AHIP 2025 FINAL EXAM
Complete Study Guide with Questions and Correct Verified
Answers
With 50 Questions & Answers
1. 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?
Original Medicare covers ambulance services. am
2. Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently
reviewed her Medicare Summary Notice (MSN) and disagrees with a determination
that partially denied one of her claims for services. What advice would you give her?
Mrs. Duarte should file an appeal of this initial determination within 120 days
of the date she received the MSN in the mail.am
3. 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? am
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.
4. Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you
tell Mrs. Park that might be of assistance?
am
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.am
, 5. Mrs. Quinn recently turned 66 and decided after many years of work to retire and
begin receiving Social Security benefits. Shortly thereafter Mrs. Quinn received a
letter informing her that she had been automatically enrolled in Medicare Part B.
She wants to understand what this means. What should you tell Mrs. Quinn?
Part B primarily covers physician services. She will be paying a monthly
premium and, except for many preventive and screening tests, generally will
have 20% co-payments for these services, in addition to an annual
deductible.am
6. 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? am
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.am
7. Mr. Singh would like drug coverage but does not want to be enrolled in a
Medicare Advantage plan. What should you tell him?
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. am
8. Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed
full 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? am
Most individuals who are citizens and age 65 or over are covered under Part
A by virtue of having paid Medicare taxes while working, though some may
be covered as a result of paying monthly premiums.
9. Mr. Xi will soon turn age 65 and has come to you for advice as to what services are
provided under Original Medicare. What should you tell Mr. Xi that best describes
the health coverage provided to Medicare beneficiaries?
Beneficiaries under Original Medicare have no cost-sharing for most
preventive services. am
10. 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
Complete Study Guide with Questions and Correct Verified
Answers
With 50 Questions & Answers
1. 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?
Original Medicare covers ambulance services. am
2. Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently
reviewed her Medicare Summary Notice (MSN) and disagrees with a determination
that partially denied one of her claims for services. What advice would you give her?
Mrs. Duarte should file an appeal of this initial determination within 120 days
of the date she received the MSN in the mail.am
3. 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? am
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.
4. Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you
tell Mrs. Park that might be of assistance?
am
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.am
, 5. Mrs. Quinn recently turned 66 and decided after many years of work to retire and
begin receiving Social Security benefits. Shortly thereafter Mrs. Quinn received a
letter informing her that she had been automatically enrolled in Medicare Part B.
She wants to understand what this means. What should you tell Mrs. Quinn?
Part B primarily covers physician services. She will be paying a monthly
premium and, except for many preventive and screening tests, generally will
have 20% co-payments for these services, in addition to an annual
deductible.am
6. 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? am
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.am
7. Mr. Singh would like drug coverage but does not want to be enrolled in a
Medicare Advantage plan. What should you tell him?
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. am
8. Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed
full 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? am
Most individuals who are citizens and age 65 or over are covered under Part
A by virtue of having paid Medicare taxes while working, though some may
be covered as a result of paying monthly premiums.
9. Mr. Xi will soon turn age 65 and has come to you for advice as to what services are
provided under Original Medicare. What should you tell Mr. Xi that best describes
the health coverage provided to Medicare beneficiaries?
Beneficiaries under Original Medicare have no cost-sharing for most
preventive services. am
10. 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
