AHIP 2025 FINAL EXAM 50 QUESTIONS AND THEIR ONLY
ANSWERS
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? - answers✔✔Original Medicare covers ambulance services.
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? - answers✔✔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 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? - answers✔✔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. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park
that might be of assistance? - answers✔✔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? - answers✔✔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.
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? - answers✔✔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.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage
plan. What should you tell him? - answers✔✔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.
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? -
answers✔✔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. 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? - answers✔✔Beneficiaries under Original Medicare have
no cost-sharing for most preventive services.
Mr. Barker enjoys a comfortable retirement income. He recently had surgery and expected that
he would have certain services and items covered by the plan with minimal out-of-pocket costs
because his MA-PD coverage has been very good. However, when he received the bill, he was
ANSWERS
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? - answers✔✔Original Medicare covers ambulance services.
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? - answers✔✔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 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? - answers✔✔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. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park
that might be of assistance? - answers✔✔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? - answers✔✔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.
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? - answers✔✔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.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage
plan. What should you tell him? - answers✔✔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.
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? -
answers✔✔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. 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? - answers✔✔Beneficiaries under Original Medicare have
no cost-sharing for most preventive services.
Mr. Barker enjoys a comfortable retirement income. He recently had surgery and expected that
he would have certain services and items covered by the plan with minimal out-of-pocket costs
because his MA-PD coverage has been very good. However, when he received the bill, he was
