2025 AHIP TRAINING EXAM QUESTIONS AND ANSWERS 100- SOLVED
(Newest 2025)
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 ANSWERS<<>>>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. 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
ANSWERS<<>>>Medicare does not cover massage therapy, or, in general, glasses or
dentures.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell
Mrs. Park that might be of assistance? - CORRECT ANSWERS<<>>>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.
Mr. Alonso receives some help paying for his two generic prescription drugs from his
employer's retiree coverage, but he wants to compare it to a Part D prescription drug
plan. He asks you what costs he would generally expect to encounter when enrolling
into a standard Medicare Part D prescription drug plan. What should you tell him? -
CORRECT ANSWERS<<>>>He generally would pay a monthly premium, annual
deductible, and per-prescription cost-sharing.
,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? - CORRECT ANSWERS<<>>>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.
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? - CORRECT ANSWERS<<>>>He may
sign-up for Medicare at any time however coverage usually begins on the fourth
month after dialysis treatments start.
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently reviewed
her Medicare Summary Notice (MSN) and disagrees with a determination that
partially denied one of her claims for services. What advice would you give her? -
CORRECT ANSWERS<<>>>Mrs. Duarte should file an appeal of this initial determination
within 120 days of the date she received the MSN in the mail.
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? - CORRECT
ANSWERS<<>>>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.
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
, ANSWERS<<>>>Medicare will cover a total of 190 days of inpatient psychiatric care
during Mr. Rainey's entire lifetime.
Mr. Xi will soon turn age 65 and has come to you for advice as to what services are
provided under Original Medicare. What should you tell Mr. Xi that best describes the
health coverage provided to Medicare beneficiaries? - CORRECT
ANSWERS<<>>>Beneficiaries under Original Medicare have no cost-sharing for most
preventive services.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare
Advantage plan. What should you tell him? - CORRECT ANSWERS<<>>>Mr. Singh can
enroll in a stand-alone prescription drug plan and continue to be covered for Part A
and Part B services through Original Fee-for-Service Medicare.
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? - CORRECT ANSWERS<<>>>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.
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? - CORRECT
ANSWERS<<>>>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.
(Newest 2025)
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 ANSWERS<<>>>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. 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
ANSWERS<<>>>Medicare does not cover massage therapy, or, in general, glasses or
dentures.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell
Mrs. Park that might be of assistance? - CORRECT ANSWERS<<>>>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.
Mr. Alonso receives some help paying for his two generic prescription drugs from his
employer's retiree coverage, but he wants to compare it to a Part D prescription drug
plan. He asks you what costs he would generally expect to encounter when enrolling
into a standard Medicare Part D prescription drug plan. What should you tell him? -
CORRECT ANSWERS<<>>>He generally would pay a monthly premium, annual
deductible, and per-prescription cost-sharing.
,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? - CORRECT ANSWERS<<>>>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.
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? - CORRECT ANSWERS<<>>>He may
sign-up for Medicare at any time however coverage usually begins on the fourth
month after dialysis treatments start.
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently reviewed
her Medicare Summary Notice (MSN) and disagrees with a determination that
partially denied one of her claims for services. What advice would you give her? -
CORRECT ANSWERS<<>>>Mrs. Duarte should file an appeal of this initial determination
within 120 days of the date she received the MSN in the mail.
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? - CORRECT
ANSWERS<<>>>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.
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
, ANSWERS<<>>>Medicare will cover a total of 190 days of inpatient psychiatric care
during Mr. Rainey's entire lifetime.
Mr. Xi will soon turn age 65 and has come to you for advice as to what services are
provided under Original Medicare. What should you tell Mr. Xi that best describes the
health coverage provided to Medicare beneficiaries? - CORRECT
ANSWERS<<>>>Beneficiaries under Original Medicare have no cost-sharing for most
preventive services.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare
Advantage plan. What should you tell him? - CORRECT ANSWERS<<>>>Mr. Singh can
enroll in a stand-alone prescription drug plan and continue to be covered for Part A
and Part B services through Original Fee-for-Service Medicare.
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? - CORRECT ANSWERS<<>>>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.
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? - CORRECT
ANSWERS<<>>>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.
