2025 NURSING 412 AHIP FINAL EXAM
TEST Questions and Answers
100%Correct/Verified
,2
Mrs. Pena is 66 years old, has coverage under an employer plan,
and will retire next year. She heard she must enroll in Part B at the
beginning of the year to ensureno gap in coverage. What can you tell
her? ✓She may enroll at any time while she is covered under her
employer plan, but she will have a special eight-month enrollment
period after the last month on her employer plan that differs from
the standard general enrollment period, during which she may
enroll in Medicare Part B.
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has
been employedfull time, and paid taxes during that entire period.
She is concerned that she will not qualify for coverage under part A
because she was not born in the United States. What should you tell
her? ✓Most individuals who are citizens and age 65
or over are covered under Part A by virtue of having paid
Medicare taxes whileworking, though some may be covered as a
result of paying monthly premiums.
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 butreplace her existing Medigap plan
pg. 2
,3
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.
Mrs. West wears glasses and dentures and has enjoyed
considerable pain relieffrom arthritis through massage therapy.
She is concerned about whether or notMedicare will cover these
items and services. What should you tell her?
✓✓Medicare does not cover massage therapy, or, in general, glasses
or dentures.
Mr. Patel is in good health and is preparing a budget in anticipation
of his retirement when he turns 66. He wants to understand the
health care costs he mightbe exposed to under Medicare if he were
to require hospitalization as a result of anillness. In general terms,
what could you tell him about his costs for inpatient hospital
services
under Original Medicare? ✓✓Under Original Medicare, there is a
single deductible amount due for the first 60 days of any inpatient
hospital stay, after which it converts into a per-day coinsurance
amount through day 90. After day 90,he would pay a daily amount
pg. 3
, 4
up to 60 days over his lifetime, after which he wouldbe responsible
for all costs.
Ms. Henderson believes that she will qualify for Medicare Coverage
when she turns 65, without paying any premiums, because she has
been working for 40 yearsand paying Medicare taxes. What should
you tell her? ✓✓To obtain Part B coverage, she must pay a standard
monthly premium, though it is higher for individuals with higher
incomes.
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 afterdialysis
treatments start.
Juan Perez, who is turning age 65 next month, intends to work for
several more years at Smallcap, Incorporated. Smallcap has a
workforce of15 employees and offers employer-sponsored
healthcare coverage. Juan is a naturalized citizen and has
pg. 4
TEST Questions and Answers
100%Correct/Verified
,2
Mrs. Pena is 66 years old, has coverage under an employer plan,
and will retire next year. She heard she must enroll in Part B at the
beginning of the year to ensureno gap in coverage. What can you tell
her? ✓She may enroll at any time while she is covered under her
employer plan, but she will have a special eight-month enrollment
period after the last month on her employer plan that differs from
the standard general enrollment period, during which she may
enroll in Medicare Part B.
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has
been employedfull time, and paid taxes during that entire period.
She is concerned that she will not qualify for coverage under part A
because she was not born in the United States. What should you tell
her? ✓Most individuals who are citizens and age 65
or over are covered under Part A by virtue of having paid
Medicare taxes whileworking, though some may be covered as a
result of paying monthly premiums.
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 butreplace her existing Medigap plan
pg. 2
,3
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.
Mrs. West wears glasses and dentures and has enjoyed
considerable pain relieffrom arthritis through massage therapy.
She is concerned about whether or notMedicare will cover these
items and services. What should you tell her?
✓✓Medicare does not cover massage therapy, or, in general, glasses
or dentures.
Mr. Patel is in good health and is preparing a budget in anticipation
of his retirement when he turns 66. He wants to understand the
health care costs he mightbe exposed to under Medicare if he were
to require hospitalization as a result of anillness. In general terms,
what could you tell him about his costs for inpatient hospital
services
under Original Medicare? ✓✓Under Original Medicare, there is a
single deductible amount due for the first 60 days of any inpatient
hospital stay, after which it converts into a per-day coinsurance
amount through day 90. After day 90,he would pay a daily amount
pg. 3
, 4
up to 60 days over his lifetime, after which he wouldbe responsible
for all costs.
Ms. Henderson believes that she will qualify for Medicare Coverage
when she turns 65, without paying any premiums, because she has
been working for 40 yearsand paying Medicare taxes. What should
you tell her? ✓✓To obtain Part B coverage, she must pay a standard
monthly premium, though it is higher for individuals with higher
incomes.
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 afterdialysis
treatments start.
Juan Perez, who is turning age 65 next month, intends to work for
several more years at Smallcap, Incorporated. Smallcap has a
workforce of15 employees and offers employer-sponsored
healthcare coverage. Juan is a naturalized citizen and has
pg. 4
