AHIP 2025 Module's 1-5 | 100 COMPLETE QUESTIONS AND ANSWERS | 100% RATED CORRECT | 100%
VERIFIED | GRADED A+| GET IT CORRECT!! | 2025 LATEST UPDATED
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? - correct answer He
generally would pay a monthly premium, annual deductible, and per-prescription cost-sharing.
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? -
correct 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.
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? - correct answer Beneficiaries under Original Medicare
have no cost-sharing for most preventive services.
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? - correct
answer 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.
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? - correct answer He may sign-up for Medicare at any time however
coverage usually begins on the fourth month after dialysis treatments start.
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? - correct answer
Under Original Medicare, there is a single deductible amount due for the first 60 days of any
inpatient hospital stay, after which it converts into a per-day coinsurance amount through day
90. After day 90, he would pay a daily amount up to 60 days over his lifetime, after which he
would be responsible for all costs.
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? - correct answer
,AHIP 2025 Module's 1-5 | 100 COMPLETE QUESTIONS AND ANSWERS | 100% RATED CORRECT | 100%
VERIFIED | GRADED A+| GET IT CORRECT!! | 2025 LATEST UPDATED
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. Diaz continued working with his company and was insured under his employer's group plan
until he reached age 68. He has heard that there is a premium penalty for those who did not
sign up for Part B when first eligible and wants to know how much he will have to pay. What
should you tell him? - correct answer Mr. Diaz will not pay any penalty because he had
continuous coverage under his employer's plan.
Mrs. Paterson is concerned about the deductibles and co-payments associated with Original
Medicare. What can you tell her about Medigap as an option to address this concern? - correct
answer Medigap plans do not cover Original Medicare benefits, but they coordinate with
Original Medicare coverage.
What impact, if any, have recent regulatory changes had on Medigap plans? - correct answer
The Part B deductible is no longer covered for individuals newly eligible for Medicare starting
January 1, 2020.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park
that might be of assistance? - correct 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.
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? - correct answer 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.
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? - correct answer 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.
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? - correct answer Beneficiaries must
file an appeal related to Part A or B services within 120 days of the date they get the MSN in the
mail. If a beneficiary disagrees with the Medicare Administrative Contractor's decision, they
have 180 days after getting the decision notice to request a reconsideration by a Qualified
Independent Contractor.
, AHIP 2025 Module's 1-5 | 100 COMPLETE QUESTIONS AND ANSWERS | 100% RATED CORRECT | 100%
VERIFIED | GRADED A+| GET IT CORRECT!! | 2025 LATEST UPDATED
Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and would like
to know which of the following services Original Medicare will cover if the appropriate criteria
are met. What could you tell her? - correct answer Original Medicare covers ambulance
services.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage
plan. What should you tell him? - correct answer 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.
Ms. Brooks has aggressive cancer and would like to know if Medicare will cover hospice services
in case she needs them. What should you tell her? - correct answer Medicare covers hospice
services, and they will be available for her.
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? - correct answer Medicare Part A
provides coverage for inpatient psychiatric care for up to 190 lifetime days.
Anita Magri will turn age 65 in August 2023. Anita intends to enroll in Original Medicare Part A
and Part B. She would also like to enroll in a Medicare Supplement (Medigap) plan. Anita's older
neighbor Mel has told her about the Medigap Plan F in which he is enrolled. It not only provides
foreign travel emergency benefits but also covers his Medicare Part B deductible. Anita comes
to you for advice. What should you tell her? - correct answer You are sorry to disappoint Anita,
but a Medigap F plan is no longer available to those who turn age 65 after January 1, 2020.
Anita might instead consider other Medigap plans that offer foreign travel benefits but do not
cover the Part B deductible.
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? - correct answer Medicare does not cover
massage therapy, or, in general, glasses or dentures.
Ms. Gibson recently lost her employer group health and drug coverage and now she wants to
enroll in a PPO that does not include drug coverage. What should you tell her about obtaining
drug coverage? - correct answer She can enroll in the PPO, but she will not be able to purchase
a stand-alone Medicare Part D prescription drug plan.
Mrs. Velasquez cares for her frail elderly mother, Maria, who lives in North Carolina. She is
worried that without additional support, her mother will need to go into a nursing home. Mrs.
Velasquez asks you if there is any Medicare plan that might allow her mother to remain in the
community rather than going into a nursing home. How should you advise Mrs. Velasquez? -
correct answer There are Programs of All-Inclusive Care for the Elderly (PACE) for frail elderly
VERIFIED | GRADED A+| GET IT CORRECT!! | 2025 LATEST UPDATED
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? - correct answer He
generally would pay a monthly premium, annual deductible, and per-prescription cost-sharing.
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? -
correct 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.
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? - correct answer Beneficiaries under Original Medicare
have no cost-sharing for most preventive services.
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? - correct
answer 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.
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? - correct answer He may sign-up for Medicare at any time however
coverage usually begins on the fourth month after dialysis treatments start.
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? - correct answer
Under Original Medicare, there is a single deductible amount due for the first 60 days of any
inpatient hospital stay, after which it converts into a per-day coinsurance amount through day
90. After day 90, he would pay a daily amount up to 60 days over his lifetime, after which he
would be responsible for all costs.
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? - correct answer
,AHIP 2025 Module's 1-5 | 100 COMPLETE QUESTIONS AND ANSWERS | 100% RATED CORRECT | 100%
VERIFIED | GRADED A+| GET IT CORRECT!! | 2025 LATEST UPDATED
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. Diaz continued working with his company and was insured under his employer's group plan
until he reached age 68. He has heard that there is a premium penalty for those who did not
sign up for Part B when first eligible and wants to know how much he will have to pay. What
should you tell him? - correct answer Mr. Diaz will not pay any penalty because he had
continuous coverage under his employer's plan.
Mrs. Paterson is concerned about the deductibles and co-payments associated with Original
Medicare. What can you tell her about Medigap as an option to address this concern? - correct
answer Medigap plans do not cover Original Medicare benefits, but they coordinate with
Original Medicare coverage.
What impact, if any, have recent regulatory changes had on Medigap plans? - correct answer
The Part B deductible is no longer covered for individuals newly eligible for Medicare starting
January 1, 2020.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park
that might be of assistance? - correct 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.
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? - correct answer 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.
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? - correct answer 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.
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? - correct answer Beneficiaries must
file an appeal related to Part A or B services within 120 days of the date they get the MSN in the
mail. If a beneficiary disagrees with the Medicare Administrative Contractor's decision, they
have 180 days after getting the decision notice to request a reconsideration by a Qualified
Independent Contractor.
, AHIP 2025 Module's 1-5 | 100 COMPLETE QUESTIONS AND ANSWERS | 100% RATED CORRECT | 100%
VERIFIED | GRADED A+| GET IT CORRECT!! | 2025 LATEST UPDATED
Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and would like
to know which of the following services Original Medicare will cover if the appropriate criteria
are met. What could you tell her? - correct answer Original Medicare covers ambulance
services.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage
plan. What should you tell him? - correct answer 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.
Ms. Brooks has aggressive cancer and would like to know if Medicare will cover hospice services
in case she needs them. What should you tell her? - correct answer Medicare covers hospice
services, and they will be available for her.
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? - correct answer Medicare Part A
provides coverage for inpatient psychiatric care for up to 190 lifetime days.
Anita Magri will turn age 65 in August 2023. Anita intends to enroll in Original Medicare Part A
and Part B. She would also like to enroll in a Medicare Supplement (Medigap) plan. Anita's older
neighbor Mel has told her about the Medigap Plan F in which he is enrolled. It not only provides
foreign travel emergency benefits but also covers his Medicare Part B deductible. Anita comes
to you for advice. What should you tell her? - correct answer You are sorry to disappoint Anita,
but a Medigap F plan is no longer available to those who turn age 65 after January 1, 2020.
Anita might instead consider other Medigap plans that offer foreign travel benefits but do not
cover the Part B deductible.
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? - correct answer Medicare does not cover
massage therapy, or, in general, glasses or dentures.
Ms. Gibson recently lost her employer group health and drug coverage and now she wants to
enroll in a PPO that does not include drug coverage. What should you tell her about obtaining
drug coverage? - correct answer She can enroll in the PPO, but she will not be able to purchase
a stand-alone Medicare Part D prescription drug plan.
Mrs. Velasquez cares for her frail elderly mother, Maria, who lives in North Carolina. She is
worried that without additional support, her mother will need to go into a nursing home. Mrs.
Velasquez asks you if there is any Medicare plan that might allow her mother to remain in the
community rather than going into a nursing home. How should you advise Mrs. Velasquez? -
correct answer There are Programs of All-Inclusive Care for the Elderly (PACE) for frail elderly
