Ahip 2025 final Exam with Correct Answers
Mrs. Paterson is concerned about the deductibles and co-payments associated with Original Medicare.
What can you tell her about Medigap as an option to address this concern? - CORRECT ANSWER -
Medigap plans help beneficiaries cover Original Medicare benefits, but they coordinate with Original
Medicare coverage.
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? - CORRECT ANSWER - 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.
What impact, if any, have recent regulatory changes had on Medigap plans? - CORRECT ANSWER - b.
The Part B deductible is no longer covered for individuals newly eligible for Medicare starting January 1,
2020.
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? - CORRECT ANSWER - Medicare will cover a total of 190 days of
inpatient psychiatric care during Mr. Rainey's entire lifetime.
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is being successfully
treated for that condition. However, she and her physicians feel that after her lengthy hospital stay, she
will need a month or two of nursing and rehabilitative care. What should you tell them about Original
Medicare's coverage of care in a skilled nursing facility? - CORRECT ANSWER -
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? - CORRECT ANSWER - Medicare does not cover massage therapy, or, in
general, glasses or dentures.
, Ms. Gibson recently lost her employer group health and drug coverage and now she wants to enroll in a
PPO that does not include drug coverage. What should you tell her about obtaining drug coverage? -
CORRECT ANSWER - She can enroll in the PPO, but she will not be able to purchase a stand-alone
Medicare Part D prescription drug plan.
Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage. What
should you tell her? - CORRECT ANSWER - Mrs. Radford must be entitled to Part A and enrolled in Part B
to enroll in Medicare Advantage.
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 thought
would be fully covered. He called you to ask what he could do? What could you tell him? - CORRECT
ANSWER - You can offer to review the plans appeal process to help him ask the plan to review the
coverage decision.
Mr. Sanchez has just turned 65 and is entitled to Part A but has not enrolled in Part B because he has
coverage through an employer plan. If he wants to enroll in a Medicare Advantage plan, what will he
have to do? - CORRECT ANSWER - He will have to enroll in Part B.
Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan's terms and
conditions for payment. Mary Rodgers sees Dr. Brennan for treatment. How much may Dr. Brennan
charge? - CORRECT ANSWER -
Mrs. Chou likes a Private Fee-for-Service (PFFS) plan available in her area that does not include drug
coverage. She wants to enroll in the plan and enroll in a stand-alone prescription drug plan. What should
you tell her? - CORRECT ANSWER - She could enroll in a PFFS plan and a stand-alone Medicare
prescription drug plan.
Mrs. Paterson is concerned about the deductibles and co-payments associated with Original Medicare.
What can you tell her about Medigap as an option to address this concern? - CORRECT ANSWER -
Medigap plans help beneficiaries cover Original Medicare benefits, but they coordinate with Original
Medicare coverage.
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? - CORRECT ANSWER - 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.
What impact, if any, have recent regulatory changes had on Medigap plans? - CORRECT ANSWER - b.
The Part B deductible is no longer covered for individuals newly eligible for Medicare starting January 1,
2020.
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? - CORRECT ANSWER - Medicare will cover a total of 190 days of
inpatient psychiatric care during Mr. Rainey's entire lifetime.
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is being successfully
treated for that condition. However, she and her physicians feel that after her lengthy hospital stay, she
will need a month or two of nursing and rehabilitative care. What should you tell them about Original
Medicare's coverage of care in a skilled nursing facility? - CORRECT ANSWER -
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? - CORRECT ANSWER - Medicare does not cover massage therapy, or, in
general, glasses or dentures.
, Ms. Gibson recently lost her employer group health and drug coverage and now she wants to enroll in a
PPO that does not include drug coverage. What should you tell her about obtaining drug coverage? -
CORRECT ANSWER - She can enroll in the PPO, but she will not be able to purchase a stand-alone
Medicare Part D prescription drug plan.
Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage. What
should you tell her? - CORRECT ANSWER - Mrs. Radford must be entitled to Part A and enrolled in Part B
to enroll in Medicare Advantage.
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 thought
would be fully covered. He called you to ask what he could do? What could you tell him? - CORRECT
ANSWER - You can offer to review the plans appeal process to help him ask the plan to review the
coverage decision.
Mr. Sanchez has just turned 65 and is entitled to Part A but has not enrolled in Part B because he has
coverage through an employer plan. If he wants to enroll in a Medicare Advantage plan, what will he
have to do? - CORRECT ANSWER - He will have to enroll in Part B.
Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan's terms and
conditions for payment. Mary Rodgers sees Dr. Brennan for treatment. How much may Dr. Brennan
charge? - CORRECT ANSWER -
Mrs. Chou likes a Private Fee-for-Service (PFFS) plan available in her area that does not include drug
coverage. She wants to enroll in the plan and enroll in a stand-alone prescription drug plan. What should
you tell her? - CORRECT ANSWER - She could enroll in a PFFS plan and a stand-alone Medicare
prescription drug plan.
