2025 AHIP FINAL
Boosted EXAM (
Latest 2025/2026 )
with Questions and
Verified
Answers, 100%
Graded A+
Question 1
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.
Correct Answer
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?
Question 2
Medicare does not cover massage therapy, or, in general, glasses or dentures.
Correct Answer
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?
Question 3
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.
Correct Answer
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell
Mrs. Park that might be of assistance?
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,Question 4
He generally would pay a monthly premium, annual deductible, and per-prescription
costsharing.
Correct Answer
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?
Question 5
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.
Correct Answer
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?
Question 6
He may sign-up for Medicare at any time however coverage usually begins on the
fourth month after dialysis treatments start.
Correct Answer
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?
Question 7
Mrs. Duarte should file an appeal of this initial determination within 120 days of the
date she received the MSN in the mail.
Correct Answer
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?
Question 8
Part D covers prescription drugs and she should look at her premiums, formulary, and
costsharing among other factors to see if they have changed.
Correct Answer
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?
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, Question 9
Medicare will cover a total of 190 days of inpatient psychiatric care during Mr.
Rainey's entire lifetime.
Correct Answer
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?
Question 10
Beneficiaries under Original Medicare have no cost-sharing for most preventive
services.
Correct Answer
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?
Question 11
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.
Correct Answer
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare
Advantage plan. What should you tell him?
Question 12
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.
Correct Answer
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?
Question 13
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.
Correct Answer
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?
Trusted by thousands of students and professionals worldwide Page 3 of 25
Boosted EXAM (
Latest 2025/2026 )
with Questions and
Verified
Answers, 100%
Graded A+
Question 1
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.
Correct Answer
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?
Question 2
Medicare does not cover massage therapy, or, in general, glasses or dentures.
Correct Answer
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?
Question 3
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.
Correct Answer
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell
Mrs. Park that might be of assistance?
Trusted by thousands of students and professionals worldwide Page 1 of 25
,Question 4
He generally would pay a monthly premium, annual deductible, and per-prescription
costsharing.
Correct Answer
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?
Question 5
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.
Correct Answer
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?
Question 6
He may sign-up for Medicare at any time however coverage usually begins on the
fourth month after dialysis treatments start.
Correct Answer
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?
Question 7
Mrs. Duarte should file an appeal of this initial determination within 120 days of the
date she received the MSN in the mail.
Correct Answer
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?
Question 8
Part D covers prescription drugs and she should look at her premiums, formulary, and
costsharing among other factors to see if they have changed.
Correct Answer
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?
Trusted by thousands of students and professionals worldwide Page 2 of 25
, Question 9
Medicare will cover a total of 190 days of inpatient psychiatric care during Mr.
Rainey's entire lifetime.
Correct Answer
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?
Question 10
Beneficiaries under Original Medicare have no cost-sharing for most preventive
services.
Correct Answer
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?
Question 11
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.
Correct Answer
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare
Advantage plan. What should you tell him?
Question 12
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.
Correct Answer
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?
Question 13
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.
Correct Answer
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?
Trusted by thousands of students and professionals worldwide Page 3 of 25
