AHIP FINAL EXAM, PRACTICE EXAM AND STUDY GUIDE LATEST
2025/2026 ACTUAL EXAM 135 QUESTIONS WITH CORRECT
ANSWERS 100% VERIFIED GRADED A+
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? -
CORRECT ANSWER -Medicare will cover Mrs. Shield's skilled nursing services provided during
the first 20 days of her stay, after which she would have a copay until she has been in the facility
for 100 days.
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? - CORRECT ANSWER -Medicare does not cover
massage therapy, or, in general, glasses or dentures.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park
that might be of assistance? - CORRECT ANSWER -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.
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 prescription drug plan. What should you tell him? - CORRECT ANSWER -He generally
would pay a monthly premium, annual deductible, and per-prescription cost-sharing.
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 but replace her existing Medigap
plan with one that provides drug coverage. What should you tell her? - CORRECT ANSWER -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.
,Mr. LDavis Lis L52 Lyears Lold Land Lhas Lrecently Lbeen Ldiagnosed Lwith Lend-stage Lrenal Ldisease
L(ESRD) Land Lwill Lsoon Lbegin Ldialysis. LHe Lis Lwondering Lif Lhe Lcan Lobtain Lcoverage Lunder
LMedicare. LWhat Lshould Lyou Ltell Lhim? L- LCORRECT LANSWER L-He Lmay Lsign-up Lfor LMedicare
Lat Lany Ltime Lhowever Lcoverage Lusually Lbegins Lon Lthe Lfourth Lmonth Lafter Ldialysis
Ltreatments Lstart.
Mrs. LDuarte Lis Lenrolled Lin LOriginal LMedicare LParts LA Land LB. LShe Lhas Lrecently Lreviewed Lher
Medicare LSummary LNotice L(MSN) Land Ldisagrees Lwith La Ldetermination Lthat Lpartially Ldenied
Lone Lof Lher Lclaims Lfor Lservices. LWhat Ladvice Lwould Lyou Lgive Lher? L- LCORRECT LANSWER L-
Mrs. LDuarte Lshould Lfile Lan Lappeal Lof Lthis Linitial Ldetermination Lwithin L120 Ldays Lof Lthe
Ldate Lshe Lreceived Lthe LMSN Lin Lthe Lmail.
Mrs. LGeisler's Lneighbor Ltold Lher Lshe Lshould Llook Lat Lher LPart LD Loptions Lduring Lthe Lannual
LMedicare Lenrollment Lperiod Lbecause Lthe Lfeatures Lof LPart LD Lmight Lhave Lchanged. LMrs.
LGeisler Lcan't Lremember Lwhat LPart LD Lis Lso Lshe Lcalled Lyou Lto Lask Lwhat Lher Lneighbor Lwas
Ltalking Labout.
What Lcould Lyou Ltell Lher? L- LCORRECT LANSWER L-Part LD Lcovers Lprescription Ldrugs Land Lshe
Lshould Llook Lat Lher Lpremiums, Lformulary, Land Lcost-sharing Lamong Lother Lfactors Lto Lsee Lif
Lthey Lhave Lchanged.
Mr. LRainey Lis Lexperiencing Lparanoid Ldelusions Land Lhis Lphysician Lfeels Lthat Lhe Lshould Lbe
Lhospitalized. LWhat Lshould Lyou Ltell LMr. LRainey L(or Lhis Lrepresentative) Labout Lthe Llength Lof
Lan
inpatient Lpsychiatric Lhospital Lstay Lthat LMedicare Lwill Lcover? L- LCORRECT LANSWER L-Medicare
Lwill Lcover La Ltotal Lof L190 Ldays Lof Linpatient Lpsychiatric Lcare Lduring LMr. LRainey's Lentire
Llifetime.
Mr. LXi Lwill Lsoon Lturn Lage L65 Land Lhas Lcome Lto Lyou Lfor Ladvice Las Lto Lwhat Lservices Lare
Lprovided Lunder LOriginal LMedicare. LWhat Lshould Lyou Ltell LMr. LXi Lthat Lbest Ldescribes Lthe
Lhealth Lcoverage Lprovided Lto LMedicare Lbeneficiaries? L- LCORRECT LANSWER L-Beneficiaries
Lunder LOriginal LMedicare Lhave Lno Lcost-sharing Lfor Lmost Lpreventive Lservices.
Mr. LSingh Lwould Llike Ldrug Lcoverage Lbut Ldoes Lnot Lwant Lto Lbe Lenrolled Lin La LMedicare
LAdvantage Lplan. LWhat Lshould Lyou Ltell Lhim? L- LCORRECT LANSWER L-Mr. LSingh Lcan Lenroll Lin
La Lstand-alone Lprescription Ldrug Lplan Land Lcontinue Lto Lbe Lcovered Lfor LPart LA Land LPart LB
,Lservices Lthrough LOriginal LFee-for-Service LMedicare.
, Mrs. LChen Lwill Lbe L65 Lsoon, Lhas Lbeen La Lcitizen Lfor Ltwelve Lyears, Lhas Lbeen Lemployed Lfull
Ltime, Land Lpaid Ltaxes Lduring Lthat Lentire Lperiod. LShe Lis Lconcerned Lthat Lshe Lwill Lnot Lqualify
Lfor Lcoverage Lunder Lpart LA Lbecause Lshe Lwas Lnot Lborn Lin Lthe LUnited LStates. LWhat Lshould
Lyou Ltell Lher? L-
CORRECT LANSWER L-Most Lindividuals Lwho Lare Lcitizens Land Lage L65 Lor Lover Lare Lcovered
Lunder LPart LA Lby Lvirtue Lof Lhaving Lpaid LMedicare Ltaxes Lwhile Lworking, Lthough Lsome Lmay
Lbe Lcovered Las La Lresult Lof Lpaying Lmonthly Lpremiums.
Mrs. LQuinn Lrecently Lturned L66 Land Ldecided Lafter Lmany Lyears Lof Lwork Lto Lretire Land Lbegin
Lreceiving LSocial LSecurity Lbenefits. LShortly Lthereafter LMrs. LQuinn Lreceived La Lletter
Linforming Lher Lthat Lshe Lhad Lbeen Lautomatically Lenrolled Lin LMedicare LPart LB. LShe Lwants Lto
Lunderstand Lwhat Lthis Lmeans. LWhat Lshould Lyou Ltell LMrs. LQuinn? L- LCORRECT LANSWER L-Part
LB Lprimarily Lcovers Lphysician Lservices. LShe Lwill Lbe Lpaying La Lmonthly Lpremium Land, Lexcept
Lfor Lmany Lpreventive Land Lscreening Ltests, Lgenerally Lwill Lhave L20% Lco-payments Lfor Lthese
Lservices, Lin Laddition Lto Lan Lannual Ldeductible.
Mr. LPatel Lis Lin Lgood Lhealth Land Lis Lpreparing La Lbudget Lin Lanticipation Lof Lhis Lretirement
Lwhen Lhe Lturns L66. LHe Lwants Lto Lunderstand Lthe Lhealth Lcare Lcosts Lhe Lmight Lbe Lexposed
Lto Lunder LMedicare Lif Lhe Lwere Lto Lrequire Lhospitalization Lbecause Lof Lan Lillness. LIn Lgeneral
Lterms, Lwhat Lcould Lyou Ltell Lhim Labout Lhis Lcosts Lfor Linpatient Lhospital Lservices Lunder
LOriginal LMedicare? L- LCORRECT LANSWER
-Under LOriginal LMedicare, Lthere Lis La Lsingle Ldeductible Lamount Ldue Lfor Lthe Lfirst L60 Ldays
Lof Lany Linpatient Lhospital Lstay, Lafter Lwhich Lit Lconverts Linto La Lper-day Lcoinsurance Lamount
Lthrough Lday
90. LAfter Lday L90, Lhe Lwould Lpay La Ldaily Lamount Lup Lto L60 Ldays Lover Lhis Llifetime, Lafter
Lwhich Lhe Lwould Lbe Lresponsible Lfor Lall Lcosts.
What Limpact, Lif Lany, Lhave Lrecent Lregulatory Lchanges Lhad Lon LMedigap Lplans? L- LCORRECT
ANSWER L-The LPart LB Ldeductible Lis Lno Llonger Lcovered Lfor Lindividuals Lnewly Leligible Lfor
LMedicare Lstarting LJanuary L1, L2020.
Mrs. LPaterson Lis Lconcerned Labout Lthe Ldeductibles Land Lco-payments Lassociated Lwith
LOriginal LMedicare. LWhat Lcan Lyou Ltell Lher Labout LMedigap Las Lan Loption Lto Laddress Lthis
Lconcern? L-
CORRECT LANSWER L-Medigap Lplans Ldo Lnot Lcover LOriginal LMedicare Lbenefits, Lbut Lthey
Lcoordinate Lwith LOriginal LMedicare Lcoverage.
2025/2026 ACTUAL EXAM 135 QUESTIONS WITH CORRECT
ANSWERS 100% VERIFIED GRADED A+
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? -
CORRECT ANSWER -Medicare will cover Mrs. Shield's skilled nursing services provided during
the first 20 days of her stay, after which she would have a copay until she has been in the facility
for 100 days.
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? - CORRECT ANSWER -Medicare does not cover
massage therapy, or, in general, glasses or dentures.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park
that might be of assistance? - CORRECT ANSWER -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.
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 prescription drug plan. What should you tell him? - CORRECT ANSWER -He generally
would pay a monthly premium, annual deductible, and per-prescription cost-sharing.
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 but replace her existing Medigap
plan with one that provides drug coverage. What should you tell her? - CORRECT ANSWER -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.
,Mr. LDavis Lis L52 Lyears Lold Land Lhas Lrecently Lbeen Ldiagnosed Lwith Lend-stage Lrenal Ldisease
L(ESRD) Land Lwill Lsoon Lbegin Ldialysis. LHe Lis Lwondering Lif Lhe Lcan Lobtain Lcoverage Lunder
LMedicare. LWhat Lshould Lyou Ltell Lhim? L- LCORRECT LANSWER L-He Lmay Lsign-up Lfor LMedicare
Lat Lany Ltime Lhowever Lcoverage Lusually Lbegins Lon Lthe Lfourth Lmonth Lafter Ldialysis
Ltreatments Lstart.
Mrs. LDuarte Lis Lenrolled Lin LOriginal LMedicare LParts LA Land LB. LShe Lhas Lrecently Lreviewed Lher
Medicare LSummary LNotice L(MSN) Land Ldisagrees Lwith La Ldetermination Lthat Lpartially Ldenied
Lone Lof Lher Lclaims Lfor Lservices. LWhat Ladvice Lwould Lyou Lgive Lher? L- LCORRECT LANSWER L-
Mrs. LDuarte Lshould Lfile Lan Lappeal Lof Lthis Linitial Ldetermination Lwithin L120 Ldays Lof Lthe
Ldate Lshe Lreceived Lthe LMSN Lin Lthe Lmail.
Mrs. LGeisler's Lneighbor Ltold Lher Lshe Lshould Llook Lat Lher LPart LD Loptions Lduring Lthe Lannual
LMedicare Lenrollment Lperiod Lbecause Lthe Lfeatures Lof LPart LD Lmight Lhave Lchanged. LMrs.
LGeisler Lcan't Lremember Lwhat LPart LD Lis Lso Lshe Lcalled Lyou Lto Lask Lwhat Lher Lneighbor Lwas
Ltalking Labout.
What Lcould Lyou Ltell Lher? L- LCORRECT LANSWER L-Part LD Lcovers Lprescription Ldrugs Land Lshe
Lshould Llook Lat Lher Lpremiums, Lformulary, Land Lcost-sharing Lamong Lother Lfactors Lto Lsee Lif
Lthey Lhave Lchanged.
Mr. LRainey Lis Lexperiencing Lparanoid Ldelusions Land Lhis Lphysician Lfeels Lthat Lhe Lshould Lbe
Lhospitalized. LWhat Lshould Lyou Ltell LMr. LRainey L(or Lhis Lrepresentative) Labout Lthe Llength Lof
Lan
inpatient Lpsychiatric Lhospital Lstay Lthat LMedicare Lwill Lcover? L- LCORRECT LANSWER L-Medicare
Lwill Lcover La Ltotal Lof L190 Ldays Lof Linpatient Lpsychiatric Lcare Lduring LMr. LRainey's Lentire
Llifetime.
Mr. LXi Lwill Lsoon Lturn Lage L65 Land Lhas Lcome Lto Lyou Lfor Ladvice Las Lto Lwhat Lservices Lare
Lprovided Lunder LOriginal LMedicare. LWhat Lshould Lyou Ltell LMr. LXi Lthat Lbest Ldescribes Lthe
Lhealth Lcoverage Lprovided Lto LMedicare Lbeneficiaries? L- LCORRECT LANSWER L-Beneficiaries
Lunder LOriginal LMedicare Lhave Lno Lcost-sharing Lfor Lmost Lpreventive Lservices.
Mr. LSingh Lwould Llike Ldrug Lcoverage Lbut Ldoes Lnot Lwant Lto Lbe Lenrolled Lin La LMedicare
LAdvantage Lplan. LWhat Lshould Lyou Ltell Lhim? L- LCORRECT LANSWER L-Mr. LSingh Lcan Lenroll Lin
La Lstand-alone Lprescription Ldrug Lplan Land Lcontinue Lto Lbe Lcovered Lfor LPart LA Land LPart LB
,Lservices Lthrough LOriginal LFee-for-Service LMedicare.
, Mrs. LChen Lwill Lbe L65 Lsoon, Lhas Lbeen La Lcitizen Lfor Ltwelve Lyears, Lhas Lbeen Lemployed Lfull
Ltime, Land Lpaid Ltaxes Lduring Lthat Lentire Lperiod. LShe Lis Lconcerned Lthat Lshe Lwill Lnot Lqualify
Lfor Lcoverage Lunder Lpart LA Lbecause Lshe Lwas Lnot Lborn Lin Lthe LUnited LStates. LWhat Lshould
Lyou Ltell Lher? L-
CORRECT LANSWER L-Most Lindividuals Lwho Lare Lcitizens Land Lage L65 Lor Lover Lare Lcovered
Lunder LPart LA Lby Lvirtue Lof Lhaving Lpaid LMedicare Ltaxes Lwhile Lworking, Lthough Lsome Lmay
Lbe Lcovered Las La Lresult Lof Lpaying Lmonthly Lpremiums.
Mrs. LQuinn Lrecently Lturned L66 Land Ldecided Lafter Lmany Lyears Lof Lwork Lto Lretire Land Lbegin
Lreceiving LSocial LSecurity Lbenefits. LShortly Lthereafter LMrs. LQuinn Lreceived La Lletter
Linforming Lher Lthat Lshe Lhad Lbeen Lautomatically Lenrolled Lin LMedicare LPart LB. LShe Lwants Lto
Lunderstand Lwhat Lthis Lmeans. LWhat Lshould Lyou Ltell LMrs. LQuinn? L- LCORRECT LANSWER L-Part
LB Lprimarily Lcovers Lphysician Lservices. LShe Lwill Lbe Lpaying La Lmonthly Lpremium Land, Lexcept
Lfor Lmany Lpreventive Land Lscreening Ltests, Lgenerally Lwill Lhave L20% Lco-payments Lfor Lthese
Lservices, Lin Laddition Lto Lan Lannual Ldeductible.
Mr. LPatel Lis Lin Lgood Lhealth Land Lis Lpreparing La Lbudget Lin Lanticipation Lof Lhis Lretirement
Lwhen Lhe Lturns L66. LHe Lwants Lto Lunderstand Lthe Lhealth Lcare Lcosts Lhe Lmight Lbe Lexposed
Lto Lunder LMedicare Lif Lhe Lwere Lto Lrequire Lhospitalization Lbecause Lof Lan Lillness. LIn Lgeneral
Lterms, Lwhat Lcould Lyou Ltell Lhim Labout Lhis Lcosts Lfor Linpatient Lhospital Lservices Lunder
LOriginal LMedicare? L- LCORRECT LANSWER
-Under LOriginal LMedicare, Lthere Lis La Lsingle Ldeductible Lamount Ldue Lfor Lthe Lfirst L60 Ldays
Lof Lany Linpatient Lhospital Lstay, Lafter Lwhich Lit Lconverts Linto La Lper-day Lcoinsurance Lamount
Lthrough Lday
90. LAfter Lday L90, Lhe Lwould Lpay La Ldaily Lamount Lup Lto L60 Ldays Lover Lhis Llifetime, Lafter
Lwhich Lhe Lwould Lbe Lresponsible Lfor Lall Lcosts.
What Limpact, Lif Lany, Lhave Lrecent Lregulatory Lchanges Lhad Lon LMedigap Lplans? L- LCORRECT
ANSWER L-The LPart LB Ldeductible Lis Lno Llonger Lcovered Lfor Lindividuals Lnewly Leligible Lfor
LMedicare Lstarting LJanuary L1, L2020.
Mrs. LPaterson Lis Lconcerned Labout Lthe Ldeductibles Land Lco-payments Lassociated Lwith
LOriginal LMedicare. LWhat Lcan Lyou Ltell Lher Labout LMedigap Las Lan Loption Lto Laddress Lthis
Lconcern? L-
CORRECT LANSWER L-Medigap Lplans Ldo Lnot Lcover LOriginal LMedicare Lbenefits, Lbut Lthey
Lcoordinate Lwith LOriginal LMedicare Lcoverage.
