AHIP FINAL EXAM, PRACTICE EXAM AND STUDY GUIDE LATEST 2025/2026 ACTUAL EXAM 135 QUESTIONS WITH CORRECT ANSWERS 100% VERIFIED GRADED A+

AHIP FINAL EXAM, PRACTICE EXAM
AND STUDY GUIDE LATEST 2025/2026
ACTUAL EXAM 135 QUESTIONS WITH
CORRECT ANSWERS 100% VERIFIED
GRADED A+
Mrs.fgShieldsfgisfgcoveredfgbyfgOriginalfgMedicare.fgShefgsustainedfgafghipfgfracturefgandfgisfgbeingfgsuccessf
ullyfgtreatedfgforfgthatfgcondition.fgHowever,fgshefgandfgherfgphysiciansfgfeelfgthatfgafterfgherfglengthyfghos
pitalfgstay,fgshefgwillfgneedfgafgmonthfgorfgtwofgoffgnursingfgandfgrehabilitativefgcare.fgWhatfgshouldfgyoufgt
ellfgthemfgaboutfgOriginalfgMedicare'sfgcoveragefgoffgcarefginfgafgskilledfgnursingfgfacility?fg-
fgcorrectfganswer✅✅MedicarefgwillfgcoverfgMrs.fgShield'sfgskilledfgnursingfgservicesfgprovidedfgduringfgt

hefgfirstfg20fgdaysfgoffgherfgstay,fgafterfgwhichfgshefgwouldfghavefgafgcopayfguntilfgshefghasfgbeenfginfgthefgfa
cilityfgforfg100fgdays.



Mrs.fgWestfgwearsfgglassesfgandfgdenturesfgandfghasfgenjoyedfgconsiderablefgpainfgrelieffgfromfgarthritisfgt
hroughfgmassagefgtherapy.fgShefgisfgconcernedfgaboutfgwhetherfgorfgnotfgMedicarefgwillfgcoverfgthesefgite
msfgandfgservices.fgWhatfgshouldfgyoufgtellfgher?fg-
fgcorrectfganswer✅✅Medicarefgdoesfgnotfgcoverfgmassagefgtherapy,fgor,fginfggeneral,fgglassesfgorfgdent

ures.



Mrs.fgParkfgisfganfgelderlyfgretiree.fgMrs.fgParkfghasfgafglowfgfixedfgincome.fgWhatfgcouldfgyoufgtellfgMrs.fgPa
rkfgthatfgmightfgbefgoffgassistance?fg-
fgcorrectfganswer✅✅ShefgshouldfgcontactfgherfgstatefgMedicaidfgagencyfgtofgseefgiffgshefgqualifiesfgforfg

onefgoffgseveralfgprogramsfgthatfgcanfghelpfgwithfgMedicarefgcostsfgforfgwhichfgshefgisfgresponsible.



Mr.fgAlonsofgreceivesfgsomefghelpfgpayingfgforfghisfgtwofggenericfgprescriptionfgdrugsfgfromfghisfgemployer'
sfgretireefgcoverage,fgbutfghefgwantsfgtofgcomparefgitfgtofgafgPartfgDfgprescriptionfgdrugfgplan.fgHefgasksfgyo
ufgwhatfgcostsfghefgwouldfggenerallyfgexpectfgtofgencounterfgwhenfgenrollingfgintofgafgstandardfgMedicarefg
PartfgDfgprescriptionfgdrugfgplan.fgWhatfgshouldfgyoufgtellfghim?fg-
fgcorrectfganswer✅✅Hefggenerallyfgwouldfgpayfgafgmonthlyfgpremium,fgannualfgdeductible,fgandfgper-

prescriptionfgcost-sharing.



Mrs.fgGonzalezfgisfgenrolledfginfgOriginalfgMedicarefgandfghasfgafgMedigapfgpolicyfgasfgwell,fgbutfgitfgprovide
sfgnofgdrugfgcoverage.fgShefgwouldfglikefgtofgkeepfgthefgcoveragefgshefghasfgbutfgreplacefgherfgexistingfgMed

,igapfgplanfgwithfgonefgthatfgprovidesfgdrugfgcoverage.fgWhatfgshouldfgyoufgtellfgher?fg-
fgcorrectfganswer✅✅Mrs.fgGonzalezfgcannotfgpurchasefgafgMedigapfgplanfgthatfgcoversfgdrugs,fgbutfgshe

fgcouldfgkeepfgherfgMedigapfgpolicyfgandfgenrollfginfgafgPartfgDfgprescriptionfgdrugfgplan.




Mr.fgDavisfgisfg52fgyearsfgoldfgandfghasfgrecentlyfgbeenfgdiagnosedfgwithfgend-
stagefgrenalfgdiseasefg(ESRD)fgandfgwillfgsoonfgbeginfgdialysis.fgHefgisfgwonderingfgiffghefgcanfgobtainfgcover
agefgunderfgMedicare.fgWhatfgshouldfgyoufgtellfghim?fg-fgcorrectfganswer✅✅Hefgmayfgsign-
upfgforfgMedicarefgatfganyfgtimefghoweverfgcoveragefgusuallyfgbeginsfgonfgthefgfourthfgmonthfgafterfgdialys
isfgtreatmentsfgstart.



Mrs.fgDuartefgisfgenrolledfginfgOriginalfgMedicarefgPartsfgAfgandfgB.fgShefghasfgrecentlyfgreviewedfgherfgMed
icarefgSummaryfgNoticefg(MSN)fgandfgdisagreesfgwithfgafgdeterminationfgthatfgpartiallyfgdeniedfgonefgoffgh
erfgclaimsfgforfgservices.fgWhatfgadvicefgwouldfgyoufggivefgher?fg-
fgcorrectfganswer✅✅Mrs.fgDuartefgshouldfgfilefganfgappealfgoffgthisfginitialfgdeterminationfgwithinfg120fg

daysfgoffgthefgdatefgshefgreceivedfgthefgMSNfginfgthefgmail.



Mrs.fgGeisler'sfgneighborfgtoldfgherfgshefgshouldfglookfgatfgherfgPartfgDfgoptionsfgduringfgthefgannualfgMedic
arefgenrollmentfgperiodfgbecausefgthefgfeaturesfgoffgPartfgDfgmightfghavefgchanged.fgMrs.fgGeislerfgcan'tfgr
ememberfgwhatfgPartfgDfgisfgsofgshefgcalledfgyoufgtofgaskfgwhatfgherfgneighborfgwasfgtalkingfgabout.fgWhatfg
couldfgyoufgtellfgher?fg-
fgcorrectfganswer✅✅PartfgDfgcoversfgprescriptionfgdrugsfgandfgshefgshouldfglookfgatfgherfgpremiums,fgfo

rmulary,fgandfgcost-sharingfgamongfgotherfgfactorsfgtofgseefgiffgtheyfghavefgchanged.



Mr.fgRaineyfgisfgexperiencingfgparanoidfgdelusionsfgandfghisfgphysicianfgfeelsfgthatfghefgshouldfgbefghospital
ized.fgWhatfgshouldfgyoufgtellfgMr.fgRaineyfg(orfghisfgrepresentative)fgaboutfgthefglengthfgoffganfginpatientfg
psychiatricfghospitalfgstayfgthatfgMedicarefgwillfgcover?fg-
fgcorrectfganswer✅✅Medicarefgwillfgcoverfgafgtotalfgoffg190fgdaysfgoffginpatientfgpsychiatricfgcarefgdurin

gfgMr.fgRainey'sfgentirefglifetime.



Mr.fgXifgwillfgsoonfgturnfgagefg65fgandfghasfgcomefgtofgyoufgforfgadvicefgasfgtofgwhatfgservicesfgarefgprovided
fgunderfgOriginalfgMedicare.fgWhatfgshouldfgyoufgtellfgMr.fgXifgthatfgbestfgdescribesfgthefghealthfgcoveragefg

providedfgtofgMedicarefgbeneficiaries?fg-
fgcorrectfganswer✅✅BeneficiariesfgunderfgOriginalfgMedicarefghavefgnofgcost-

sharingfgforfgmostfgpreventivefgservices.



Mr.fgSinghfgwouldfglikefgdrugfgcoveragefgbutfgdoesfgnotfgwantfgtofgbefgenrolledfginfgafgMedicarefgAdvantage
fgplan.fgWhatfgshouldfgyoufgtellfghim?fg-fgcorrectfganswer✅✅Mr.fgSinghfgcanfgenrollfginfgafgstand-

, alonefgprescriptionfgdrugfgplanfgandfgcontinuefgtofgbefgcoveredfgforfgPartfgAfgandfgPartfgBfgservicesfgthroug
hfgOriginalfgFee-for-ServicefgMedicare.



Mrs.fgChenfgwillfgbefg65fgsoon,fghasfgbeenfgafgcitizenfgforfgtwelvefgyears,fghasfgbeenfgemployedfgfullfgtime,fg
andfgpaidfgtaxesfgduringfgthatfgentirefgperiod.fgShefgisfgconcernedfgthatfgshefgwillfgnotfgqualifyfgforfgcoverag
efgunderfgpartfgAfgbecausefgshefgwasfgnotfgbornfginfgthefgUnitedfgStates.fgWhatfgshouldfgyoufgtellfgher?fg-
fgcorrectfganswer✅✅Mostfgindividualsfgwhofgarefgcitizensfgandfgagefg65fgorfgoverfgarefgcoveredfgunderfg

PartfgAfgbyfgvirtuefgoffghavingfgpaidfgMedicarefgtaxesfgwhilefgworking,fgthoughfgsomefgmayfgbefgcoveredfgas
fgafgresultfgoffgpayingfgmonthlyfgpremiums.




Mrs.fgQuinnfgrecentlyfgturnedfg66fgandfgdecidedfgafterfgmanyfgyearsfgoffgworkfgtofgretirefgandfgbeginfgrecei
vingfgSocialfgSecurityfgbenefits.fgShortlyfgthereafterfgMrs.fgQuinnfgreceivedfgafgletterfginformingfgherfgthatfg
shefghadfgbeenfgautomaticallyfgenrolledfginfgMedicarefgPartfgB.fgShefgwantsfgtofgunderstandfgwhatfgthisfgm
eans.fgWhatfgshouldfgyoufgtellfgMrs.fgQuinn?fg-
fgcorrectfganswer✅✅PartfgBfgprimarilyfgcoversfgphysicianfgservices.fgShefgwillfgbefgpayingfgafgmonthlyfgp

remiumfgand,fgexceptfgforfgmanyfgpreventivefgandfgscreeningfgtests,fggenerallyfgwillfghavefg20%fgco-
paymentsfgforfgthesefgservices,fginfgadditionfgtofganfgannualfgdeductible.



Mr.fgPatelfgisfginfggoodfghealthfgandfgisfgpreparingfgafgbudgetfginfganticipationfgoffghisfgretirementfgwhenfgh
efgturnsfg66.fgHefgwantsfgtofgunderstandfgthefghealthfgcarefgcostsfghefgmightfgbefgexposedfgtofgunderfgMedi
carefgiffghefgwerefgtofgrequirefghospitalizationfgbecausefgoffganfgillness.fgInfggeneralfgterms,fgwhatfgcouldfgy
oufgtellfghimfgaboutfghisfgcostsfgforfginpatientfghospitalfgservicesfgunderfgOriginalfgMedicare?fg-
fgcorrectfganswer✅✅UnderfgOriginalfgMedicare,fgtherefgisfgafgsinglefgdeductiblefgamountfgduefgforfgthef

gfirstfg60fgdaysfgoffganyfginpatientfghospitalfgstay,fgafterfgwhichfgitfgconvertsfgintofgafgper-

dayfgcoinsurancefgamountfgthroughfgdayfg90.fgAfterfgdayfg90,fghefgwouldfgpayfgafgdailyfgamountfgupfgtofg60f
gdaysfgoverfghisfglifetime,fgafterfgwhichfghefgwouldfgbefgresponsiblefgforfgallfgcosts.




Whatfgimpact,fgiffgany,fghavefgrecentfgregulatoryfgchangesfghadfgonfgMedigapfgplans?fg-
fgcorrectfganswer✅✅ThefgPartfgBfgdeductiblefgisfgnofglongerfgcoveredfgforfgindividualsfgnewlyfgeligiblefgf

orfgMedicarefgstartingfgJanuaryfg1,fg2020.



Mrs.fgPatersonfgisfgconcernedfgaboutfgthefgdeductiblesfgandfgco-
paymentsfgassociatedfgwithfgOriginalfgMedicare.fgWhatfgcanfgyoufgtellfgherfgaboutfgMedigapfgasfganfgoptio
nfgtofgaddressfgthisfgconcern?fg-
fgcorrectfganswer✅✅MedigapfgplansfgdofgnotfgcoverfgOriginalfgMedicarefgbenefits,fgbutfgtheyfgcoordina

tefgwithfgOriginalfgMedicarefgcoverage.