AHIP 2025 FINAL EXAM QUESTIONS
AND ANSWERS
Mrs. bTurner bis bcomparing bher bemployer's bretiree binsurance bto bOriginal bMedicare
band bwould blike bto bknow bwhich bof bthe bfollowing bservices bOriginal bMedicare bwill
bcover bif bthe bappropriate bcriteria bare bmet. bWhat bcould byou btell bher? b- bcorrect
banswer b✔✔Original bMedicare bcovers bambulance bservices.
Mrs. bDuarte bis benrolled bin bOriginal bMedicare bParts bA band bB. bShe bhas brecently
breviewed bher bMedicare bSummary bNotice b(MSN) band bdisagrees bwith ba
bdetermination bthat bpartially bdenied bone bof bher bclaims bfor bservices. bWhat badvice
bwould byou bgive bher? b- bcorrect banswer b✔✔Mrs. bDuarte bshould bfile ban bappeal bof
bthis binitial bdetermination bwithin b120 bdays bof bthe bdate bshe breceived bthe bMSN bin
bthe bmail.
Mrs. bGeisler's bneighbor btold bher bshe bshould blook bat bher bPart bD boptions bduring
bthe bannual bMedicare benrollment bperiod bbecause bthe bfeatures bof bPart bD bmight
bhave bchanged. bMrs. bGeisler bcan't bremember bwhat bPart bD bis bso bshe bcalled byou
bto bask bwhat bher bneighbor bwas btalking babout. bWhat bcould byou btell bher? b- bcorrect
banswer b✔✔Part bD bcovers bprescription bdrugs band bshe bshould blook bat bher
bpremiums, bformulary, band bcost-sharing bamong bother bfactors bto bsee bif bthey bhave
bchanged.
Mrs. bPark bis ban belderly bretiree. bMrs. bPark bhas ba blow bfixed bincome. bWhat bcould
byou btell bMrs. bPark bthat bmight bbe bof bassistance? b- bcorrect banswer b✔✔She bshould
bcontact bher bstate bMedicaid bagency bto bsee bif bshe bqualifies bfor bone bof bseveral
bprograms bthat bcan bhelp bwith bMedicare bcosts bfor bwhich bshe bis bresponsible.
Mrs. bQuinn brecently bturned b66 band bdecided bafter bmany byears bof bwork bto bretire
band bbegin breceiving bSocial bSecurity bbenefits. bShortly bthereafter bMrs. bQuinn
breceived ba bletter binforming bher bthat bshe bhad bbeen bautomatically benrolled bin
bMedicare bPart bB. bShe bwants bto bunderstand bwhat bthis bmeans. bWhat bshould byou
, btell bMrs. bQuinn? b- bcorrect banswer b✔✔Part bB bprimarily bcovers bphysician bservices.
bShe bwill bbe bpaying ba bmonthly bpremium band, bexcept bfor bmany bpreventive band
bscreening btests, bgenerally bwill bhave b20% bco-payments bfor bthese bservices, bin
baddition bto ban bannual bdeductible.
Anita bMagri bwill bturn bage b65 bin bAugust b2023. bAnita bintends bto benroll bin bOriginal
bMedicare bPart bA band bPart bB. bShe bwould balso blike bto benroll bin ba bMedicare
bSupplement b(Medigap) bplan. bAnita's bolder bneighbor bMel bhas btold bher babout bthe
bMedigap bPlan bF bin bwhich bhe bis benrolled. bIt bnot bonly bprovides bforeign btravel
bemergency bbenefits bbut balso bcovers bhis bMedicare bPart bB bdeductible. bAnita
bcomes bto byou bfor badvice. bWhat bshould byou btell bher? b- bcorrect banswer b✔✔You
bare bsorry bto bdisappoint bAnita, bbut ba bMedigap bF bplan bis bno blonger bavailable bto
bthose bwho bturn bage b65 bafter bJanuary b1, b2020. bAnita bmight binstead bconsider
bother bMedigap bplans bthat boffer bforeign btravel bbenefits bbut bdo bnot bcover bthe bPart
bB bdeductible.
Mr. bSingh bwould blike bdrug bcoverage bbut bdoes bnot bwant bto bbe benrolled bin ba
bMedicare bAdvantage bplan. bWhat bshould byou btell bhim? b- bcorrect banswer b✔✔Mr.
bSingh bcan benroll bin ba bstand-alone bprescription bdrug bplan band bcontinue bto bbe
bcovered bfor bPart bA band bPart bB bservices bthrough bOriginal bFee-for-Service
bMedicare.
Mrs. bChen bwill bbe b65 bsoon, bhas bbeen ba bcitizen bfor btwelve byears, bhas bbeen
bemployed bfull btime, band bpaid btaxes bduring bthat bentire bperiod. bShe bis bconcerned
bthat bshe bwill bnot bqualify bfor bcoverage bunder bpart bA bbecause bshe bwas bnot bborn
bin bthe bUnited bStates. bWhat bshould byou btell bher? b- bcorrect banswer b✔✔Most
bindividuals bwho bare bcitizens band bage b65 bor bover bare bcovered bunder bPart bA bby
bvirtue bof bhaving bpaid bMedicare btaxes bwhile bworking, bthough bsome bmay bbe
bcovered bas ba bresult bof bpaying bmonthly bpremiums.
Mr. bXi bwill bsoon bturn bage b65 band bhas bcome bto byou bfor badvice bas bto bwhat
bservices bare bprovided bunder bOriginal bMedicare. bWhat bshould byou btell bMr. bXi bthat
bbest bdescribes bthe bhealth bcoverage bprovided bto bMedicare bbeneficiaries? b- bcorrect
banswer b✔✔Beneficiaries bunder bOriginal bMedicare bhave bno bcost-sharing bfor bmost
bpreventive bservices.
Mr. bBarker benjoys ba bcomfortable bretirement bincome. bHe brecently bhad bsurgery band
bexpected bthat bhe bwould bhave bcertain bservices band bitems bcovered bby bthe bplan
bwith bminimal bout-of-pocket bcosts bbecause bhis bMA-PD bcoverage bhas bbeen bvery
bgood. bHowever, bwhen bhe breceived bthe bbill, bhe bwas bsurprised bto bsee blarge
bcharges bin bexcess bof bhis bmaximum bout-of-pocket blimit bthat bincluded bsome
bservices band bitems bhe bthought bwould bbe bfully bcovered. bHe bcalled byou bto bask
bwhat bhe bcould bdo? bWhat bcould byou btell bhim? b- bcorrect banswer b✔✔You bcan boffer
bto breview bthe bplans bappeal bprocess bto bhelp bhim bask bthe bplan bto breview bthe
bcoverage bdecision.
AND ANSWERS
Mrs. bTurner bis bcomparing bher bemployer's bretiree binsurance bto bOriginal bMedicare
band bwould blike bto bknow bwhich bof bthe bfollowing bservices bOriginal bMedicare bwill
bcover bif bthe bappropriate bcriteria bare bmet. bWhat bcould byou btell bher? b- bcorrect
banswer b✔✔Original bMedicare bcovers bambulance bservices.
Mrs. bDuarte bis benrolled bin bOriginal bMedicare bParts bA band bB. bShe bhas brecently
breviewed bher bMedicare bSummary bNotice b(MSN) band bdisagrees bwith ba
bdetermination bthat bpartially bdenied bone bof bher bclaims bfor bservices. bWhat badvice
bwould byou bgive bher? b- bcorrect banswer b✔✔Mrs. bDuarte bshould bfile ban bappeal bof
bthis binitial bdetermination bwithin b120 bdays bof bthe bdate bshe breceived bthe bMSN bin
bthe bmail.
Mrs. bGeisler's bneighbor btold bher bshe bshould blook bat bher bPart bD boptions bduring
bthe bannual bMedicare benrollment bperiod bbecause bthe bfeatures bof bPart bD bmight
bhave bchanged. bMrs. bGeisler bcan't bremember bwhat bPart bD bis bso bshe bcalled byou
bto bask bwhat bher bneighbor bwas btalking babout. bWhat bcould byou btell bher? b- bcorrect
banswer b✔✔Part bD bcovers bprescription bdrugs band bshe bshould blook bat bher
bpremiums, bformulary, band bcost-sharing bamong bother bfactors bto bsee bif bthey bhave
bchanged.
Mrs. bPark bis ban belderly bretiree. bMrs. bPark bhas ba blow bfixed bincome. bWhat bcould
byou btell bMrs. bPark bthat bmight bbe bof bassistance? b- bcorrect banswer b✔✔She bshould
bcontact bher bstate bMedicaid bagency bto bsee bif bshe bqualifies bfor bone bof bseveral
bprograms bthat bcan bhelp bwith bMedicare bcosts bfor bwhich bshe bis bresponsible.
Mrs. bQuinn brecently bturned b66 band bdecided bafter bmany byears bof bwork bto bretire
band bbegin breceiving bSocial bSecurity bbenefits. bShortly bthereafter bMrs. bQuinn
breceived ba bletter binforming bher bthat bshe bhad bbeen bautomatically benrolled bin
bMedicare bPart bB. bShe bwants bto bunderstand bwhat bthis bmeans. bWhat bshould byou
, btell bMrs. bQuinn? b- bcorrect banswer b✔✔Part bB bprimarily bcovers bphysician bservices.
bShe bwill bbe bpaying ba bmonthly bpremium band, bexcept bfor bmany bpreventive band
bscreening btests, bgenerally bwill bhave b20% bco-payments bfor bthese bservices, bin
baddition bto ban bannual bdeductible.
Anita bMagri bwill bturn bage b65 bin bAugust b2023. bAnita bintends bto benroll bin bOriginal
bMedicare bPart bA band bPart bB. bShe bwould balso blike bto benroll bin ba bMedicare
bSupplement b(Medigap) bplan. bAnita's bolder bneighbor bMel bhas btold bher babout bthe
bMedigap bPlan bF bin bwhich bhe bis benrolled. bIt bnot bonly bprovides bforeign btravel
bemergency bbenefits bbut balso bcovers bhis bMedicare bPart bB bdeductible. bAnita
bcomes bto byou bfor badvice. bWhat bshould byou btell bher? b- bcorrect banswer b✔✔You
bare bsorry bto bdisappoint bAnita, bbut ba bMedigap bF bplan bis bno blonger bavailable bto
bthose bwho bturn bage b65 bafter bJanuary b1, b2020. bAnita bmight binstead bconsider
bother bMedigap bplans bthat boffer bforeign btravel bbenefits bbut bdo bnot bcover bthe bPart
bB bdeductible.
Mr. bSingh bwould blike bdrug bcoverage bbut bdoes bnot bwant bto bbe benrolled bin ba
bMedicare bAdvantage bplan. bWhat bshould byou btell bhim? b- bcorrect banswer b✔✔Mr.
bSingh bcan benroll bin ba bstand-alone bprescription bdrug bplan band bcontinue bto bbe
bcovered bfor bPart bA band bPart bB bservices bthrough bOriginal bFee-for-Service
bMedicare.
Mrs. bChen bwill bbe b65 bsoon, bhas bbeen ba bcitizen bfor btwelve byears, bhas bbeen
bemployed bfull btime, band bpaid btaxes bduring bthat bentire bperiod. bShe bis bconcerned
bthat bshe bwill bnot bqualify bfor bcoverage bunder bpart bA bbecause bshe bwas bnot bborn
bin bthe bUnited bStates. bWhat bshould byou btell bher? b- bcorrect banswer b✔✔Most
bindividuals bwho bare bcitizens band bage b65 bor bover bare bcovered bunder bPart bA bby
bvirtue bof bhaving bpaid bMedicare btaxes bwhile bworking, bthough bsome bmay bbe
bcovered bas ba bresult bof bpaying bmonthly bpremiums.
Mr. bXi bwill bsoon bturn bage b65 band bhas bcome bto byou bfor badvice bas bto bwhat
bservices bare bprovided bunder bOriginal bMedicare. bWhat bshould byou btell bMr. bXi bthat
bbest bdescribes bthe bhealth bcoverage bprovided bto bMedicare bbeneficiaries? b- bcorrect
banswer b✔✔Beneficiaries bunder bOriginal bMedicare bhave bno bcost-sharing bfor bmost
bpreventive bservices.
Mr. bBarker benjoys ba bcomfortable bretirement bincome. bHe brecently bhad bsurgery band
bexpected bthat bhe bwould bhave bcertain bservices band bitems bcovered bby bthe bplan
bwith bminimal bout-of-pocket bcosts bbecause bhis bMA-PD bcoverage bhas bbeen bvery
bgood. bHowever, bwhen bhe breceived bthe bbill, bhe bwas bsurprised bto bsee blarge
bcharges bin bexcess bof bhis bmaximum bout-of-pocket blimit bthat bincluded bsome
bservices band bitems bhe bthought bwould bbe bfully bcovered. bHe bcalled byou bto bask
bwhat bhe bcould bdo? bWhat bcould byou btell bhim? b- bcorrect banswer b✔✔You bcan boffer
bto breview bthe bplans bappeal bprocess bto bhelp bhim bask bthe bplan bto breview bthe
bcoverage bdecision.
