AHIP FINAL EXAM, PRACTICE EXAM
AND STUDY GUIDE LATEST 2025/2026
ACTUAL EXAM 135 QUESTIONS WITH
CORRECT ANSWERS 100% VERIFIED
GRADED A+
Mrs.mShieldsmismcoveredmbymOriginalmMedicare.mShemsustainedmamhipmfracturemandmismbeingmsucce
ssfullymtreatedmformthatmcondition.mHowever,mshemandmhermphysiciansmfeelmthatmaftermhermlengthy
mhospitalmstay,mshemwillmneedmammonthmormtwomofmnursingmandmrehabilitativemcare.mWhatmshouldm
youmtellmthemmaboutmOriginalmMedicare'smcoveragemofmcareminmamskilledmnursingmfacility?m-
mCORRECTmANSWERSmMedicaremwillmcovermMrs.mShield'smskilledmnursingmservicesmprovidedmdurin
gmthemfirstm20mdaysmofmhermstay,maftermwhichmshemwouldmhavemamcopaymuntilmshemhasmbeenminmthe
mfacilitymform100mdays.
Mrs.mWestmwearsmglassesmandmdenturesmandmhasmenjoyedmconsiderablempainmreliefmfrommarthritis
mthroughmmassagemtherapy.mShemismconcernedmaboutmwhethermormnotmMedicaremwillmcovermthese
mitemsmandmservices.mWhatmshouldmyoumtellmher?m-
mCORRECTmANSWERSmMedicaremdoesmnotmcovermmassagemtherapy,mor,minmgeneral,mglassesmormde
ntures.
Mrs.mParkmismanmelderlymretiree.mMrs.mParkmhasmamlowmfixedmincome.mWhatmcouldmyoumtellmMrs.mP
arkmthatmmightmbemofmassistance?m-
mCORRECTmANSWERSmShemshouldmcontactmhermstatemMedicaidmagencymtomseemifmshemqualifiesmfor
monemofmseveralmprogramsmthatmcanmhelpmwithmMedicaremcostsmformwhichmshemismresponsible.
Mr.mAlonsomreceivesmsomemhelpmpayingmformhismtwomgenericmprescriptionmdrugsmfrommhismemploy
er'smretireemcoverage,mbutmhemwantsmtomcomparemitmtomamPartmDmprescriptionmdrugmplan.mHemasks
myoumwhatmcostsmhemwouldmgenerallymexpectmtomencountermwhenmenrollingmintomamstandardmMed
icaremPartmDmprescriptionmdrugmplan.mWhatmshouldmyoumtellmhim?m-
mCORRECTmANSWERSmHemgenerallymwouldmpaymammonthlympremium,mannualmdeductible,mandmper
-prescriptionmcost-sharing.
,Mrs.mGonzalezmismenrolledminmOriginalmMedicaremandmhasmamMedigapmpolicymasmwell,mbutmitmprovi
desmnomdrugmcoverage.mShemwouldmlikemtomkeepmthemcoveragemshemhasmbutmreplacemhermexistingm
Medigapmplanmwithmonemthatmprovidesmdrugmcoverage.mWhatmshouldmyoumtellmher?m-
mCORRECTmANSWERSmMrs.mGonzalezmcannotmpurchasemamMedigapmplanmthatmcoversmdrugs,mbutms
hemcouldmkeepmhermMedigapmpolicymandmenrollminmamPartmDmprescriptionmdrugmplan.
Mr.mDavismism52myearsmoldmandmhasmrecentlymbeenmdiagnosedmwithmend-
stagemrenalmdiseasem(ESRD)mandmwillmsoonmbeginmdialysis.mHemismwonderingmifmhemcanmobtainmcov
eragemundermMedicare.mWhatmshouldmyoumtellmhim?m-mCORRECTmANSWERSmHemmaymsign-
upmformMedicarematmanymtimemhowevermcoveragemusuallymbeginsmonmthemfourthmmonthmaftermdial
ysismtreatmentsmstart.
Mrs.mDuartemismenrolledminmOriginalmMedicaremPartsmAmandmB.mShemhasmrecentlymreviewedmhermM
edicaremSummarymNoticem(MSN)mandmdisagreesmwithmamdeterminationmthatmpartiallymdeniedmone
mofmhermclaimsmformservices.mWhatmadvicemwouldmyoumgivemher?m-
mCORRECTmANSWERSmMrs.mDuartemshouldmfilemanmappealmofmthisminitialmdeterminationmwithinm12
0mdaysmofmthemdatemshemreceivedmthemMSNminmthemmail.
Mrs.mGeisler'smneighbormtoldmhermshemshouldmlookmatmhermPartmDmoptionsmduringmthemannualmMe
dicaremenrollmentmperiodmbecausemthemfeaturesmofmPartmDmmightmhavemchanged.mMrs.mGeislermca
n'tmremembermwhatmPartmDmismsomshemcalledmyoumtomaskmwhatmhermneighbormwasmtalkingmabout.m
Whatmcouldmyoumtellmher?m-
mCORRECTmANSWERSmPartmDmcoversmprescriptionmdrugsmandmshemshouldmlookmatmhermpremiums,m
formulary,mandmcost-sharingmamongmothermfactorsmtomseemifmtheymhavemchanged.
Mr.mRaineymismexperiencingmparanoidmdelusionsmandmhismphysicianmfeelsmthatmhemshouldmbemhospi
talized.mWhatmshouldmyoumtellmMr.mRaineym(ormhismrepresentative)maboutmthemlengthmofmanminpati
entmpsychiatricmhospitalmstaymthatmMedicaremwillmcover?m-
mCORRECTmANSWERSmMedicaremwillmcovermamtotalmofm190mdaysmofminpatientmpsychiatricmcaremduri
ngmMr.mRainey'smentiremlifetime.
, Mr.mXimwillmsoonmturnmagem65mandmhasmcomemtomyoumformadvicemasmtomwhatmservicesmaremprovide
dmundermOriginalmMedicare.mWhatmshouldmyoumtellmMr.mXimthatmbestmdescribesmthemhealthmcovera
gemprovidedmtomMedicarembeneficiaries?m-
mCORRECTmANSWERSmBeneficiariesmundermOriginalmMedicaremhavemnomcost-
sharingmformmostmpreventivemservices.
Mr.mSinghmwouldmlikemdrugmcoveragembutmdoesmnotmwantmtombemenrolledminmamMedicaremAdvanta
gemplan.mWhatmshouldmyoumtellmhim?m-mCORRECTmANSWERSmMr.mSinghmcanmenrollminmamstand-
alonemprescriptionmdrugmplanmandmcontinuemtombemcoveredmformPartmAmandmPartmBmservicesmthrou
ghmOriginalmFee-for-ServicemMedicare.
Mrs.mChenmwillmbem65msoon,mhasmbeenmamcitizenmformtwelvemyears,mhasmbeenmemployedmfullmtime,
mandmpaidmtaxesmduringmthatmentiremperiod.mShemismconcernedmthatmshemwillmnotmqualifymformcove
ragemundermpartmAmbecausemshemwasmnotmbornminmthemUnitedmStates.mWhatmshouldmyoumtellmher?
m-
mCORRECTmANSWERSmMostmindividualsmwhomaremcitizensmandmagem65mormovermaremcoveredmunder
mPartmAmbymvirtuemofmhavingmpaidmMedicaremtaxesmwhilemworking,mthoughmsomemmaymbemcovered
masmamresultmofmpayingmmonthlympremiums.
Mrs.mQuinnmrecentlymturnedm66mandmdecidedmaftermmanymyearsmofmworkmtomretiremandmbeginmrec
eivingmSocialmSecuritymbenefits.mShortlymthereaftermMrs.mQuinnmreceivedmamletterminformingmhermt
hatmshemhadmbeenmautomaticallymenrolledminmMedicaremPartmB.mShemwantsmtomunderstandmwhatmt
hismmeans.mWhatmshouldmyoumtellmMrs.mQuinn?m-
mCORRECTmANSWERSmPartmBmprimarilymcoversmphysicianmservices.mShemwillmbempayingmammonthlym
premiummand,mexceptmformmanympreventivemandmscreeningmtests,mgenerallymwillmhavem20%mco-
paymentsmformthesemservices,minmadditionmtomanmannualmdeductible.
Mr.mPatelmisminmgoodmhealthmandmismpreparingmambudgetminmanticipationmofmhismretirementmwhenm
hemturnsm66.mHemwantsmtomunderstandmthemhealthmcaremcostsmhemmightmbemexposedmtomundermM
edicaremifmhemweremtomrequiremhospitalizationmbecausemofmanmillness.mInmgeneralmterms,mwhatmco
uldmyoumtellmhimmaboutmhismcostsmforminpatientmhospitalmservicesmundermOriginalmMedicare?m-
mCORRECTmANSWERSmUndermOriginalmMedicare,mtheremismamsinglemdeductiblemamountmduemformth
emfirstm60mdaysmofmanyminpatientmhospitalmstay,maftermwhichmitmconvertsmintomamper-
AND STUDY GUIDE LATEST 2025/2026
ACTUAL EXAM 135 QUESTIONS WITH
CORRECT ANSWERS 100% VERIFIED
GRADED A+
Mrs.mShieldsmismcoveredmbymOriginalmMedicare.mShemsustainedmamhipmfracturemandmismbeingmsucce
ssfullymtreatedmformthatmcondition.mHowever,mshemandmhermphysiciansmfeelmthatmaftermhermlengthy
mhospitalmstay,mshemwillmneedmammonthmormtwomofmnursingmandmrehabilitativemcare.mWhatmshouldm
youmtellmthemmaboutmOriginalmMedicare'smcoveragemofmcareminmamskilledmnursingmfacility?m-
mCORRECTmANSWERSmMedicaremwillmcovermMrs.mShield'smskilledmnursingmservicesmprovidedmdurin
gmthemfirstm20mdaysmofmhermstay,maftermwhichmshemwouldmhavemamcopaymuntilmshemhasmbeenminmthe
mfacilitymform100mdays.
Mrs.mWestmwearsmglassesmandmdenturesmandmhasmenjoyedmconsiderablempainmreliefmfrommarthritis
mthroughmmassagemtherapy.mShemismconcernedmaboutmwhethermormnotmMedicaremwillmcovermthese
mitemsmandmservices.mWhatmshouldmyoumtellmher?m-
mCORRECTmANSWERSmMedicaremdoesmnotmcovermmassagemtherapy,mor,minmgeneral,mglassesmormde
ntures.
Mrs.mParkmismanmelderlymretiree.mMrs.mParkmhasmamlowmfixedmincome.mWhatmcouldmyoumtellmMrs.mP
arkmthatmmightmbemofmassistance?m-
mCORRECTmANSWERSmShemshouldmcontactmhermstatemMedicaidmagencymtomseemifmshemqualifiesmfor
monemofmseveralmprogramsmthatmcanmhelpmwithmMedicaremcostsmformwhichmshemismresponsible.
Mr.mAlonsomreceivesmsomemhelpmpayingmformhismtwomgenericmprescriptionmdrugsmfrommhismemploy
er'smretireemcoverage,mbutmhemwantsmtomcomparemitmtomamPartmDmprescriptionmdrugmplan.mHemasks
myoumwhatmcostsmhemwouldmgenerallymexpectmtomencountermwhenmenrollingmintomamstandardmMed
icaremPartmDmprescriptionmdrugmplan.mWhatmshouldmyoumtellmhim?m-
mCORRECTmANSWERSmHemgenerallymwouldmpaymammonthlympremium,mannualmdeductible,mandmper
-prescriptionmcost-sharing.
,Mrs.mGonzalezmismenrolledminmOriginalmMedicaremandmhasmamMedigapmpolicymasmwell,mbutmitmprovi
desmnomdrugmcoverage.mShemwouldmlikemtomkeepmthemcoveragemshemhasmbutmreplacemhermexistingm
Medigapmplanmwithmonemthatmprovidesmdrugmcoverage.mWhatmshouldmyoumtellmher?m-
mCORRECTmANSWERSmMrs.mGonzalezmcannotmpurchasemamMedigapmplanmthatmcoversmdrugs,mbutms
hemcouldmkeepmhermMedigapmpolicymandmenrollminmamPartmDmprescriptionmdrugmplan.
Mr.mDavismism52myearsmoldmandmhasmrecentlymbeenmdiagnosedmwithmend-
stagemrenalmdiseasem(ESRD)mandmwillmsoonmbeginmdialysis.mHemismwonderingmifmhemcanmobtainmcov
eragemundermMedicare.mWhatmshouldmyoumtellmhim?m-mCORRECTmANSWERSmHemmaymsign-
upmformMedicarematmanymtimemhowevermcoveragemusuallymbeginsmonmthemfourthmmonthmaftermdial
ysismtreatmentsmstart.
Mrs.mDuartemismenrolledminmOriginalmMedicaremPartsmAmandmB.mShemhasmrecentlymreviewedmhermM
edicaremSummarymNoticem(MSN)mandmdisagreesmwithmamdeterminationmthatmpartiallymdeniedmone
mofmhermclaimsmformservices.mWhatmadvicemwouldmyoumgivemher?m-
mCORRECTmANSWERSmMrs.mDuartemshouldmfilemanmappealmofmthisminitialmdeterminationmwithinm12
0mdaysmofmthemdatemshemreceivedmthemMSNminmthemmail.
Mrs.mGeisler'smneighbormtoldmhermshemshouldmlookmatmhermPartmDmoptionsmduringmthemannualmMe
dicaremenrollmentmperiodmbecausemthemfeaturesmofmPartmDmmightmhavemchanged.mMrs.mGeislermca
n'tmremembermwhatmPartmDmismsomshemcalledmyoumtomaskmwhatmhermneighbormwasmtalkingmabout.m
Whatmcouldmyoumtellmher?m-
mCORRECTmANSWERSmPartmDmcoversmprescriptionmdrugsmandmshemshouldmlookmatmhermpremiums,m
formulary,mandmcost-sharingmamongmothermfactorsmtomseemifmtheymhavemchanged.
Mr.mRaineymismexperiencingmparanoidmdelusionsmandmhismphysicianmfeelsmthatmhemshouldmbemhospi
talized.mWhatmshouldmyoumtellmMr.mRaineym(ormhismrepresentative)maboutmthemlengthmofmanminpati
entmpsychiatricmhospitalmstaymthatmMedicaremwillmcover?m-
mCORRECTmANSWERSmMedicaremwillmcovermamtotalmofm190mdaysmofminpatientmpsychiatricmcaremduri
ngmMr.mRainey'smentiremlifetime.
, Mr.mXimwillmsoonmturnmagem65mandmhasmcomemtomyoumformadvicemasmtomwhatmservicesmaremprovide
dmundermOriginalmMedicare.mWhatmshouldmyoumtellmMr.mXimthatmbestmdescribesmthemhealthmcovera
gemprovidedmtomMedicarembeneficiaries?m-
mCORRECTmANSWERSmBeneficiariesmundermOriginalmMedicaremhavemnomcost-
sharingmformmostmpreventivemservices.
Mr.mSinghmwouldmlikemdrugmcoveragembutmdoesmnotmwantmtombemenrolledminmamMedicaremAdvanta
gemplan.mWhatmshouldmyoumtellmhim?m-mCORRECTmANSWERSmMr.mSinghmcanmenrollminmamstand-
alonemprescriptionmdrugmplanmandmcontinuemtombemcoveredmformPartmAmandmPartmBmservicesmthrou
ghmOriginalmFee-for-ServicemMedicare.
Mrs.mChenmwillmbem65msoon,mhasmbeenmamcitizenmformtwelvemyears,mhasmbeenmemployedmfullmtime,
mandmpaidmtaxesmduringmthatmentiremperiod.mShemismconcernedmthatmshemwillmnotmqualifymformcove
ragemundermpartmAmbecausemshemwasmnotmbornminmthemUnitedmStates.mWhatmshouldmyoumtellmher?
m-
mCORRECTmANSWERSmMostmindividualsmwhomaremcitizensmandmagem65mormovermaremcoveredmunder
mPartmAmbymvirtuemofmhavingmpaidmMedicaremtaxesmwhilemworking,mthoughmsomemmaymbemcovered
masmamresultmofmpayingmmonthlympremiums.
Mrs.mQuinnmrecentlymturnedm66mandmdecidedmaftermmanymyearsmofmworkmtomretiremandmbeginmrec
eivingmSocialmSecuritymbenefits.mShortlymthereaftermMrs.mQuinnmreceivedmamletterminformingmhermt
hatmshemhadmbeenmautomaticallymenrolledminmMedicaremPartmB.mShemwantsmtomunderstandmwhatmt
hismmeans.mWhatmshouldmyoumtellmMrs.mQuinn?m-
mCORRECTmANSWERSmPartmBmprimarilymcoversmphysicianmservices.mShemwillmbempayingmammonthlym
premiummand,mexceptmformmanympreventivemandmscreeningmtests,mgenerallymwillmhavem20%mco-
paymentsmformthesemservices,minmadditionmtomanmannualmdeductible.
Mr.mPatelmisminmgoodmhealthmandmismpreparingmambudgetminmanticipationmofmhismretirementmwhenm
hemturnsm66.mHemwantsmtomunderstandmthemhealthmcaremcostsmhemmightmbemexposedmtomundermM
edicaremifmhemweremtomrequiremhospitalizationmbecausemofmanmillness.mInmgeneralmterms,mwhatmco
uldmyoumtellmhimmaboutmhismcostsmforminpatientmhospitalmservicesmundermOriginalmMedicare?m-
mCORRECTmANSWERSmUndermOriginalmMedicare,mtheremismamsinglemdeductiblemamountmduemformth
emfirstm60mdaysmofmanyminpatientmhospitalmstay,maftermwhichmitmconvertsmintomamper-
