2025 AHIP - Final Exam with Answers
1. a: 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?
Question 1Answera.Medicare will cover a total of 190 days of inpatient psychiatric
care during Mr. Rainey's entire lifetime.b.Medicare will cover, at its allowable amount,
as many stays as are needed throughout Mr. Rainey's life, as long as no single stay
exceeds 190 days.c.Medicare inpatient psychiatric coverage is limited to the same
number of days covered for typical inpatient stays.d.Inpatient psychiatric services
are not covered under Original Medicare.
2. a: 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?
Question 2Answera.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.b.Part D covers physician and non-physician practitioner services and the
deductible has not changed this year, but the physician charges may go up.c.Part D
covers long-term care services, and she should not worry because there has been
no change in coverage. d.Part D covers hospital and home health services and the
cost-sharing has changed this year.
3. b: 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?
Question 3Answera.Medigap is a replacement for Original Medicare and she has
been paying for double coverage. She should simply drop her Medigap policy.b.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.c.Mrs. Gonzalez
can purchase a Medigap plan that covers drugs, but it likely will not offer coverage
that is equivalent to that provided under Part D.d.Mrs. Gonzalez should purchase a
K or L Medigap plan.
4. b: 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?
Question 4Answera.He may not sign-up for Medicare until he reaches age 62,
the date he first becomes eligible for Social Security benefits.b.He may sign-up
for Medicare at any time however coverage usually begins on the fourth month
after dialysis treatments start.c.He may sign-up for Medicare at any time however
1/3
1. a: 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?
Question 1Answera.Medicare will cover a total of 190 days of inpatient psychiatric
care during Mr. Rainey's entire lifetime.b.Medicare will cover, at its allowable amount,
as many stays as are needed throughout Mr. Rainey's life, as long as no single stay
exceeds 190 days.c.Medicare inpatient psychiatric coverage is limited to the same
number of days covered for typical inpatient stays.d.Inpatient psychiatric services
are not covered under Original Medicare.
2. a: 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?
Question 2Answera.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.b.Part D covers physician and non-physician practitioner services and the
deductible has not changed this year, but the physician charges may go up.c.Part D
covers long-term care services, and she should not worry because there has been
no change in coverage. d.Part D covers hospital and home health services and the
cost-sharing has changed this year.
3. b: 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?
Question 3Answera.Medigap is a replacement for Original Medicare and she has
been paying for double coverage. She should simply drop her Medigap policy.b.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.c.Mrs. Gonzalez
can purchase a Medigap plan that covers drugs, but it likely will not offer coverage
that is equivalent to that provided under Part D.d.Mrs. Gonzalez should purchase a
K or L Medigap plan.
4. b: 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?
Question 4Answera.He may not sign-up for Medicare until he reaches age 62,
the date he first becomes eligible for Social Security benefits.b.He may sign-up
for Medicare at any time however coverage usually begins on the fourth month
after dialysis treatments start.c.He may sign-up for Medicare at any time however
1/3
