AHIP FINAL EXAM, PRACTICE EXAM
AND STUDY GUIDE LATEST
2025/2026 EXAM QUESTIONS
WITH CORRECT ANSWERS
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.
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.
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.
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.
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.
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.
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?
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?
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?
, 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?
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?
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?
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?
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.
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?
AND STUDY GUIDE LATEST
2025/2026 EXAM QUESTIONS
WITH CORRECT ANSWERS
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.
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.
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.
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.
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.
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.
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?
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?
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?
, 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?
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?
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?
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?
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.
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?
