AHIP FINAL EXAM TEST QUESTIONS
AND ANSWERS 2026 PRACTICE
TEST WITH VERIFIED ANSWERS
◉ 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?
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?
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?
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?
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. 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?
Answer: He may sign-up for Medicare at any time however coverage
usually begins on the fourth month after dialysis treatments start.
◉ 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?
Answer: Mrs. Duarte should file an appeal of this initial determination
within 120 days of the date she received the MSN in the mail.
◉ 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?
Answer: 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.
,◉ 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?
Answer: Medicare will cover a total of 190 days of inpatient psychiatric
care during Mr. Rainey's entire lifetime.
◉ 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?
Answer: Beneficiaries under Original Medicare have no cost-sharing for
most preventive services.
◉ Mr. Singh would like drug coverage but does not want to be enrolled
in a Medicare Advantage plan. What should you tell him?
Answer: 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.
◉ 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?
Answer: 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.
◉ 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?
Answer: 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.
◉ 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 might be exposed to under Medicare if he were to require
hospitalization because of an illness. In general terms, what could you
tell him about his costs for inpatient hospital services under Original
Medicare?
Answer: 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 up to 60 days over his lifetime, after
which he would be responsible for all costs.
◉ What impact, if any, have recent regulatory changes had on Medigap
plans?
Answer: The Part B deductible is no longer covered for individuals
newly eligible for Medicare starting January 1, 2020.
AND ANSWERS 2026 PRACTICE
TEST WITH VERIFIED ANSWERS
◉ 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?
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?
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?
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?
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. 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?
Answer: He may sign-up for Medicare at any time however coverage
usually begins on the fourth month after dialysis treatments start.
◉ 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?
Answer: Mrs. Duarte should file an appeal of this initial determination
within 120 days of the date she received the MSN in the mail.
◉ 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?
Answer: 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.
,◉ 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?
Answer: Medicare will cover a total of 190 days of inpatient psychiatric
care during Mr. Rainey's entire lifetime.
◉ 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?
Answer: Beneficiaries under Original Medicare have no cost-sharing for
most preventive services.
◉ Mr. Singh would like drug coverage but does not want to be enrolled
in a Medicare Advantage plan. What should you tell him?
Answer: 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.
◉ 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?
Answer: 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.
◉ 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?
Answer: 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.
◉ 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 might be exposed to under Medicare if he were to require
hospitalization because of an illness. In general terms, what could you
tell him about his costs for inpatient hospital services under Original
Medicare?
Answer: 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 up to 60 days over his lifetime, after
which he would be responsible for all costs.
◉ What impact, if any, have recent regulatory changes had on Medigap
plans?
Answer: The Part B deductible is no longer covered for individuals
newly eligible for Medicare starting January 1, 2020.
