k j k jk jk jk jk jk jk jk




4. Juan Perez, who is turning age 65 next month, intends to work for several more years at
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk




Smallcap, Incorporated. Smallcap has a workforce of 15 employees and offers employer-
jk jk jk jk jk jk jk jk jk jk jk jk




sponsored healthcare coverage. Juan is a naturalized citizen and has contributed to the jk jk jk jk jk jk jk jk jk jk jk jk




Medicare system for over 20 years. Juan asks you if he will be entitled to Medicare and if
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk




he enrolls how that will impact his employer- sponsored healthcare coverage. How
jk jk jk jk jk jk jk jk jk jk jk jk




would you respond?
jk jk jk




a. Juan is likely to be ineligible for Medicare since he was born outside the United States and
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk




jk has only contributed to the Medicare system for 20 years.
jk jk jk jk jk jk jk jk jk

, b. jk




the q j k u j k jk q j k u j k primary payor jk q j k u j k jk q j k u j k of jk q j k u j k his jk q j k u j k healthcare jk q j k u j k claims jk q




but
Smallcap
j k j uk u
q j kj k q
jk j k u j k must jk q j k u j k continue jk q j k u j k to offer q
jk j k u j k q
jk j k u j k




sponsored payor.
c. Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls his employer-
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk




jk sponsored coverage would continue to be the primary payor while Medicare would be jk jk jk jk jk jk jk jk jk jk jk jk




jk considered a secondary payor of his healthcare claims. jk jk jk jk jk jk jk




Incorrect: Medicare is the primary payor for individuals who have group health coverage jk jk jk jk jk jk jk jk jk jk jk jk




jk due to their continued employment with a small employer. A small group health plan is
jk jk jk jk jk jk jk jk jk jk jk jk jk jk




jk one offered by a company with fewer than 20 employees.
jk jk jk jk jk jk jk jk jk




d. Juan is likely to be eligible for Medicare once he turns age 65 and if he j k j k j k j k j k j k j k j k j k j k j k j k j k j k j k




enrolls Medicare would become the primary payor of his healthcare claims and Smallcap
j k jk jk jk jk jk jk jk jk jk jk jk jk




does not have to continue to offer him coverage comparable to those under age 65 under its
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk




employer-sponsored group health plan.
jk jk jk jk




Source:Module 1,Slide -Eligibility forPartA andPartBBenefitsandSlide -Medicare for jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk




Individuals Who Are Still Working - Small GHPs and Slide - Medicare
jk jk j k j k j k j k j k j k j k j k j k j k




Coordination with Employer Group Health
j k jk j k j k j k




PlansQuestion4 jk




5. Mr. Baueris 49yearsold,buteighteen monthsagohe was declareddisabledbythe Social
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk




jk Security Administration and has been receiving disability payments. He is wondering jk jk jk jk jk jk jk jk jk jk




jk whether he can obtain coverage under Medicare. What should you tell him? jk jk jk jk jk jk jk jk jk jk jk




a. After receiving such disability payments for 24 months, he will be q
jk j k u j k q
jk j k u j k q
jk j k u j k jk q j k u j k jk q j k u j k jk q j k u j k jk q j k u j k q
jk j k u j k q
jk j k u j k q
jk j k u j k




q automatically enrolled in Medicare,
j k u j k jk q j k u j k jk q j k u j k qu




regardless
o
fage.
b. Individuals who become eligible for such disability payments only have to j k j k j k j k j k j k j k j k j k j k




wait 12 months before j k j k jk j k




they can applyforcoverageunderMedicare. qu jk jk jk




c. Individuals receiving such disability payments from the Social Security j k j k j k j k j k j k j k j k




jk Administration continue to receive those payments but only become eligible for j k j k jk jk jk jk jk jk jk jk




jk Medicare upon reaching age 65. jk jk jk jk




d. He becameeligible forMedicarewhenhisdisabilityeligibilitydeterminationwas
qu jk




jk first made. Source: Module 1, Slide - Medicare Enrollment Part A & B
qu jk jk jk jk jk jk jk jk jk jk jk