AHIP 2025 Module 1 questions and
answers
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?
a.Part D covers long-term care services, and she should not worry because there has been no
change in coverage.
b.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.
c.Part D covers hospital and home health services and the cost-sharing has changed this year.
d.Part D covers physician and non-physician practitioner services and the deductible has not
changed this year, but the physician charges may go up.-ANS >b.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.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park
that might be of assistance?
a.She should not sign up for a Medicare Advantage plan.
b.She should only seek help from private organizations to cover her Medicare costs.
c.She should contact her state Medicaid agency to see if she qualifies for one of several programs
that can help with Medicare costs for which she is responsible.
d.She can apply to the Medicare agency for lower premiums and cost-sharing.-ANS >c.She should
contact her state Medicaid agency to see if she qualifies for one of several programs that can help
with Medicare costs for which she is responsible.
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?
a.Medigap plans do not cover Original Medicare benefits, but they coordinate with Original
Medicare coverage.
b.If Mrs. Paterson applies during the Medigap open enrollment period, she will have to undergo a
medical review to determine if she has a pre-existing condition that would increase the premium
for a Medigap policy.
c.Medigap plans are not sold by private companies and are a government insurance product.
d.All costs not covered by Medicare are covered by some Medigap plans.-ANS >a.Medigap plans
do not cover Original Medicare benefits, but they coordinate with Original Medicare coverage.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage
plan. What should you tell him?
a.Part D prescription drug coverage can only be obtained by enrollment into a Medicare
Advantage plan that also covers Part A and Part B services.
b.Mr. Singh will have to enroll in Medicaid if he wishes to obtain prescription drug coverage
, through some means other than a Medicare Advantage plan.
c.Mr. Singh must leave Original Medicare to receive drug coverage.
d.Mr. Singh can enroll in a stand-alone prescription drug plan and continue to be covered for Part
A and Part B services through Original Fee-for-Service Medicare.-ANS >d.Mr. Singh can enroll in a
stand-alone prescription drug plan and continue to be covered for Part A and Part B services
through Original Fee-for-Service Medicare.
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?
a.He may sign-up for Medicare at any time and coverage usually begins immediately.
b.He may sign-up for Medicare at any time however coverage usually begins on the fourth month
after dialysis treatments start.
c.He may not sign-up for Medicare until he reaches age 62, the date he first becomes eligible for
Social Security benefits.
d.He may sign-up for Medicare at any time however coverage usually begins on the sixth month
after dialysis treatments start.-ANS >b.He may sign-up for Medicare at any time however
coverage usually begins on the fourth month after dialysis treatments start.
Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and would like to
know which of the following services Original Medicare will cover if the appropriate criteria are
met. What could you tell her?
a.Original Medicare covers cosmetic surgery.
b.Original Medicare covers routine dental care.
c.Original Medicare covers routine long-term custodial care.
d.Original Medicare covers ambulance services.-ANS >d.Original Medicare covers ambulance
services.
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?
a.Medicare inpatient psychiatric coverage is limited to the same number of days covered for
typical inpatient stays.
b.Medicare will cover, at its allowable amount, as many stays as are needed throughout Mr.
Rainey's life, as long as no single stay exceeds 190 days.
c.Inpatient psychiatric services are not covered under Original Medicare.
d.Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's entire
lifetime.-ANS >d.Medicare will cover a total of 190 days of inpatient psychiatric care during Mr.
Rainey's entire lifetime.
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?
a.Medicare covers 80% of the cost of these three services.
b.Medicare covers glasses, but not dentures or massage therapy.
c.Medicare does not cover massage therapy, or, in general, glasses or dentures.
d.Medicare covers 50% of the cost of these three services.-ANS >c.Medicare does not cover
massage therapy, or, in general, glasses or dentures.
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
answers
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?
a.Part D covers long-term care services, and she should not worry because there has been no
change in coverage.
b.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.
c.Part D covers hospital and home health services and the cost-sharing has changed this year.
d.Part D covers physician and non-physician practitioner services and the deductible has not
changed this year, but the physician charges may go up.-ANS >b.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.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park
that might be of assistance?
a.She should not sign up for a Medicare Advantage plan.
b.She should only seek help from private organizations to cover her Medicare costs.
c.She should contact her state Medicaid agency to see if she qualifies for one of several programs
that can help with Medicare costs for which she is responsible.
d.She can apply to the Medicare agency for lower premiums and cost-sharing.-ANS >c.She should
contact her state Medicaid agency to see if she qualifies for one of several programs that can help
with Medicare costs for which she is responsible.
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?
a.Medigap plans do not cover Original Medicare benefits, but they coordinate with Original
Medicare coverage.
b.If Mrs. Paterson applies during the Medigap open enrollment period, she will have to undergo a
medical review to determine if she has a pre-existing condition that would increase the premium
for a Medigap policy.
c.Medigap plans are not sold by private companies and are a government insurance product.
d.All costs not covered by Medicare are covered by some Medigap plans.-ANS >a.Medigap plans
do not cover Original Medicare benefits, but they coordinate with Original Medicare coverage.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage
plan. What should you tell him?
a.Part D prescription drug coverage can only be obtained by enrollment into a Medicare
Advantage plan that also covers Part A and Part B services.
b.Mr. Singh will have to enroll in Medicaid if he wishes to obtain prescription drug coverage
, through some means other than a Medicare Advantage plan.
c.Mr. Singh must leave Original Medicare to receive drug coverage.
d.Mr. Singh can enroll in a stand-alone prescription drug plan and continue to be covered for Part
A and Part B services through Original Fee-for-Service Medicare.-ANS >d.Mr. Singh can enroll in a
stand-alone prescription drug plan and continue to be covered for Part A and Part B services
through Original Fee-for-Service Medicare.
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?
a.He may sign-up for Medicare at any time and coverage usually begins immediately.
b.He may sign-up for Medicare at any time however coverage usually begins on the fourth month
after dialysis treatments start.
c.He may not sign-up for Medicare until he reaches age 62, the date he first becomes eligible for
Social Security benefits.
d.He may sign-up for Medicare at any time however coverage usually begins on the sixth month
after dialysis treatments start.-ANS >b.He may sign-up for Medicare at any time however
coverage usually begins on the fourth month after dialysis treatments start.
Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and would like to
know which of the following services Original Medicare will cover if the appropriate criteria are
met. What could you tell her?
a.Original Medicare covers cosmetic surgery.
b.Original Medicare covers routine dental care.
c.Original Medicare covers routine long-term custodial care.
d.Original Medicare covers ambulance services.-ANS >d.Original Medicare covers ambulance
services.
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?
a.Medicare inpatient psychiatric coverage is limited to the same number of days covered for
typical inpatient stays.
b.Medicare will cover, at its allowable amount, as many stays as are needed throughout Mr.
Rainey's life, as long as no single stay exceeds 190 days.
c.Inpatient psychiatric services are not covered under Original Medicare.
d.Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's entire
lifetime.-ANS >d.Medicare will cover a total of 190 days of inpatient psychiatric care during Mr.
Rainey's entire lifetime.
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?
a.Medicare covers 80% of the cost of these three services.
b.Medicare covers glasses, but not dentures or massage therapy.
c.Medicare does not cover massage therapy, or, in general, glasses or dentures.
d.Medicare covers 50% of the cost of these three services.-ANS >c.Medicare does not cover
massage therapy, or, in general, glasses or dentures.
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
