AHIP ALL MODULES QUESTIONS WITH CORRECT ANSWERS 2025

AHIP ALL MODULES QUESTIONS
WITH CORRECT ANSWERS 2025/2026
Ms.AHendersonAbelievesAthatAsheAwillAqualifyAforAMedicareACoverageAwhenAsheAturnsA65,Awith
outApayingAanyApremiums,AbecauseAsheAhasAbeenAworkingAforA40AyearsAandApayingAMedicareAt
axes.AWhatAshouldAyouAtellAher?A-
AcorrectAanswersToAobtainAPartABAcoverage,AsheAmustApayAaAstandardAmonthlyApremium,Athou


ghAitAisAhigherAforAindividualsAwithAhigherAincomes.

Mr.APatelAisAinAgoodAhealthAandAisApreparingAaAbudgetAinAanticipationAofAhisAretirementAwhenA
heAturnsA66.AHeAwantsAtoAunderstandAtheAhealthAcareAcostsAheAmightAbeAexposedAtoAunderAM
edicareAifAheAwereAtoArequireAhospitalizationAasAaAresultAofAanAillness.AInAgeneralAterms,AwhatAc
ouldAyouAtellAhimAaboutAhisAcostsAforAinpatientAhospitalAservicesAunderAOriginalAMedicare?A-
AcorrectAanswersUnderAOriginalAMedicare,AthereAisAaAsingleAdeductibleAamountAdueAforAtheAfir


stA60AdaysAofAanyAinpatientAhospitalAstay,AafterAwhichAitAconvertsAintoAaAper-
dayAcoinsuranceAamountAthroughAdayA90.AAfterAdayA90,AheAwouldApayAaAdailyAamountAupAtoA6
0AdaysAoverAhisAlifetime,AafterAwhichAheAwouldAbeAresponsibleAforAallAcosts.

JuanAPerez,AwhoAisAturningAageA65AnextAmonth,AintendsAtoAworkAforAseveralAmoreAyearsAatASm
allcap,AIncorporated.ASmallcapAhasAaAworkforceAofA15AemployeesAandAoffersAemployer-
sponsoredAhealthcareAcoverage.AJuanAisAaAnaturalizedAcitizenAandAhasAcontributedAtoAtheAMed
icareAsystemAforAoverA20Ayears.AJuanAasksAyouAifAheAwillAbeAentitledAtoAMedicareAandAifAheAenro
llsAhowAthatAwillAimpactAhisAemployer-
sponsoredAhealthcareAcoverage.AHowAwouldAyouArespond?A-
AcorrectAanswersJuanAisAlikelyAtoAbeAeligibleAforAMedicareAonceAheAturnsAageA65AandAifAheAenro


llsAMedicareAwouldAbecomeAtheAprimaryApayorAofAhisAhealthcareAclaimsAandASmallcapAdoesAn
otAhaveAtoAcontinueAtoAofferAhimAcoverageAcomparableAtoAthoseAunderAageA65AunderAitsAempl
oyer-sponsoredAgroupAhealthAplan.

AgentAJohnAMillerAisAmeetingAwithAJerryASmith,AaAnewAprospect.AJerryAisAcurrentlyAenrolledAinA
MedicareAPartsAAAandAB.AJerryAhasAalsoApurchasedAaAMedicareASupplementA(Medigap)AplanAw
hichAheAhasAhadAforAseveralAyears.AHowever,AtheAplanAdoesAnotAprovideAdrugAbenefits.AHowAw
ouldAyouAadviseAAgentAJohnAMillerAtoAproceed?A-
AcorrectAanswersTellAprospectAJerryASmithAthatAheAshouldAconsiderAaddingAaAstandaloneAPartA


DAprescriptionAdrugAcoverageApolicyAtoAhisApresentAcoverage.

Mrs.APeňaAisA66AyearsAold,AhasAcoverageAunderAanAemployerAplan,AandAwillAretireAnextAyear.ASh
eAheardAsheAmustAenrollAinAPartABAatAtheAbeginningAofAtheAyearAtoAensureAnoAgapAinAcoverage.A
WhatAcanAyouAtellAher?A-
AcorrectAanswersSheAmayAenrollAatAanyAtimeAwhileAsheAisAcoveredAunderAherAemployerAplan,Ab


utAsheAwillAhaveAaAspecialAeight-
monthAenrollmentAperiodAafterAtheAlastAmonthAonAherAemployerAplanAthatAdiffersAfromAtheAst
andardAgeneralAenrollmentAperiod,AduringAwhichAsheAmayAenrollAinAMedicareAPartAB.

,Mr.ACapadonaAwouldAlikeAtoApurchaseAaAMedicareAAdvantageA(MA)AplanAandAaAMedigapAplanAt
oApickAupAcostsAnotAcoveredAbyAthatAplan.AWhatAshouldAyouAtellAhim?A-
AcorrectAanswersItAisAillegalAforAyouAtoAsellAMr.ACapadonaAaAMedigapAplanAifAheAisAenrolledAinAa


nAMAAplan,AandAbesides,AMedigapAonlyAworksAwithAOriginalAMedicare.

Ms.AMooreAplansAtoAretireAwhenAsheAturnsA65AinAaAfewAmonths.ASheAisAinAexcellentAhealthAandA
willAhaveAconsiderableAincomeAwhenAsheAretires.ASheAisAconcernedAthatAherAincomeAwillAmake
AitAimpossibleAforAherAtoAqualifyAforAMedicare.AWhatAcouldAyouAtellAherAtoAaddressAherAconcer


n?A-
AcorrectAanswersMedicareAisAaAprogramAforApeopleAageA65AorAolderAandAthoseAunderAageA65Aw


ithAcertainAdisabilities,Aend-
stageArenalAdisease,AandALouAGehrig'sAdiseaseAsoAsheAwillAbeAeligibleAforAMedicare.

Mr.ABuckAhasAseveralAfamilyAmembersAwhoAdiedAfromAdifferentAcancers.AHeAwantsAtoAknowAifA
MedicareAcoversAcancerAscreening.AWhatAshouldAyouAtellAhim?A-
AcorrectAanswersMedicareAcoversAtheAperiodicAperformanceAofAaArangeAofAscreeningAtestsAtha


tAareAmeantAtoAprovideAearlyAdetectionAofAdisease.AMr.ABuckAwillAneedAtoAcheckAspecificAtestsA
beforeAobtainingAthemAtoAseeAifAtheyAwillAbeAcovered.

Mrs.ADuarteAisAenrolledAinAOriginalAMedicareAPartsAAAandAB.ASheAhasArecentlyAreviewedAherAM
edicareASummaryANoticeA(MSN)AandAdisagreesAwithAaAdeterminationAthatApartiallyAdeniedAon
eAofAherAclaimsAforAservices.AWhatAadviceAwouldAyouAgiveAher?A-
AcorrectAanswersMrs.ADuarteAshouldAfileAanAappealAofAthisAinitialAdetermination AwithinA120Ada


ysAofAtheAdateAsheAreceivedAtheAMSNAinAtheAmail.

Mrs.AGonzalezAisAenrolledAinAOriginalAMedicareAandAhasAaAMedigapApolicyAasAwell,AbutAitAprovi
desAnoAdrugAcoverage.ASheAwouldAlikeAtoAkeepAtheAcoverageAsheAhasAbutAreplaceAherAexistingA
MedigapAplanAwithAoneAthatAprovidesAdrugAcoverage.AWhatAshouldAyouAtellAher?A-
AcorrectAanswersMrs.AGonzalezAcannotApurchaseAaAMedigapAplanAthatAcoversAdrugs,AbutAsheAc


ouldAkeepAherAMedigapApolicyAandAenrollAinAaAPartADAprescriptionAdrugAplan.

Mr.AAlonsoAreceivesAsomeAhelpApayingAforAhisAtwoAgenericAprescriptionAdrugsAfromAhisAemplo
yer'sAretireeAcoverage,AbutAheAwantsAtoAcompareAitAtoAaAPartADAprescriptionAdrugAplan.AHeAask
sAyouAwhatAcostsAheAwouldAgenerallyAexpectAtoAencounterAwhenAenrollingAintoAaAstandardAMe
dicareAPartADAprescriptionAdrugAplan.AWhatAshouldAyouAtellAhim?A-
AcorrectAanswersHeAgenerallyAwouldApayAaAmonthlyApremium,AannualAdeductible,AandAper-


prescriptionAcost-sharing.

Mr.AMoy'sAwifeAhasAaAMedicareAAdvantageAplan,AbutAheAwantsAtoAunderstandAwhatAcoverageA
MedicareASupplementalAInsuranceAprovidesAsinceAhisAhealthAcareAneedsAareAdifferentAfromAhi
sAwife'sAneeds.AWhatAcouldAyouAtellAMr.AMoy?A-
AcorrectAanswersMedicareASupplementalAInsuranceAwouldAhelpAcoverAhisAPartAAAandAPartABAd


eductiblesAorAcoinsuranceAinAOriginalAFee-for-
ServiceA(FFS)AMedicareAasAwellAasApossiblyAsomeAservicesAthatAMedicareAdoesAnotAcover.

, Mr.ARaineyAisAexperiencingAparanoidAdelusionsAandAhisAphysicianAfeelsAthatAheAshouldAbeAhosp
italized.AWhatAshouldAyouAtellAMr.ARaineyA(orAhisArepresentative)AaboutAtheAlengthAofAanAinpati
entApsychiatricAhospitalAstayAthatAMedicareAwillAcover?A-
AcorrectAanswersMedicareAwillAcoverAaAtotalAofA190AdaysAofAinpatientApsychiatricAcareAduringA


Mr.ARainey'sAentireAlifetime.

Mrs.AChenAwillAbeA65Asoon,AhasAbeenAaAcitizenAforAtwelveAyears,AhasAbeenAemployedAfullAtime,A
andApaidAtaxesAduringAthatAentireAperiod.ASheAisAconcernedAthatAsheAwillAnotAqualifyAforAcover
ageAunderApartAAAbecauseAsheAwasAnotAbornAinAtheAUnitedAStates.AWhatAshouldAyouAtellAher?A-
AcorrectAanswersMostAindividualsAwhoAareAcitizensAandAageA65AorAoverAareAcoveredAunderAPar


tAAAbyAvirtueAofAhavingApaidAMedicareAtaxesAwhileAworking,AthoughAsomeAmayAbeAcoveredAasA
aAresultAofApayingAmonthlyApremiums.

Mrs.AParkAisAanAelderlyAretiree.AMrs.AParkAhasAaAlowAfixedAincome.AWhatAcouldAyouAtellAMrs.APa
rkAthatAmightAbeAofAassistance?A-
AcorrectAanswersSheAshouldAcontactAherAstateAMedicaidAagencyAtoAseeAifAsheAqualifiesAforAoneA


ofAseveralAprogramsAthatAcanAhelpAwithAMedicareAcostsAforAwhichAsheAisAresponsible.

Mr.ABauerAisA49AyearsAold,AbutAeighteenAmonthsAagoAheAwasAdeclaredAdisabledAbyAtheASocialAS
ecurityAAdministrationAandAhasAbeenAreceivingAdisabilityApayments.AHeAisAwonderingAwhether
AheAcanAobtainAcoverageAunderAMedicare.AWhatAshouldAyouAtellAhim?A-


AcorrectAanswersAfterAreceivingAsuchAdisabilityApaymentsAforA24Amonths,AheAwillAbeAautomatic


allyAenrolledAinAMedicare,AregardlessAofAage

Mr.ADavisAisA52AyearsAoldAandAhasArecentlyAbeenAdiagnosedAwithAend-
stageArenalAdiseaseA(ESRD)AandAwillAsoonAbeginAdialysis.AHeAisAwonderingAifAheAcanAobtainAcov
erageAunderAMedicare.AWhatAshouldAyouAtellAhim?A-AcorrectAanswersHeAmayAsign-
upAforAMedicareAatAanyAtimeAhoweverAcoverageAusuallyAbeginsAonAtheAfourthAmonthAafterAdial
ysisAtreatmentsAstart.

Mrs.AWestAwearsAglassesAandAdenturesAandAhasAenjoyedAconsiderableApainAreliefAfromAarthriti
sAthroughAmassageAtherapy.ASheAisAconcernedAaboutAwhetherAorAnotAMedicareAwillAcoverAthes
eAitemsAandAservices.AWhatAshouldAyouAtellAher?A-
AcorrectAanswersMedicareAdoesAnotAcoverAmassageAtherapy,Aor,AinAgeneral,AglassesAorAdenture


s.

Mr.ASchmidtAwouldAlikeAtoAplanAforAretirementAandAhasAaskedAyouAwhatAisAcoveredAunderAOrigi
nalAFee-for-ServiceA(FFS)AMedicare?AWhatAcouldAyouAtellAhim?A-
AcorrectAanswersPartAA,AwhichAcoversAhospital,AskilledAnursingAfacility,Ahospice,AandAhomeAhea


lthAservicesAandAPartAB,AwhichAcoversAprofessionalAservicesAsuchAasAthoseAprovidedAbyAaAdocto
rAareAcoveredAunderAOriginalAMedicare.

Mr.AXiAwillAsoonAturnAageA65AandAhasAcomeAtoAyouAforAadviceAasAtoAwhatAservicesAareAprovided
AunderAOriginalAMedicare.AWhatAshouldAyouAtellAMr.AXiAthatAbestAdescribesAtheAhealthAcoverag