2025 AHIP FINAL EXAM QUESTIONS WITH VERIFIED ANSWERS

2025 AHIP FINAL EXAM QUESTIONS
WITH VERIFIED ANSWERS
Mrs.SShieldsSisScoveredSbySOriginalSMedicare.SSheSsustainedSaShipSfractureSandSisSbeingSsuccessfullyStreate
dSforSthatScondition.SHowever,SsheSandSherSphysiciansSfeelSthatSafterSherSlengthyShospitalSstay,SsheSwillSnee
dSaSmonthSorStwoSofSnursingSandSrehabilitativeScare.SWhatSshouldSyouStellSthemSaboutSOriginalSMedicare'sS
coverageSofScareSinSaSskilledSnursingSfacility?S-ScorrectSanswer-
MedicareSwillScoverSMrs.SShield'sSskilledSnursingSservicesSprovidedSduringStheSfirstS20SdaysSofSherSstay,Safte
rSwhichSsheSwouldShaveSaScopaySuntilSsheShasSbeenSinStheSfacilitySforS100Sdays.



Mrs.SWestSwearsSglassesSandSdenturesSandShasSenjoyedSconsiderableSpainSreliefSfromSarthritisSthroughSma
ssageStherapy.SSheSisSconcernedSaboutSwhetherSorSnotSMedicareSwillScoverStheseSitemsSandSservices.SWha
tSshouldSyouStellSher?S-ScorrectSanswer-
MedicareSdoesSnotScoverSmassageStherapy,Sor,SinSgeneral,SglassesSorSdentures.



Mrs.SParkSisSanSelderlySretiree.SMrs.SParkShasSaSlowSfixedSincome.SWhatScouldSyouStellSMrs.SParkSthatSmightS
beSofSassistance?S-ScorrectSanswer-
SheSshouldScontactSherSstateSMedicaidSagencyStoSseeSifSsheSqualifiesSforSoneSofSseveralSprogramsSthatScanS
helpSwithSMedicareScostsSforSwhichSsheSisSresponsible.



Mr.SAlonsoSreceivesSsomeShelpSpayingSforShisStwoSgenericSprescriptionSdrugsSfromShisSemployer'sSretireeSc
overage,SbutSheSwantsStoScompareSitStoSaSPartSDSprescriptionSdrugSplan.SHeSasksSyouSwhatScostsSheSwouldSg
enerallySexpectStoSencounterSwhenSenrollingSintoSaSstandardSMedicareSPartSDSprescriptionSdrugSplan.SWha
tSshouldSyouStellShim?S-ScorrectSanswer-
HeSgenerallySwouldSpaySaSmonthlySpremium,SannualSdeductible,SandSper-prescriptionScost-sharing.



Mrs.SGonzalezSisSenrolledSinSOriginalSMedicareSandShasSaSMedigapSpolicySasSwell,SbutSitSprovidesSnoSdrugSc
overage.SSheSwouldSlikeStoSkeepStheScoverageSsheShasSbutSreplaceSherSexistingSMedigapSplanSwithSoneSthat
SprovidesSdrugScoverage.SWhatSshouldSyouStellSher?S-ScorrectSanswer-

Mrs.SGonzalezScannotSpurchaseSaSMedigapSplanSthatScoversSdrugs,SbutSsheScouldSkeepSherSMedigapSpolicyS
andSenrollSinSaSPartSDSprescriptionSdrugSplan.



Mr.SDavisSisS52SyearsSoldSandShasSrecentlySbeenSdiagnosedSwithSend-
stageSrenalSdiseaseS(ESRD)SandSwillSsoonSbeginSdialysis.SHeSisSwonderingSifSheScanSobtainScoverageSunderS
Medicare.SWhatSshouldSyouStellShim?S-ScorrectSanswer-HeSmaySsign-
upSforSMedicareSatSanyStimeShoweverScoverageSusuallySbeginsSonStheSfourthSmonthSafterSdialysisStreatmen
tsSstart.

,Mrs.SDuarteSisSenrolledSinSOriginalSMedicareSPartsSASandSB.SSheShasSrecentlySreviewedSherSMedicareSSum
marySNoticeS(MSN)SandSdisagreesSwithSaSdeterminationSthatSpartiallySdeniedSoneSofSherSclaimsSforSservice
s.SWhatSadviceSwouldSyouSgiveSher?S-ScorrectSanswer-
Mrs.SDuarteSshouldSfileSanSappealSofSthisSinitialSdeterminationSwithinS120SdaysSofStheSdateSsheSreceivedSth
eSMSNSinStheSmail.



Mrs.SGeisler'sSneighborStoldSherSsheSshouldSlookSatSherSPartSDSoptionsSduringStheSannualSMedicareSenrollm
entSperiodSbecauseStheSfeaturesSofSPartSDSmightShaveSchanged.SMrs.SGeislerScan'tSrememberSwhatSPartSDSi
sSsoSsheScalledSyouStoSaskSwhatSherSneighborSwasStalkingSabout.SWhatScouldSyouStellSher?S-ScorrectSanswer-
PartSDScoversSprescriptionSdrugsSandSsheSshouldSlookSatSherSpremiums,Sformulary,SandScost-
sharingSamongSotherSfactorsStoSseeSifStheyShaveSchanged.



Mr.SRaineySisSexperiencingSparanoidSdelusionsSandShisSphysicianSfeelsSthatSheSshouldSbeShospitalized.SWha
tSshouldSyouStellSMr.SRaineyS(orShisSrepresentative)SaboutStheSlengthSofSanSinpatientSpsychiatricShospitalSsta
ySthatSMedicareSwillScover?S-ScorrectSanswer-
MedicareSwillScoverSaStotalSofS190SdaysSofSinpatientSpsychiatricScareSduringSMr.SRainey'sSentireSlifetime.



Mr.SXiSwillSsoonSturnSageS65SandShasScomeStoSyouSforSadviceSasStoSwhatSservicesSareSprovidedSunderSOrigin
alSMedicare.SWhatSshouldSyouStellSMr.SXiSthatSbestSdescribesStheShealthScoverageSprovidedStoSMedicareSbe
neficiaries?S-ScorrectSanswer-BeneficiariesSunderSOriginalSMedicareShaveSnoScost-
sharingSforSmostSpreventiveSservices.



Mr.SSinghSwouldSlikeSdrugScoverageSbutSdoesSnotSwantStoSbeSenrolledSinSaSMedicareSAdvantageSplan.SWhatS
shouldSyouStellShim?S-ScorrectSanswer-Mr.SSinghScanSenrollSinSaSstand-
aloneSprescriptionSdrugSplanSandScontinueStoSbeScoveredSforSPartSASandSPartSBSservicesSthroughSOriginalSFe
e-for-ServiceSMedicare.



Mrs.SChenSwillSbeS65Ssoon,ShasSbeenSaScitizenSforStwelveSyears,ShasSbeenSemployedSfullStime,SandSpaidStaxe
sSduringSthatSentireSperiod.SSheSisSconcernedSthatSsheSwillSnotSqualifySforScoverageSunderSpartSASbecauseSs
heSwasSnotSbornSinStheSUnitedSStates.SWhatSshouldSyouStellSher?S-ScorrectSanswer-
MostSindividualsSwhoSareScitizensSandSageS65SorSoverSareScoveredSunderSPartSASbySvirtueSofShavingSpaidSMe
dicareStaxesSwhileSworking,SthoughSsomeSmaySbeScoveredSasSaSresultSofSpayingSmonthlySpremiums.



Mrs.SQuinnSrecentlySturnedS66SandSdecidedSafterSmanySyearsSofSworkStoSretireSandSbeginSreceivingSSocialSS
ecuritySbenefits.SShortlySthereafterSMrs.SQuinnSreceivedSaSletterSinformingSherSthatSsheShadSbeenSautomat
icallySenrolledSinSMedicareSPartSB.SSheSwantsStoSunderstandSwhatSthisSmeans.SWhatSshouldSyouStellSMrs.SQ

, uinn?S-ScorrectSanswer-
PartSBSprimarilyScoversSphysicianSservices.SSheSwillSbeSpayingSaSmonthlySpremiumSand,SexceptSforSmanySpr
eventiveSandSscreeningStests,SgenerallySwillShaveS20%Sco-
paymentsSforStheseSservices,SinSadditionStoSanSannualSdeductible.



Mr.SPatelSisSinSgoodShealthSandSisSpreparingSaSbudgetSinSanticipationSofShisSretirementSwhenSheSturnsS66.SH
eSwantsStoSunderstandStheShealthScareScostsSheSmightSbeSexposedStoSunderSMedicareSifSheSwereStoSrequire
ShospitalizationSbecauseSofSanSillness.SInSgeneralSterms,SwhatScouldSyouStellShimSaboutShisScostsSforSinpatie

ntShospitalSservicesSunderSOriginalSMedicare?S-ScorrectSanswer-
UnderSOriginalSMedicare,SthereSisSaSsingleSdeductibleSamountSdueSforStheSfirstS60SdaysSofSanySinpatientShos
pitalSstay,SafterSwhichSitSconvertsSintoSaSper-
dayScoinsuranceSamountSthroughSdayS90.SAfterSdayS90,SheSwouldSpaySaSdailySamountSupStoS60SdaysSoverShi
sSlifetime,SafterSwhichSheSwouldSbeSresponsibleSforSallScosts.



WhatSimpact,SifSany,ShaveSrecentSregulatorySchangesShadSonSMedigapSplans?S-ScorrectSanswer-
TheSPartSBSdeductibleSisSnoSlongerScoveredSforSindividualsSnewlySeligibleSforSMedicareSstartingSJanuaryS1,S2
020.



Mrs.SPatersonSisSconcernedSaboutStheSdeductiblesSandSco-
paymentsSassociatedSwithSOriginalSMedicare.SWhatScanSyouStellSherSaboutSMedigapSasSanSoptionStoSaddres
sSthisSconcern?S-ScorrectSanswer-
MedigapSplansSdoSnotScoverSOriginalSMedicareSbenefits,SbutStheyScoordinateSwithSOriginalSMedicareScover
age.



Mrs.STurnerSisScomparingSherSemployer'sSretireeSinsuranceStoSOriginalSMedicareSandSwouldSlikeStoSknowSw
hichSofStheSfollowingSservicesSOriginalSMedicareSwillScoverSifStheSappropriateScriteriaSareSmet.SWhatScouldS
youStellSher?S-ScorrectSanswer-OriginalSMedicareScoversSambulanceSservices.



Ms.SBrooksShasSaggressiveScancerSandSwouldSlikeStoSknowSifSMedicareSwillScoverShospiceSservicesSinScaseSs
heSneedsSthem.SWhatSshouldSyouStellSher?S-ScorrectSanswer-
MedicareScoversShospiceSservices,SandStheySwillSbeSavailableSforSher.



Mr.SDiazScontinuedSworkingSwithShisScompanySandSwasSinsuredSunderShisSemployer'sSgroupSplanSuntilSheSr
eachedSageS68.SHeShasSheardSthatSthereSisSaSpremiumSpenaltySforSthoseSwhoSdidSnotSsignSupSforSPartSBSwhe
nSfirstSeligibleSandSwantsStoSknowShowSmuchSheSwillShaveStoSpay.SWhatSshouldSyouStellShim?S-
ScorrectSanswer-

Mr.SDiazSwillSnotSpaySanySpenaltySbecauseSheShadScontinuousScoverageSunderShisSemployer'sSplan.