2025 AHIP FINAL EXAM WITH
QUESTIONS AND CORRECT
ANSWERS/RATED A+ [LATEST
VERSION]
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? -
ANSWER >>>>>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? -
ANSWER >>>>>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? - ANSWER >>>>>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? - ANSWER >>>>>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? - ANSWER >>>>>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? - ANSWER >>>>>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? -
ANSWER >>>>>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
n n n n n n n n n n n
options during the annual Medicare enrollment period
n n n n n n n
becausethe features of Part D might have changed. Mrs.
n n n n n n n n n n
Geisler can't remember what Part D is so she called you to ask
n n n n n n n n n n n n n
what her neighbor was talking about. What could you tell
n n n n n n n n n n
her? - ANSWER >>>>>Part D covers prescription drugs and she
n n n n n n n n n n
should look at her premiums, formulary, and cost-sharing
n n n n n n n n
among otherfactors to see if they have changed.
n n n n n n n n n
Mr. Rainey is experiencing paranoid delusions and his
n n n n n n n
physicianfeels that he should be hospitalized. What should you
n n n n n n n n n n
tell Mr.
n n
Rainey (or his representative) about the length of an
n n n n n n n n
inpatientpsychiatric hospital stay that Medicare will cover? -
n n n n n n n n n
nANSWER
>>>>>Medicare will cover a total of 190 days of n n n n n n n n
inpatientpsychiatric care during Mr. Rainey's entire
n n n n n n n
lifetime.
n
Mr. Xi will soon turn age 65 and has come to you for advice
n n n n n n n n n n n n n
as to what services are provided under Original Medicare.
n n n n n n n n n
What should you tell Mr. Xi that best describes the health
n n n n n n n n n n n
coverage provided to Medicare beneficiaries? - ANSWER
n n n n n n n
>>>>>Beneficiaries under Original Medicare have no cost- n n n n n n
sharing for most preventive services.
n n n n n
Mr. Singh would like drug coverage but does not want to be
n n n n n n n n n n n
enrolled in a Medicare Advantage plan. What should you tell
n n n n n n n n n n
him? - ANSWER >>>>>Mr. Singh can enroll in a stand-alone
n n n n n n n n n n
prescription drug plan and continue to be covered for Part A
n n n n n n n n n n n
and Part B services through Original Fee-for-Service Medicare.
n n n n n n n n
Mrs. Chen will be 65 soon, has been a citizen for twelve
n n n n n n n n n n n
years,has been employed full time, and paid taxes during that
n n n n n n n n n n n
entire period. She is concerned that she will not qualify for
n n n n n n n n n n n
coverage under part A because she was not born in the
n n n n n n n n n n n
QUESTIONS AND CORRECT
ANSWERS/RATED A+ [LATEST
VERSION]
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? -
ANSWER >>>>>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? -
ANSWER >>>>>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? - ANSWER >>>>>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? - ANSWER >>>>>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? - ANSWER >>>>>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? - ANSWER >>>>>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? -
ANSWER >>>>>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
n n n n n n n n n n n
options during the annual Medicare enrollment period
n n n n n n n
becausethe features of Part D might have changed. Mrs.
n n n n n n n n n n
Geisler can't remember what Part D is so she called you to ask
n n n n n n n n n n n n n
what her neighbor was talking about. What could you tell
n n n n n n n n n n
her? - ANSWER >>>>>Part D covers prescription drugs and she
n n n n n n n n n n
should look at her premiums, formulary, and cost-sharing
n n n n n n n n
among otherfactors to see if they have changed.
n n n n n n n n n
Mr. Rainey is experiencing paranoid delusions and his
n n n n n n n
physicianfeels that he should be hospitalized. What should you
n n n n n n n n n n
tell Mr.
n n
Rainey (or his representative) about the length of an
n n n n n n n n
inpatientpsychiatric hospital stay that Medicare will cover? -
n n n n n n n n n
nANSWER
>>>>>Medicare will cover a total of 190 days of n n n n n n n n
inpatientpsychiatric care during Mr. Rainey's entire
n n n n n n n
lifetime.
n
Mr. Xi will soon turn age 65 and has come to you for advice
n n n n n n n n n n n n n
as to what services are provided under Original Medicare.
n n n n n n n n n
What should you tell Mr. Xi that best describes the health
n n n n n n n n n n n
coverage provided to Medicare beneficiaries? - ANSWER
n n n n n n n
>>>>>Beneficiaries under Original Medicare have no cost- n n n n n n
sharing for most preventive services.
n n n n n
Mr. Singh would like drug coverage but does not want to be
n n n n n n n n n n n
enrolled in a Medicare Advantage plan. What should you tell
n n n n n n n n n n
him? - ANSWER >>>>>Mr. Singh can enroll in a stand-alone
n n n n n n n n n n
prescription drug plan and continue to be covered for Part A
n n n n n n n n n n n
and Part B services through Original Fee-for-Service Medicare.
n n n n n n n n
Mrs. Chen will be 65 soon, has been a citizen for twelve
n n n n n n n n n n n
years,has been employed full time, and paid taxes during that
n n n n n n n n n n n
entire period. She is concerned that she will not qualify for
n n n n n n n n n n n
coverage under part A because she was not born in the
n n n n n n n n n n n
