AHIP Final Exam 2025 with
100% correct answers
2025(passed)
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.
Mr. Diaz continued working with his company and was insured under his
employer's group plan until he reached age 68. He has heard that there is
a premium penalty for those who did not sign up for Part B when first
eligible and wants to know how much he will have to pay. What should you
tell him? - answer Mr. Diaz will not pay any penalty because he had
continuous coverage under his employer's plan.
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? - answer
Medicare will cover Mrs. Shield's skilled nursing services provided during
the first 20 days of her stay, after which she would have a copay until she
has been in the facility for 100 days.
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.
Mrs. Turner is comparing her employer's retiree insurance to Original
Medicare and would like to know which of the following services Original
, Medicare will cover if the appropriate criteria are met. What could you tell
her? - answer Original Medicare covers ambulance services.
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.
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. 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.
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.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that
you represent. It is one of three plans operated by the same organization
in Mr. Lombardi's area. The MA PPO plan does not include drug coverage,
but the other two plans do. Mr. Lombardi likes the PPO plan that does not
include drug coverage and intends to obtain his drug coverage through a
stand-alone Medicare prescription drug plan. What should you tell him
about this situation? - answer He could enroll either in one of the MA
plans that include prescription drug coverage or Original Medicare with a
Medigap plan and standalone Part D prescription drug coverage, but he
cannot enroll in the MA-only PPO plan and a stand-alone prescription drug
plan.
100% correct answers
2025(passed)
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.
Mr. Diaz continued working with his company and was insured under his
employer's group plan until he reached age 68. He has heard that there is
a premium penalty for those who did not sign up for Part B when first
eligible and wants to know how much he will have to pay. What should you
tell him? - answer Mr. Diaz will not pay any penalty because he had
continuous coverage under his employer's plan.
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? - answer
Medicare will cover Mrs. Shield's skilled nursing services provided during
the first 20 days of her stay, after which she would have a copay until she
has been in the facility for 100 days.
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.
Mrs. Turner is comparing her employer's retiree insurance to Original
Medicare and would like to know which of the following services Original
, Medicare will cover if the appropriate criteria are met. What could you tell
her? - answer Original Medicare covers ambulance services.
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.
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. 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.
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.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that
you represent. It is one of three plans operated by the same organization
in Mr. Lombardi's area. The MA PPO plan does not include drug coverage,
but the other two plans do. Mr. Lombardi likes the PPO plan that does not
include drug coverage and intends to obtain his drug coverage through a
stand-alone Medicare prescription drug plan. What should you tell him
about this situation? - answer He could enroll either in one of the MA
plans that include prescription drug coverage or Original Medicare with a
Medigap plan and standalone Part D prescription drug coverage, but he
cannot enroll in the MA-only PPO plan and a stand-alone prescription drug
plan.
