, AHIP FINAL EXAM, PRACTICE EXAM
AND STUDY GUIDE LATEST 2025/2026
ACTUAL EXAM 135 QUESTIONS WITH
CORRECT ANSWERS 100% VERIFIED
GRADED A+
1. Skilled Nursing Facility Coverage
Mrs. Shields needs rehab after hip fracture. What does Original Medicare cover?
Answer: First 20 days fully covered; copay after until day 100
Rationale: SNF care is fully covered for 20 days if criteria met, then daily coinsurance applies up
to 100 days.
2. Medicare Coverage of Glasses, Dentures, Massage
What does Medicare cover?
Answer: Does NOT cover massage therapy, glasses, or dentures
Rationale: These are generally excluded except limited eye exams after cataract surgery.
3. Low-income Medicare beneficiary assistance
Where should Mrs. Park seek help?
Answer: State Medicaid agency
Rationale: Medicare Savings Programs and Medicaid can help with premiums and cost-sharing.
4. Part D standard costs
What costs are expected in Part D?
Answer: Premium, deductible, and cost-sharing
Rationale: Standard PDP structure includes all three.
, 5. Medigap drug coverage
Can Medigap include drug coverage?
Answer: No; enroll in separate Part D plan
Rationale: Medigap policies cannot include prescription drug coverage.
6. ESRD Medicare eligibility
When does Medicare begin for ESRD?
Answer: Usually 4th month after dialysis begins
Rationale: Coverage begins after waiting period unless specific exceptions apply.
7. Medicare appeal timeframe
When to appeal MSN denial?
Answer: Within 120 days
Rationale: Standard Medicare appeals window.
8. Part D coverage basics
What is Part D?
Answer: Prescription drug coverage
Rationale: Covers outpatient prescription medications.
9. Psychiatric inpatient limit
What is lifetime limit?
Answer: 190 days lifetime limit
Rationale: Applies to inpatient psychiatric hospital stays.
10. Preventive services cost under Original Medicare
AND STUDY GUIDE LATEST 2025/2026
ACTUAL EXAM 135 QUESTIONS WITH
CORRECT ANSWERS 100% VERIFIED
GRADED A+
1. Skilled Nursing Facility Coverage
Mrs. Shields needs rehab after hip fracture. What does Original Medicare cover?
Answer: First 20 days fully covered; copay after until day 100
Rationale: SNF care is fully covered for 20 days if criteria met, then daily coinsurance applies up
to 100 days.
2. Medicare Coverage of Glasses, Dentures, Massage
What does Medicare cover?
Answer: Does NOT cover massage therapy, glasses, or dentures
Rationale: These are generally excluded except limited eye exams after cataract surgery.
3. Low-income Medicare beneficiary assistance
Where should Mrs. Park seek help?
Answer: State Medicaid agency
Rationale: Medicare Savings Programs and Medicaid can help with premiums and cost-sharing.
4. Part D standard costs
What costs are expected in Part D?
Answer: Premium, deductible, and cost-sharing
Rationale: Standard PDP structure includes all three.
, 5. Medigap drug coverage
Can Medigap include drug coverage?
Answer: No; enroll in separate Part D plan
Rationale: Medigap policies cannot include prescription drug coverage.
6. ESRD Medicare eligibility
When does Medicare begin for ESRD?
Answer: Usually 4th month after dialysis begins
Rationale: Coverage begins after waiting period unless specific exceptions apply.
7. Medicare appeal timeframe
When to appeal MSN denial?
Answer: Within 120 days
Rationale: Standard Medicare appeals window.
8. Part D coverage basics
What is Part D?
Answer: Prescription drug coverage
Rationale: Covers outpatient prescription medications.
9. Psychiatric inpatient limit
What is lifetime limit?
Answer: 190 days lifetime limit
Rationale: Applies to inpatient psychiatric hospital stays.
10. Preventive services cost under Original Medicare
