2025 AHIP FINAL EXAM 33 QUESTIONS WITH CORRECT ANSWERS 100% VERIFIED
GRADED A+
Mrs. Paterson is concerned about the deductibles and co-payments associated with Original
Medicare. What can you tell her about Medigap as an option to address this concern? -
(ANSWER)Medigap plans help beneficiaries cover Original Medicare benefits, but they coordinate
with Original Medicare coverage.
Anita Magri will turn age 65 in August 2023. Anita intends to enroll in Original Medicare Part A and
Part B. She would also like to enroll in a Medicare Supplement (Medigap) plan. Anita's older @#$%
neighbor Mel has told her about the Medigap Plan F in which he is enrolled. It not only provides
^&*()_
foreign travel emergency benefits but also covers his Medicare Part B deductible. Anita comes to
+
you for advice. What should you tell her? - (ANSWER)You are sorry to disappoint Anita, but a
Medigap F plan is no longer available to those who turn age 65 after January 1, 2020. Anita might
instead consider other Medigap plans that offer foreign travel benefits but do not cover the Part B
deductible.
What impact, if any, have recent regulatory changes had on Medigap plans? - (ANSWER)b.
The Part B deductible is no longer covered for individuals newly eligible for Medicare starting
January 1, 2020.
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? - (ANSWER)Medicare will cover a total of 190
days of inpatient psychiatric care during Mr. Rainey's entire lifetime.
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? - (ANSWER)
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? - (ANSWER)Medicare does not cover massage therapy, or,
in general, glasses or dentures.
Ms. Gibson recently lost her employer group health and drug coverage and now she wants to enroll
in a PPO that does not include drug coverage. What should you tell her about obtaining drug
coverage? - (ANSWER)She can enroll in the PPO, but she will not be able to purchase a stand-alone
Medicare Part D prescription drug plan.
Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage.
What should you tell her? - (ANSWER)Mrs. Radford must be entitled to Part A and enrolled in Part B
to enroll in Medicare Advantage.
, 2025 AHIP FINAL EXAM 33 QUESTIONS WITH CORRECT ANSWERS 100% VERIFIED
GRADED A+
Mr. Barker enjoys a comfortable retirement income. He recently had surgery and expected that he
would have certain services and items covered by the plan with minimal out-of-pocket costs
because his MA-PD coverage has been very good. However, when he received the bill, he was
surprised to see large charges in excess of his maximum out-of-pocket limit that included some
services and items he thought would be fully covered. He called you to ask what he could do? What
could you tell him? - (ANSWER)You can offer to review the plans appeal process to help him ask the @#$%
plan to review the coverage decision.
^&*()_
+
Mr. Sanchez has just turned 65 and is entitled to Part A but has not enrolled in Part B because he
has coverage through an employer plan. If he wants to enroll in a Medicare Advantage plan, what
will he have to do? - (ANSWER)He will have to enroll in Part B.
Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan's terms and
conditions for payment. Mary Rodgers sees Dr. Brennan for treatment. How much may Dr. Brennan
charge? - (ANSWER)
Mrs. Chou likes a Private Fee-for-Service (PFFS) plan available in her area that does not include
drug coverage. She wants to enroll in the plan and enroll in a stand-alone prescription drug plan.
What should you tell her? - (ANSWER)She could enroll in a PFFS plan and a stand-alone Medicare
prescription drug plan.
Mr. Kelly wants to know whether he is eligible to sign up for a Private fee-for-service (PFFS) plan.
What questions would you need to ask to determine his eligibility? - (ANSWER)You would need to
ask Mr. Kelly if he is enrolled in Part A and Part B and if he lives in the PFFS plan's service area.
Mrs. Lyons is in good health, uses a single prescription, and lives independently in her own home.
She is attracted by the idea of maintaining control over a Medical Savings Account (MSA), but is not
sure if the plan associated with the account will fit her needs. What specific piece of information
about a Medicare MSA plan would it be important for her to know, prior to enrolling in such a plan? -
(ANSWER)All MSAs cover Part A and Part B benefits, but not Part D prescription drug benefits, which
could be obtained by also enrolling in a separate prescription drug plan.
Who is most likely to benefit from the Medicare Prescription Payment Plan? - (ANSWER)
Mrs. Mulcahy, age 65, is concerned that she may not qualify for enrollment in a Medicare
prescription drug plan because, although she is entitled to Part A, she is not enrolled under
Medicare Part B. What should you tell her? - (ANSWER)An individual who is entitled to Part A or
enrolled under Part B is eligible to enroll in a Medicare prescription drug plan. As long as Mrs.
Mulcahy is entitled to Part A, she does not need to enroll under Part B before enrolling in a
prescription drug plan.
GRADED A+
Mrs. Paterson is concerned about the deductibles and co-payments associated with Original
Medicare. What can you tell her about Medigap as an option to address this concern? -
(ANSWER)Medigap plans help beneficiaries cover Original Medicare benefits, but they coordinate
with Original Medicare coverage.
Anita Magri will turn age 65 in August 2023. Anita intends to enroll in Original Medicare Part A and
Part B. She would also like to enroll in a Medicare Supplement (Medigap) plan. Anita's older @#$%
neighbor Mel has told her about the Medigap Plan F in which he is enrolled. It not only provides
^&*()_
foreign travel emergency benefits but also covers his Medicare Part B deductible. Anita comes to
+
you for advice. What should you tell her? - (ANSWER)You are sorry to disappoint Anita, but a
Medigap F plan is no longer available to those who turn age 65 after January 1, 2020. Anita might
instead consider other Medigap plans that offer foreign travel benefits but do not cover the Part B
deductible.
What impact, if any, have recent regulatory changes had on Medigap plans? - (ANSWER)b.
The Part B deductible is no longer covered for individuals newly eligible for Medicare starting
January 1, 2020.
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? - (ANSWER)Medicare will cover a total of 190
days of inpatient psychiatric care during Mr. Rainey's entire lifetime.
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? - (ANSWER)
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? - (ANSWER)Medicare does not cover massage therapy, or,
in general, glasses or dentures.
Ms. Gibson recently lost her employer group health and drug coverage and now she wants to enroll
in a PPO that does not include drug coverage. What should you tell her about obtaining drug
coverage? - (ANSWER)She can enroll in the PPO, but she will not be able to purchase a stand-alone
Medicare Part D prescription drug plan.
Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage.
What should you tell her? - (ANSWER)Mrs. Radford must be entitled to Part A and enrolled in Part B
to enroll in Medicare Advantage.
, 2025 AHIP FINAL EXAM 33 QUESTIONS WITH CORRECT ANSWERS 100% VERIFIED
GRADED A+
Mr. Barker enjoys a comfortable retirement income. He recently had surgery and expected that he
would have certain services and items covered by the plan with minimal out-of-pocket costs
because his MA-PD coverage has been very good. However, when he received the bill, he was
surprised to see large charges in excess of his maximum out-of-pocket limit that included some
services and items he thought would be fully covered. He called you to ask what he could do? What
could you tell him? - (ANSWER)You can offer to review the plans appeal process to help him ask the @#$%
plan to review the coverage decision.
^&*()_
+
Mr. Sanchez has just turned 65 and is entitled to Part A but has not enrolled in Part B because he
has coverage through an employer plan. If he wants to enroll in a Medicare Advantage plan, what
will he have to do? - (ANSWER)He will have to enroll in Part B.
Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan's terms and
conditions for payment. Mary Rodgers sees Dr. Brennan for treatment. How much may Dr. Brennan
charge? - (ANSWER)
Mrs. Chou likes a Private Fee-for-Service (PFFS) plan available in her area that does not include
drug coverage. She wants to enroll in the plan and enroll in a stand-alone prescription drug plan.
What should you tell her? - (ANSWER)She could enroll in a PFFS plan and a stand-alone Medicare
prescription drug plan.
Mr. Kelly wants to know whether he is eligible to sign up for a Private fee-for-service (PFFS) plan.
What questions would you need to ask to determine his eligibility? - (ANSWER)You would need to
ask Mr. Kelly if he is enrolled in Part A and Part B and if he lives in the PFFS plan's service area.
Mrs. Lyons is in good health, uses a single prescription, and lives independently in her own home.
She is attracted by the idea of maintaining control over a Medical Savings Account (MSA), but is not
sure if the plan associated with the account will fit her needs. What specific piece of information
about a Medicare MSA plan would it be important for her to know, prior to enrolling in such a plan? -
(ANSWER)All MSAs cover Part A and Part B benefits, but not Part D prescription drug benefits, which
could be obtained by also enrolling in a separate prescription drug plan.
Who is most likely to benefit from the Medicare Prescription Payment Plan? - (ANSWER)
Mrs. Mulcahy, age 65, is concerned that she may not qualify for enrollment in a Medicare
prescription drug plan because, although she is entitled to Part A, she is not enrolled under
Medicare Part B. What should you tell her? - (ANSWER)An individual who is entitled to Part A or
enrolled under Part B is eligible to enroll in a Medicare prescription drug plan. As long as Mrs.
Mulcahy is entitled to Part A, she does not need to enroll under Part B before enrolling in a
prescription drug plan.
