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Exam (elaborations)

AHIP QUESTIONS WITH CORRECT ANSWERS 2025

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AHIP QUESTIONS WITH CORRECT ANSWERS 2025

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HTHSCI
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HTHSCI
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HTHSCI

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March 13, 2025
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38
Written in
2024/2025
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AHIP QUESTIONS WITH CORRECT
ANSWERS 2025/2026
Ms.AMooreAplansAtoAretireAwhenAsheAturnsA65AinAaAfewAmonths.ASheAisAinAexcellentAhealthAandA
willAhaveAconsiderableAincomeAwhenAsheAretires.ASheAisAconcernedAthatAherAincomeAwillAmake
AitAimpossibleAforAherAtoAqualifyAforAMedicare.AWhatAcouldAyouAtellAherAtoAaddressAherAconcer


n?A-
AcorrectAanswersMedicareAisAaAprogramAforApeopleAageA65AorAolderAandAthoseAunderAageA65Aw


ithAcertainAdisabilities,AendAstageArenalAdiseaseAandALouAGehrig'sAdisease,AsoAsheAwillAbeAeligibl
eAforAMedicare.

Mr.ASchmidtAwouldAlikeAtoAplanAforAretirementAandAhasAaskedAyouAwhatAisAcoveredAunderAOrigi
nalAFee-for-ServiceA(FFS)AMedicare?AWhatAcouldAyouAtellAhim?A-
AcorrectAanswersPartAA,AwhichAcoversAhospital,AskilledAnursingAfacility,AhospiceAandAhomeAheal


thAservicesAandAPartAB,AwhichAcoversAprofessionalAservicesAsuchAasAthoseAprovidedAbyAaAdocto
rAareAcoveredAunderAOriginalAMedicare.

Mr.AHernandezAisAconcernedAthatAifAheAsignsAupAforAaAMedicareAAdvantageAplan,AtheAhealthApl
anAmay,AatAsomeAtimeAinAtheAfuture,AreduceAhisAbenefitsAbelowAwhatAisAavailableAinAOriginalAM
edicare.AWhatAshouldAyouAtellAhimAaboutAhisAconcern?A-
AcorrectAanswersMedicareAhealthAplansAmustAcoverAallAbenefitsAavailableAunderAMedicareAPar


tAAAandAPartAB.AManyAalsoAcoverAPartADAprescriptionAdrugs.

Mrs.ARobertsAhasAjustAreceivedAaAnewAMedicareAidentityAcardAinAtheAmail.ASheAisAconcernedAth
atAitAisAaAforgeryAsinceAitAdoesAnotAhaveAherASocialASecurityAnumberAonAit.AWhatAshouldAyouAtel
lAher?A-
AcorrectAanswersTheAcardAsheAreceivedAisAvalid,AtheAchangeAhasAbeenAmadeAtoAprotectAMedica


reAbeneficiariesAfromAidentityAtheft,AandAsheAshouldAnowAdestroyAherAoldAcard.

Mrs.AWillardAwantsAtoAknowAgenerallyAhowAtheAbenefitsAunderAOriginalAMedicareAmightAcomp
areAtoAtheAbenefitApackageAofAaAMedicareAHealthAPlanAbeforeAsheAstartsAlookingAatAspecificApla
ns.AWhatAcouldAyouAtellAher?A-
AcorrectAanswersMedicareAHealthAPlansAmayAofferAextraAbenefitsAthatAOriginalAMedicareAdoes


AnotAofferAsuchAasAvision,Ahearing,AandAdentalAservicesAandAmustAincludeAaAmaximumAout-of-


pocketAlimitAonAPartAAAandAPartABAservices.

Mr.AMeoni'sAwifeAhasAaAMedicareAAdvantageAplan,AbutAheAwantsAtoAunderstandAwhatAcoverag
eAMedicareASupplementalAInsuranceAprovidesAsinceAhisAhealthAcareAneedsAareAdifferentAfromA
hisAwife'sAneeds.AWhatAcouldAyouAtellAMr.Meoni?A-
AcorrectAanswersMedicareASupplementalAInsuranceAwouldAhelpAcoverAhisAPartAAAandAPartABAco


stAsharingAinAOriginalAFee-for-
ServiceA(FFS)AMedicareAasAwellAasApossiblyAsomeAservicesAthatAMedicareAdoesAnotAcover.

,Mrs.AChenAwillAbeA65Asoon,AhasAbeenAaAcitizenAforAtwelveAyears,AhasAbeenAemployedAfullAtime,A
andApaidAtaxesAduringAthatAentireAperiod.ASheAisAconcernedAthatAsheAwillAnotAqualifyAforAcover
ageAunderApartAAAbecauseAsheAwasAnotAbornAinAtheAUnitedAStates.AWhatAshouldAyouAtellAher?A-
AcorrectAanswersMostAindividualsAwhoAareAcitizensAandAoverAageA65AareAcoveredAunderAPartAAA


byAvirtueAofAhavingApaidAMedicareAtaxesAwhileAworking,AthoughAsomeAmayAbeAcoveredAasAaAre
sultAofApayingAmonthlyApremiums.

Mr.ABauerAisA49AyearsAold,AbutAeighteenAmonthsAagoAheAwasAdeclaredAdisabledAbyAtheASocialAS
ecurityAAdministrationAandAhasAbeenAreceivingAdisabilityApayments.AHeAisAwonderingAwhether
AheAcanAobtainAcoverageAunderAMedicare.AWhatAshouldAyouAtellAhim?A-


AcorrectAanswersAfterAreceivingAsuchAdisabilityApaymentsAforA24Amonths,AheAwillAbeAautomatic


allyAenrolledAinAMedicare,AregardlessAofAage.

Mr.ADentonAisA52AyearsAoldAandAhasArecentlyAbeenAdiagnosedAwithAend-
stageArenalAdiseaseA(ESRD)AandAwillAsoonAbeginAdialysis.AHeAisAwonderingAifAheAcanAobtainAcov
erageAunderAMedicare.AWhatAshouldAyouAtellAhim?A-AcorrectAanswersHeAmayAsign-
upAforAMedicareAatAanyAtimeAhoweverAcoverageAusuallyAbeginsAonAtheAfourthAmonthAafterAdial
ysisAtreatmentsAstart.

Ms.AHendersonAbelievesAthatAsheAwillAqualifyAforAMedicareAcoverageAwhenAsheAturnsA65,Awith
outApayingAanyApremiums,AbecauseAsheAhasAbeenAworkingAforA40AyearsAandApayingAMedicareAt
axes.AWhatAshouldAyouAtellAher?A-
AcorrectAanswersInAorderAtoAobtainAPartABAcoverage,AsheAmustApayAaAstandardAmonthlyApremi


um,AthoughAitAisAhigherAforAindividualsAwithAhigherAincomes.

Mr.ADiazAcontinuedAworkingAwithAhisAcompanyAandAwasAinsuredAunderAhisAemployer'sAgroupAp
lanAuntilAheAreachedAageA68.AHeAhasAheardAthatAthereAisAaApremiumApenaltyAforAthoseAwhoAdid
AnotAsignAupAforAPartABAwhenAfirstAeligibleAandAwantsAtoAknowAhowAmuchAheAwillAhaveAtoApay.A


WhatAshouldAyouAtellAhim?A-
AcorrectAanswersMr.ADiazAwillAnotApayAanyApenaltyAbecauseAheAhadAcontinuousAcoverageAunde


rAhisAemployer'sAplan.

Mrs.APeňaAisA66AyearsAold,AhasAcoverageAunderAanAemployerAplanAandAwillAretireAnextAyear.ASh
eAheardAsheAmustAenrollAinAPartABAatAtheAbeginningAofAtheAyearAtoAensureAnoAgapAinAcoverage.A
WhatAcanAyouAtellAher?A-
AcorrectAanswersSheAmayAenrollAatAanyAtimeAwhileAsheAisAcoveredAunderAherAemployerAplan,Ab


utAsheAwillAhaveAaAspecialAeight-
monthAenrollmentAperiodAthatAdiffersAfromAtheAstandardAgeneralAenrollmentAperiod,AduringAw
hichAsheAmayAenrollAinAMedicareAPartAB.

Mrs.AKelly,AageA65,AisAentitledAtoAPartAA,AbutAhasAnotAyetAenrolledAinAPartAB.ASheAisAconsideringA
enrollmentAinAaAMedicareAhealthAplanA(PartAC).AWhatAshouldAyouAadviseAherAtoAdoAbeforeAsheA
willAbeAableAtoAenrollAintoAaAMedicareAhealthAplan?A-
AcorrectAanswersInAorderAtoAjoinAaAMedicareAhealthAplan,AsheAalsoAmustAenrollAinAPartAB.

,Mrs.AParkAisAanAelderlyAretiree.ASheAhasAaAlow,AfixedAincome.AWhatAcouldAyouAtellAMrs.AParkAth
atAmightAbeAofAassistance?A-
AcorrectAanswersSheAshouldAcontactAherAstateAMedicaidAagencyAtoAseeAifAsheAqualifiesAforAoneA


ofAseveralAprogramsAthatAcanAhelpAwithAMedicareAcostsAforAwhichAsheAisAresponsible.

Mr.AWuAisAeligibleAforAMedicare.AHeAhasAlimitedAfinancialAresourcesAbutAfailedAtoAqualifyAforAth
eAPartADAlow-
incomeAsubsidy.AWhereAmightAheAturnAforAhelpAwithAhisAprescriptionAdrugAcosts?A-
AcorrectAanswersMr.AWuAmayAstillAqualifyAforAhelpAinApayingAPartADAcostsAthroughAhisAStateAPha


rmaceuticalAAssistanceAProgram.

Mr.APatelAisAinAgoodAhealthAandAisApreparingAaAbudgetAinAanticipationAofAhisAretirementAwhenA
heAturnsA66.AHeAwantsAtoAunderstandAtheAhealthAcareAcostsAheAmightAbeAexposedAtoAunderAM
edicareAifAheAwereAtoArequireAhospitalizationAasAaAresultAofAanAillness.AInAgeneralAterms,AwhatAc
ouldAyouAtellAhimAaboutAhisAcostsAforAinpatientAhospitalAservicesAunderAOriginalAMedicare?A-
AcorrectAanswersUnderAOriginalAMedicare,AthereAisAaAsingleAdeductibleAamountAdueAforAtheAfir


stA60AdaysAofAanyAinpatientAhospitalAstay,AafterAwhichAitAconvertsAintoAaAper-
dayAcoinsuranceAamountAthroughAdayA90.AAfterAdayA90,AheAwouldApayAaAdailyAamountAupAtoA6
0AdaysAoverAhisAlifetime,AafterAwhichAheAwouldAbeAresponsibleAforAallAcosts

Mrs.AShieldsAisAcoveredAbyAOriginalAMedicare.ASheAsustainedAaAhipAfractureAandAisAbeingAsucce
ssfullyAtreatedAforAthatAcondition.AHowever,AsheAandAherAphysiciansAfeelAthatAafterAherAlengthy
AhospitalAstayAsheAwillAneedAaAmonthAorAtwoAofAnursingAandArehabilitativeAcare.AWhatAshouldAy


ouAtellAthemAaboutAOriginalAMedicare'sAcoverageAofAcareAinAaAskilledAnursingAfacility?A-
AcorrectAanswersMedicareAwillAcoverAMrs.AShields'AskilledAnursingAservicesAprovidedAduringAth


eAfirstA20AdaysAofAherAstay,AafterAwhichAsheAwouldAhaveAaAcoinsuranceAuntilAsheAhasAbeenAinAth
eAfacilityAforA100Adays

Mr.ARaineyAisAexperiencingAparanoidAdelusionsAandAhisAphysicianAfeelsAthatAheAshouldAbeAhosp
italized.AWhatAshouldAyouAtellAMr.ARaineyA(orAhisArepresentative)AaboutAtheAlengthAofAanAinpati
entApsychiatricAhospitalAstayAthatAMedicareAwillAcover?A-
AcorrectAanswersMedicareAwillAcoverAaAtotalAofA190AdaysAofAinpatientApsychiatricAcareAduringA


Mr.ARainey'sAentireAlifetime.

Mrs.AQuinnAhasArecentlyAturnedA66AandAdecidedAafterAmanyAyearsAofAworkAtoAbeginAreceivingA
SocialASecurityAbenefits.AShortlyAthereafterAMrs.AQuinnAreceivedAaAletterAinformingAherAthatAsh
eAhasAbeenAautomaticallyAenrolledAinAMedicareAPartAB.ASheAwantsAtoAunderstandAwhatAthisAm
eans.AWhatAshouldAyouAtellAMrs.AQuinn?A-
AcorrectAanswersPartABAprimarilyAcoversAphysicianAservices.ASheAwillAbeApayingAaAmonthlyApre


miumAand,AwithAtheAexceptionAofAmanyApreventiveAandAscreeningAtests,AgenerallyAwillAhaveA2
0%Aco-paymentsAforAtheseAservices,AinAadditionAtoAanAannualAdeductible.

Mr.ABuckAhasAseveralAfamilyAmembersAwhoAdiedAfromAdifferentAcancers.AHeAwantsAtoAknowAifA
MedicareAcoversAcancerAscreening.AWhatAshouldAyouAtellAhim?A-

, AcorrectAanswersMedicareAcoversAperiodicAperformanceAofAaArangeAofAscreeningAtestsAthatAare
AmeantAtoAprovideAearlyAdetectionAofAdisease.AMr.ABuckAwillAneedAtoAcheckAspecificAtestsAbefor


eAobtainingAthemAtoAseeAifAtheyAwillAbeAcovered

Mrs.ATurnerAisAcomparingAherAemployer'sAretireeAinsuranceAtoAOriginalAMedicareAandAwouldAli
keAtoAknowAwhichAofAtheAfollowingAservicesAOriginalAMedicareAwillAcoverAifAtheAappropriateAcri
teriaAareAmet?AWhatAcouldAyouAtellAher?A-
AcorrectAanswersOriginalAMedicareAcoversAambulanceAservices.



Mrs.AWolfAwearsAglassesAandAdenturesAandAhasAenjoyedAconsiderableApainAreliefAfromAarthriti
sAthroughAacupuncture.ASheAisAconcernedAaboutAwhetherAorAnotAMedicareAwillAcoverAtheseAit
emsAandAservices.AWhatAshouldAyouAtellAher?A-
AcorrectAanswersMedicareAdoesAnotAcoverAacupuncture,Aor,AinAgeneral,AglassesAorAdentures.



Mr.ASinghAwouldAlikeAdrugAcoverage,AbutAdoesAnotAwantAtoAbeAenrolledAintoAaAhealthAplan.AWh
atAshouldAyouAtellAhim?A-AcorrectAanswersMr.ASinghAcanAenrollAinAaAstand-
aloneAprescriptionAdrugAplanAandAcontinueAtoAbeAcoveredAforAPartAAAandAPartABAservicesAthrou
ghAOriginalAFee-for-ServiceAMedicare.

Mr.AAlonsoAreceivesAsomeAhelpApayingAforAhisAtwoAgenericAprescriptionAdrugsAfromAhisAemplo
yer'sAretireeAcoverage,AbutAheAwantsAtoAcompareAitAtoAaAPartADAprescriptionAdrugAplan.AHeAask
sAyouAwhatAcostsAheAwouldAgenerallyAexpectAtoAencounterAwhenAenrollingAintoAaAstandardAMe
dicareAPartADAprescriptionAdrugAplan.AWhatAshouldAyouAtellAhim?A-
AcorrectAanswersHeAgenerallyAwouldApayAaAmonthlyApremium,AannualAdeductible,AandAper-


prescriptionAcostAsharing

Mrs.AGeisler'sAneighborAtoldAherAsheAshouldAlookAatAherAPartADAoptionsAduringAtheAannualAMe
dicareAenrollmentAperiodAbecauseAfeaturesAofAPartADAmightAhaveAchanged.AMrs.AGeislerAcan'tA
rememberAwhatAPartADAisAsoAsheAcalledAyouAtoAaskAwhatAherAneighborAwasAtalkingAabout.AWha
tAcouldAyouAtellAher?A-
AcorrectAanswersPartADAcoversAprescriptionAdrugsAandAsheAshouldAlookAatAherApremiums,Aform


ulary,AandAcostAsharingAamongAotherAfactorsAtoAseeAifAtheyAhaveAchanged.

Mrs.APatersonAisAconcernedAaboutAtheAdeductiblesAandAco-
paymentsAassociatedAwithAOriginalAMedicare.AWhatAcanAyouAtellAherAaboutAMedigapAasAanAop
tionAtoAaddressAthisAconcern?A-
AcorrectAanswersMedigapAplansAhelpAbeneficiariesAcoverAcoinsurance,Aco-


payments,Aand/orAdeductiblesAforAmedicallyAnecessaryAservices.

Mrs.AGonzalezAisAenrolledAinAOriginalAMedicareAandAhasAaAMedigapApolicyAasAwell,AbutAitAprovi
desAnoAdrugAcoverage.ASheAwouldAlikeAtoAkeepAtheAcoverageAsheAhas,AbutAreplaceAherAexistingA
MedigapAplanAwithAoneAthatAprovidesAdrugAcoverage.AWhatAshouldAyouAtellAher?A-
AcorrectAanswersMrs.AGonzalezAcannotApurchaseAaAMedigapAplanAthatAcoversAdrugs,AbutAsheAc


ouldAkeepAherAMedigapApolicyAandAenrollAinAaAPartADAprescriptionAdrugAplan.
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