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AHIP Final Exam 2025/2026 – Updated Questions and Revised Answers | 100% Guarantee Pass

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This document includes the most recent and updated AHIP Final Exam questions along with revised, 100% accurate answers for the 2025/2026 certification period. It thoroughly covers all exam sections, including Medicare Parts A–D, plan marketing regulations, fraud and abuse, and compliance training. Crafted for reliability and clarity, this resource ensures a guaranteed pass and is ideal for both first-time test takers and renewals.

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AHIP2025Final ExamUpdatedQuestionsand
Verified Answers, 100% Guarantee Pass



Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and
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sisbeingsuccessfullytreated forthatcondition. However,she andher
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s physiciansfeelthatafterherlengthyhospitalstay,shewillneedamonthor two
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sof nursing and rehabilitative care. What should you tell them about Original
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sMedicare's coverage of care in a skilled nursing facility?
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- correct answer - Medicare will cover Mrs. Shield'sskilled nursing services
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s
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provided during thefirst 20 daysof her stay, after which she would have a copay
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suntil she has been in the facility for 100 days.
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Mrs. West wears glasses and dentures andhasenjoyed considerable pain relief
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s from arthritis through massage therapy. She is concerned about
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,


whetherornotMedicarewillcovertheseitemsandservices.Whatshould you
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s tell her?
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- correct answer -Medicaredoesnotcovermassagetherapy,or,ingeneral,
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s glasses or dentures. s s




Mrs.Parkisanelderlyretiree.Mrs.Parkhasalowfixedincome.Whatcould you
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s tell Mrs. Park that might be of assistance?
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- correct answer - Sheshouldcontact her state Medicaid agency to see if
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shequalifiesforoneofseveral programsthatcanhelpwithMedicarecosts for
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s which she is responsible.
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Mr. Alonso receives some help paying for his two generic prescription drugs
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fromhisemployer'sretireecoverage,buthewantstocompareittoa Part D
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sprescription drug plan. He asksyou whatcosts he wouldgenerally expect to s s s s s s s s s s s s




sencounter when enrolling into a standard Medicare Part D prescription drug
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s plan. What should you tell him?
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- correct answer -Hegenerallywouldpayamonthlypremium,annual
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s deductible, and per-prescription cost-sharing. s s s




Mrs.GonzalezisenrolledinOriginalMedicareandhasaMedigappolicyas
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s well,butitprovidesnodrugcoverage.Shewouldliketokeepthecoverage
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,


shehasbutreplaceherexisting Medigapplanwithonethatprovidesdrug
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coverage. What should you tell her? s s s s s




- correct answer - Mrs.Gonzalez cannot purchase a Medigap plan that
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coversdrugs,butshecouldkeepherMedigappolicyandenrollinaPartD
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s prescription drug plan. s s




Mr. Davis is 52 years old and has recently been diagnosed with end-stage
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s renal disease (ESRD) and will soon begin dialysis. He is wondering if he can
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s obtain coverage under Medicare. What should you tell him?
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- correct answer - He may sign-up for Medicare at any time however
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coverageusuallybeginson thefourth monthafterdialysistreatmentsstart.
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Mrs.DuarteisenrolledinOriginalMedicarePartsAandB.Shehasrecently
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s reviewed her Medicare Summary Notice (MSN) and disagrees with a
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s determination that partially denied one of her claims for services. What s s s s s s s s s s




s advice would you give her?
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- correct answer - Mrs.Duarte shouldfile anappeal of thisinitial
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determinationwithin120daysofthedateshereceivedtheMSNinthemail. s s s s s s s s s s s




Mrs. Geisler's neighbor told her she should look at her Part D options
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s duringtheannualMedicareenrollment period becausethefeaturesofPart
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,


Dmighthave changed. Mrs. Geisler can't rememberwhat PartD is so she
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calledyoutoaskwhatherneighborwastalkingabout.Whatcouldyoutell her?
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- correct answer - PartDcoversprescriptiondrugsandsheshouldlookat
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herpremiums,formulary,andcost-sharingamongotherfactorstoseeif they
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s have changed.s




Mr.Raineyisexperiencingparanoiddelusionsandhisphysicianfeelsthathe
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s should be hospitalized. What should you tell Mr. Rainey (or his representative)
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sabout the length of an inpatient psychiatric hospital stay that Medicare will
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s cover?

- correct answer -Medicarewillcoveratotalof190daysofinpatient
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s psychiatric care during Mr. Rainey's entire lifetime. s s s s s s




Mr. Xi will soon turn age 65 and has come to you for advice as to what servicesare
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providedunderOriginalMedicare.WhatshouldyoutellMr.Xi thatbest
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describesthehealthcoverageprovidedtoMedicarebeneficiaries?
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- correctanswer-BeneficiariesunderOriginalMedicarehaveno
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s cost-sharing for most preventive services. s s s s




Mr.Singhwouldlikedrugcoveragebutdoesnotwanttobeenrolledina
s s s s s s s s s s s s s s

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