Ahip 2025 Module 1 Questions with
Correct Answers
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? - ANSWERSBeneficiaries under
Original Medicare have no cost-sharing for most preventive services
Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving
Social Security benefits. Shortly thereafter Mrs. Quinn received a letter informing her
that she has been automatically enrolled in Medicare Part B. She wants to understand
what this means. What should you tell Mrs. Quinn? - ANSWERSPart B primarily covers
physician services. She will be paying a monthly premium and, except for many
preventive screening and tests, generally will have 20 percent co-payments for these
services in addition to an annual deductible
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? - ANSWERSHe may sign up for Medicare at any
time however coverage usually begins on the fourth month after dialysis treatment
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? -
ANSWERSHe generally would pay a monthly premium, annual deductible, and per-
prescription cost sharing.
Ms. Brooks has an aggressive cancer and would like to know if Medicare will cover
hospice services in case she needs them. What should you tell her? -
ANSWERSMedicare covers hospice services and they will be available to her.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell
Mrs. Park that might be of assistance? - ANSWERSShe 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. 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? -
ANSWERSMrs. Duarte should file an appeal of this initial determination within 120 days
of the date she received the MSN in the mail.
Correct Answers
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? - ANSWERSBeneficiaries under
Original Medicare have no cost-sharing for most preventive services
Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving
Social Security benefits. Shortly thereafter Mrs. Quinn received a letter informing her
that she has been automatically enrolled in Medicare Part B. She wants to understand
what this means. What should you tell Mrs. Quinn? - ANSWERSPart B primarily covers
physician services. She will be paying a monthly premium and, except for many
preventive screening and tests, generally will have 20 percent co-payments for these
services in addition to an annual deductible
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? - ANSWERSHe may sign up for Medicare at any
time however coverage usually begins on the fourth month after dialysis treatment
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? -
ANSWERSHe generally would pay a monthly premium, annual deductible, and per-
prescription cost sharing.
Ms. Brooks has an aggressive cancer and would like to know if Medicare will cover
hospice services in case she needs them. What should you tell her? -
ANSWERSMedicare covers hospice services and they will be available to her.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell
Mrs. Park that might be of assistance? - ANSWERSShe 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. 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? -
ANSWERSMrs. Duarte should file an appeal of this initial determination within 120 days
of the date she received the MSN in the mail.
