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2025 AHIP Final Exam Questions and Answers with Solutions
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2025 AHIP Final Exam Questions and Answers with Solutions
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2025 AHIP Final ExamMrs. Shields is covered via Original Medicare. She sustained a hip fracture and is being
efficiently handled for that situation. However, she and her physicians feel that when her
lengthy medical institution stay, she can want a month or of nursing and rehabilitative care.
What should you tell them approximately Original Medicare's insurance of care in a skilled
nursing facility? - ANSMedicare will cowl Mrs. Shield's professional nursing services
provided at some point of the primary 20 days of her live, after which she could have a
copay until she has been in the facility for a hundred days.
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from
arthritis through rubdown remedy. She is involved about whether or now not Medicare will
cover these objects and services. What have to you inform her? - ANSMedicare does not
cowl massage therapy, or, in popular, glasses or dentures.
Mrs. Park is an aged retiree. Mrs. Park has a low fixed earnings. What could you inform Mrs.
Park that might be of help? - ANSShe should touch her nation Medicaid enterprise to look if
she qualifies for one in all several programs that may help with Medicare expenses for which
she is responsible.
Mr. Alonso gets a few assist buying his regular prescribed drugs from his enterprise's retiree
insurance, however he desires to evaluate it to a Part D prescription drug plan. He asks you
what expenses he might commonly anticipate to encounter whilst enrolling right into a
popular Medicare Part D prescription drug plan. What ought to you inform him? - ANSHe
typically could pay a month-to-month top rate, annual deductible, and per-prescription
fee-sharing.
Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as nicely, but it
offers no drug insurance. She would like to preserve the coverage she has however replace
her existing Medigap plan with one that offers drug coverage. What need to you inform her?
- ANSMrs. Gonzalez can not purchase a Medigap plan that covers drugs, but she should
keep her Medigap policy and join in a Part D prescription drug plan.
Mr. Davis is 52 years old and has currently been diagnosed with give up-level renal disease
(ESRD) and could soon begin dialysis. He is wondering if he can gain insurance under
Medicare. What should you tell him? - ANSHe may additionally signal-up for Medicare at any
time but insurance commonly starts on the fourth month after dialysis remedies begin.
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 in part denied one
among her claims for offerings. What advice could you deliver her? - ANSMrs. Duarte should
record an attraction of this preliminary willpower within a hundred and twenty days of the
date she received the MSN within the mail.
,Mrs. Geisler's neighbor instructed her she have to have a look at her Part D options in the
course of the once a year Medicare enrollment duration because the functions of Part D may
have changed. Mrs. Geisler cannot remember what Part D is so she known as you to ask
what her neighbor turned into speaking approximately. What ought to you inform her? -
ANSPart D covers prescription drugs and she need to examine her premiums, formulary,
and value-sharing among different elements to look if they have modified.
Mr. Rainey is experiencing paranoid delusions and his medical doctor feels that he should be
hospitalized. What ought to you inform Mr. Rainey (or his consultant) about the length of an
inpatient psychiatric clinic stay that Medicare will cover? - ANSMedicare will cowl a complete
of 190 days of inpatient psychiatric care at some point of Mr. Rainey's complete lifetime.
Mr. Xi will quickly turn age sixty five and has come to you for recommendation as to what
services are furnished beneath Original Medicare. What have to you tell Mr. Xi that best
describes the health coverage supplied to Medicare beneficiaries? - ANSBeneficiaries
underneath Original Medicare haven't any value-sharing for maximum preventive services.
Mr. Singh would like drug insurance however does not want to be enrolled in a Medicare
Advantage plan. What need to you tell him? - ANSMr. Singh can sign up in a stand-by
myself prescription drug plan and remain blanketed for Part A and Part B services thru
Original Fee-for-Service Medicare.
Mrs. Chen will be 65 quickly, has been a citizen for twelve years, has been employed full
time, and paid taxes during that complete duration. She is involved that she will not qualify
for coverage under element A due to the fact she turned into now not born within the United
States. What must you inform her? - ANSMost people who are citizens and age 65 or over
are covered underneath Part A via distinctive feature of getting paid Medicare taxes while
operating, although some may be blanketed as a result of paying month-to-month charges.
Mrs. Quinn lately turned sixty six and decided after a few years of labor to retire and start
receiving Social Security advantages. Shortly thereafter Mrs. Quinn received a letter
informing her that she have been automatically enrolled in Medicare Part B. She desires to
apprehend what this indicates. What ought to you inform Mrs. Quinn? - ANSPart B usually
covers physician offerings. She may be paying a monthly top rate and, except for many
preventive and screening tests, usually will have 20% co-payments for those services,
similarly to an annual deductible.
Mr. Patel is in proper fitness and is preparing a finances in anticipation of his retirement while
he turns 66. He desires to apprehend the fitness care charges he might be exposed to
underneath Medicare if he have been to require hospitalization due to an contamination. In
widespread terms, what ought to you inform him approximately his fees for inpatient
sanatorium services under Original Medicare? - ANSUnder Original Medicare, there is a
unmarried deductible quantity due for the primary 60 days of any inpatient clinic live, and
then it converts into a per-day coinsurance amount via day ninety. After day ninety, he might
pay a every day quantity up to 60 days over his lifetime, after which he would be responsible
for all prices.
, What effect, if any, have latest regulatory adjustments had on Medigap plans? - ANSThe
Part B deductible is no longer covered for people newly eligible for Medicare beginning
January 1, 2020.
Mrs. Paterson is concerned approximately the deductibles and co-bills associated with
Original Medicare. What can you tell her approximately Medigap as an option to cope with
this subject? - ANSMedigap plans do now not cover Original Medicare advantages, but they
coordinate with Original Medicare coverage.
Mrs. Turner is comparing her business enterprise's retiree coverage to Original Medicare
and would really like to realize which of the subsequent offerings Original Medicare will cowl
if the best standards are met. What ought to you inform her? - ANSOriginal Medicare covers
ambulance services.
Ms. Brooks has competitive most cancers and would love to know if Medicare will cowl
hospice offerings in case she desires them. What need to you tell her? - ANSMedicare
covers hospice services, and they may be to be had for her.
Mr. Diaz persisted running together with his enterprise and changed into insured under his
corporation's group plan till he reached age 68. He has heard that there's a premium penalty
for individuals who did not sign on for Part B when first eligible and desires to know how a
great deal he'll have to pay. What have to you tell him? - ANSMr. Diaz will no longer pay any
penalty due to the fact he had continuous insurance under his business enterprise's plan.
Anita Magri will turn age 65 in August 2023. Anita intends to enroll in Original Medicare Part
A and Part B. She could additionally like to sign up for a Medicare Supplement (Medigap)
plan. Anita's older neighbor Mel has instructed her approximately the Medigap Plan F in
which he is enrolled. It not handiest offers overseas journey emergency advantages however
also covers his Medicare Part B deductible. Anita comes to you for advice. What need to you
tell her? - ANSYou are sorry to disappoint Anita, but a Medigap F plan is now not to be had
to those who turn age sixty five after January 1, 2020. Anita might alternatively recollect
different Medigap plans that offer overseas travel advantages but do no longer cowl the Part
B deductible.
Hank's Fish Store, Inc. Is a small employer with simply 15 employees placed in Florida.
Hank, the store owner, has supplied fantastic health benefits to the store's body of workers.
William, one in all the shop's long-time employees, will quickly be reaching age sixty five and
eligible for Medicare. William is in right health. He intends to remain an energetic full-time
employee, running several years after becoming eligible for Medicare. What kind(s) of retiree
fitness gain will Hank's Fish Store be capable of offer William? - ANSHank's can preserve to
provide William the identical employee health gain plan, or, if William enrolls in Medicare
Part B, it could join him in a Medicare Advantage plan that is supplied to the general public.
Mr. Sanchez has simply grew to become 65 and is entitled to Part A however has no longer
enrolled in Part B due to the fact he has coverage through an enterprise plan. If he wants to
enroll in a Medicare Advantage plan, what will he have to do? - ANSHe will have to sign up
in Part B.
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