AHIP 2025 Final Exam Updated Questions and
Verified Answers, 100% Guarantee Pass
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. - Correct Answer>>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 does not cover massage therapy, or, in general, glasses or dentures. -
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?
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. - Correct
Answer>>Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could
you tell Mrs. Park that might be of assistance?
He generally would pay a monthly premium, annual deductible, and per-prescription
cost-sharing. - Correct Answer>>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?
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. - Correct
Answer>>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?
He may sign-up for Medicare at any time however coverage usually begins on the fourth
month after dialysis treatments start. - Correct Answer>>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?
Mrs. Duarte should file an appeal of this initial determination within 120 days of the date
she received the MSN in the mail. - Correct Answer>>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?
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. - Correct Answer>>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?
Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's
entire lifetime. - Correct Answer>>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?
Beneficiaries under Original Medicare have no cost-sharing for most preventive
services. - Correct Answer>>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?
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. - Correct
Answer>>Mr. Singh would like drug coverage but does not want to be enrolled in a
Medicare Advantage plan. What should you tell him?
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. - Correct Answer>>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?
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. - Correct Answer>>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?
Under Original Medicare, there is a single deductible amount due for the first 60 days of
any inpatient hospital stay, after which it converts into a per-day coinsurance amount
through day 90. After day 90, he would pay a daily amount up to 60 days over his
lifetime, after which he would be responsible for all costs. - Correct Answer>>Mr. Patel
is in good health and is preparing a budget in anticipation of his retirement when he
, turns 66. He wants to understand the health care costs he might be exposed to under
Medicare if he were to require hospitalization because of an illness. In general terms,
what could you tell him about his costs for inpatient hospital services under Original
Medicare?
The Part B deductible is no longer covered for individuals newly eligible for Medicare
starting January 1, 2020. - Correct Answer>>What impact, if any, have recent regulatory
changes had on Medigap plans?
Medigap plans do not cover Original Medicare benefits, but they coordinate with
Original Medicare coverage. - Correct Answer>>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?
Original Medicare covers ambulance services. - Correct Answer>>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?
Medicare covers hospice services, and they will be available for her. - Correct
Answer>>Ms. Brooks has aggressive cancer and would like to know if Medicare will
cover hospice services in case she needs them. What should you tell her?
Mr. Diaz will not pay any penalty because he had continuous coverage under his
employer's plan. - Correct Answer>>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?
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. - Correct
Answer>>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?
Hank's can continue to offer William the same employee health benefit plan, or, if
William enrolls in Medicare Part B, it can enroll him in a Medicare Advantage plan that is
offered to the public. - Correct Answer>>Hank's Fish Store, Inc. is a small company with
just 15 employees located in Florida. Hank, the store owner, has provided excellent
health benefits to the store's workforce. William, one of the store's long-time employees,
will soon be reaching age 65 and eligible for Medicare. William is in good health. He
intends to remain an active full-time employee, working several years after becoming
Verified Answers, 100% Guarantee Pass
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. - Correct Answer>>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 does not cover massage therapy, or, in general, glasses or dentures. -
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?
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. - Correct
Answer>>Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could
you tell Mrs. Park that might be of assistance?
He generally would pay a monthly premium, annual deductible, and per-prescription
cost-sharing. - Correct Answer>>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?
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. - Correct
Answer>>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?
He may sign-up for Medicare at any time however coverage usually begins on the fourth
month after dialysis treatments start. - Correct Answer>>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?
Mrs. Duarte should file an appeal of this initial determination within 120 days of the date
she received the MSN in the mail. - Correct Answer>>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?
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. - Correct Answer>>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?
Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's
entire lifetime. - Correct Answer>>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?
Beneficiaries under Original Medicare have no cost-sharing for most preventive
services. - Correct Answer>>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?
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. - Correct
Answer>>Mr. Singh would like drug coverage but does not want to be enrolled in a
Medicare Advantage plan. What should you tell him?
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. - Correct Answer>>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?
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. - Correct Answer>>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?
Under Original Medicare, there is a single deductible amount due for the first 60 days of
any inpatient hospital stay, after which it converts into a per-day coinsurance amount
through day 90. After day 90, he would pay a daily amount up to 60 days over his
lifetime, after which he would be responsible for all costs. - Correct Answer>>Mr. Patel
is in good health and is preparing a budget in anticipation of his retirement when he
, turns 66. He wants to understand the health care costs he might be exposed to under
Medicare if he were to require hospitalization because of an illness. In general terms,
what could you tell him about his costs for inpatient hospital services under Original
Medicare?
The Part B deductible is no longer covered for individuals newly eligible for Medicare
starting January 1, 2020. - Correct Answer>>What impact, if any, have recent regulatory
changes had on Medigap plans?
Medigap plans do not cover Original Medicare benefits, but they coordinate with
Original Medicare coverage. - Correct Answer>>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?
Original Medicare covers ambulance services. - Correct Answer>>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?
Medicare covers hospice services, and they will be available for her. - Correct
Answer>>Ms. Brooks has aggressive cancer and would like to know if Medicare will
cover hospice services in case she needs them. What should you tell her?
Mr. Diaz will not pay any penalty because he had continuous coverage under his
employer's plan. - Correct Answer>>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?
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. - Correct
Answer>>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?
Hank's can continue to offer William the same employee health benefit plan, or, if
William enrolls in Medicare Part B, it can enroll him in a Medicare Advantage plan that is
offered to the public. - Correct Answer>>Hank's Fish Store, Inc. is a small company with
just 15 employees located in Florida. Hank, the store owner, has provided excellent
health benefits to the store's workforce. William, one of the store's long-time employees,
will soon be reaching age 65 and eligible for Medicare. William is in good health. He
intends to remain an active full-time employee, working several years after becoming
