AHIP Final Exam Practice Test Questions and
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Mrs. Shields is covered by Medicare will cover Mrs. Shield's skilled nursing
Original Medicare. She services provided during the first 20 days of her stay,
sustained a hip fracture after which she would have a copay until she has been
and is being successfully in the facility for 100 days.
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?
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Mrs. West wears glasses Medicare does not cover massage therapy, or, in
and dentures and has general, glasses or dentures.
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?
Mrs. Park is an elderly She should contact her state Medicaid agency to see
retiree. Mrs. Park has a low if she qualifies for one of several programs that can
fixed income. What could help with Medicare costs for which she is responsible.
you tell Mrs. Park that
might be of assistance?
Mr. Alonso receives some He generally would pay a monthly premium, annual
help paying for his two deductible, and per-prescription cost-sharing.
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?
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Mrs. Gonzalez is enrolled Mrs. Gonzalez cannot purchase a Medigap plan that
in Original Medicare and covers drugs, but she could keep her Medigap policy
has a Medigap policy as and enroll in a Part D prescription drug plan.
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?
Mr. Davis is 52 years old He may sign-up for Medicare at any time however
and has recently been coverage usually begins on the fourth month after
diagnosed with end-stage dialysis treatments start.
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 is enrolled in Mrs. Duarte should file an appeal of this initial
Original Medicare Parts A determination within 120 days of the date she received
and B. She has recently the MSN in the mail.
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?
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Mrs. Geisler's neighbor Part D covers prescription drugs and she should look
told her she should look at at her premiums, formulary, and cost-sharing among
her Part D options during other factors to see if they have changed.
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?
Mr. Rainey is experiencing Medicare will cover a total of 190 days of inpatient
paranoid delusions and his psychiatric care during Mr. Rainey's entire lifetime.
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?
Mr. Xi will soon turn age Beneficiaries under Original Medicare have no cost-
65 and has come to you sharing for most preventive services.
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?
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