AHIP FINAL EXAM, PRACTICE EXAM
AND STUDY GUIDE LATEST
VERSION 2025/2026 ALL ANSWERS
HIGHLIGHTED FOR YOUR SUCCESS
100% GUARANTEED [A+]
,AHIP FINAL EXAM, PRACTICE EXAM AND STUDY GUIDE LATEST
VERSION 2025/2026 ALL ANSWERS HIGHLIGHTED FOR YOUR
SUCCESS 100% GUARANTEED [A+]
1. 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?: 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.
2. 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?: MEDICARE DOES NOT COVER MASSAGE THERAPY, OR, IN GENERAL,
GLASSES OR DENTURES.
3. MRS. PARK IS AN ELDERLY RETIREE. MRS. PARK HAS A LOW FIXED
INCOME. WHAT COULD YOU TELL MRS. PARK THAT MIGHT BE OF
ASSISTANCE?: 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.
4. 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?: HE
GENERALLY WOULD PAY A MONTHLY PREMIUM, ANNUAL DEDUCTIBLE,
AND PER-PRESCRIPTION COST-SHARING.
5. 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?: 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.
6. 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?: HE MAY SIGN-UP FOR
MEDICARE AT ANY TIME HOWEVER COVERAGE USUALLY BEGINS ON THE
FOURTH MONTH AFTER DIALYSIS TREATMENTS START.
7. MRS. DUARTE IS ENROLLED IN ORIGINAL MEDICARE PARTS A AND B.
SHE HAS RECENTLY REVIEWED HER MEDICARE SUMMARY NOTICE (MSN)
AND DISAGREES WITH A DETERMI- NATION THAT PARTIALLY DENIED
ONE OF HER CLAIMS FOR SERVICES. WHAT ADVICE WOULD YOU GIVE
HER?: MRS. DUARTE SHOULD FILE AN APPEAL OF THIS INITIAL
DETERMINATION WITHIN 120 DAYS OF THE DATE SHE RECEIVED THE
MSN IN THE MAIL.
, 8. 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?: 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.
9. MR. RAINEY IS EXPERIENCING PARANOID DELUSIONS AND HIS
PHYSICIAN FEELS THAT HE SHOULD BE HOSPITALIZED. WHAT SHOULD
YOU TELL MR. RAINEY (OR HIS REPRESENTA- TIVE) ABOUT THE LENGTH
OF AN INPATIENT PSYCHIATRIC HOSPITAL STAY THAT MEDICARE WILL
COVER?: MEDICARE WILL COVER A TOTAL OF 190 DAYS OF INPATIENT
PSYCHIATRIC CARE DURING MR. RAINEY'S ENTIRE LIFETIME.
10. 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?-
: BENEFICIARIES UNDER ORIGINAL MEDICARE HAVE NO COST-SHARING
FOR MOST PREVENTIVE SERVICES.
11. MR. SINGH WOULD LIKE DRUG COVERAGE BUT DOES NOT WANT TO
BE ENROLLED IN A MEDICARE ADVANTAGE PLAN. WHAT SHOULD YOU
TELL HIM?: 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.
12. 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?: 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.
13. 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.
AND STUDY GUIDE LATEST
VERSION 2025/2026 ALL ANSWERS
HIGHLIGHTED FOR YOUR SUCCESS
100% GUARANTEED [A+]
,AHIP FINAL EXAM, PRACTICE EXAM AND STUDY GUIDE LATEST
VERSION 2025/2026 ALL ANSWERS HIGHLIGHTED FOR YOUR
SUCCESS 100% GUARANTEED [A+]
1. 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?: 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.
2. 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?: MEDICARE DOES NOT COVER MASSAGE THERAPY, OR, IN GENERAL,
GLASSES OR DENTURES.
3. MRS. PARK IS AN ELDERLY RETIREE. MRS. PARK HAS A LOW FIXED
INCOME. WHAT COULD YOU TELL MRS. PARK THAT MIGHT BE OF
ASSISTANCE?: 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.
4. 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?: HE
GENERALLY WOULD PAY A MONTHLY PREMIUM, ANNUAL DEDUCTIBLE,
AND PER-PRESCRIPTION COST-SHARING.
5. 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?: 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.
6. 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?: HE MAY SIGN-UP FOR
MEDICARE AT ANY TIME HOWEVER COVERAGE USUALLY BEGINS ON THE
FOURTH MONTH AFTER DIALYSIS TREATMENTS START.
7. MRS. DUARTE IS ENROLLED IN ORIGINAL MEDICARE PARTS A AND B.
SHE HAS RECENTLY REVIEWED HER MEDICARE SUMMARY NOTICE (MSN)
AND DISAGREES WITH A DETERMI- NATION THAT PARTIALLY DENIED
ONE OF HER CLAIMS FOR SERVICES. WHAT ADVICE WOULD YOU GIVE
HER?: MRS. DUARTE SHOULD FILE AN APPEAL OF THIS INITIAL
DETERMINATION WITHIN 120 DAYS OF THE DATE SHE RECEIVED THE
MSN IN THE MAIL.
, 8. 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?: 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.
9. MR. RAINEY IS EXPERIENCING PARANOID DELUSIONS AND HIS
PHYSICIAN FEELS THAT HE SHOULD BE HOSPITALIZED. WHAT SHOULD
YOU TELL MR. RAINEY (OR HIS REPRESENTA- TIVE) ABOUT THE LENGTH
OF AN INPATIENT PSYCHIATRIC HOSPITAL STAY THAT MEDICARE WILL
COVER?: MEDICARE WILL COVER A TOTAL OF 190 DAYS OF INPATIENT
PSYCHIATRIC CARE DURING MR. RAINEY'S ENTIRE LIFETIME.
10. 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?-
: BENEFICIARIES UNDER ORIGINAL MEDICARE HAVE NO COST-SHARING
FOR MOST PREVENTIVE SERVICES.
11. MR. SINGH WOULD LIKE DRUG COVERAGE BUT DOES NOT WANT TO
BE ENROLLED IN A MEDICARE ADVANTAGE PLAN. WHAT SHOULD YOU
TELL HIM?: 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.
12. 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?: 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.
13. 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.
