2025 AHIP Final Exam with Verified Answers Graded A+
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2025 AHIP
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2025 AHIP
2025 AHIP Final Exam with Verified Answers Graded A+
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.: Mrs. Shields is covered by Original Medicare.
Sh...
2025 AHIP Final Exam with Verified Answers Graded A+
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.: 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?
2. Medicare does not cover massage therapy, or, in general, glasses or den-
tures.: 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?
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.: Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What
could you tell Mrs. Park that might be of assistance?
4. He generally would pay a monthly premium, annual deductible, and per-pre-
scription cost-sharing.: 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?
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.: 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?
6. He may sign-up for Medicare at any time however coverage usually begins
on the fourth month after dialysis treatments start.: 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?
7. Mrs. Duarte should file an appeal of this initial determination within 120 days
of the date she received the MSN in the mail.: 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?
8. 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.-
, 2025 AHIP Final Exam with Verified Answers Graded A+
: 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?
9. Medicare will cover a total of 190 days of inpatient psychiatric care during
Mr. Rainey's entire lifetime.: 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?
10. Beneficiaries under Original Medicare have no cost-sharing for most pre-
ventive services.: 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?
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.: Mr. Singh would like drug coverage but does not want to be enrolled in
a Medicare Advantage plan. What should you tell him?
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.: 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?
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.-
: 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?
14. Under Original Medicare, there is a single deductible amount due for the
first 60 days of any inpatient hospital stay, after which it converts into a per-day
coinsurance amount through day 90. After day 90, he would pay a daily amount
up to 60 days over his lifetime, after which he would be responsible for all
costs.: Mr. Patel is in good health and is preparing a budget in anticipation of his
retirement when he turns 66. He wants to understand the health care costs he might
be exposed to under Medicare if he were to require hospitalization because of an
, 2025 AHIP Final Exam with Verified Answers Graded A+
illness. In general terms, what could you tell him about his costs for inpatient hospital
services under Original Medicare?
15. The Part B deductible is no longer covered for individuals newly eligible
for Medicare starting January 1, 2020.: What impact, if any, have recent regulatory
changes had on Medigap plans?
16. Medigap plans do not cover Original Medicare benefits, but they coordi-
nate with Original Medicare coverage.: Mrs. Paterson is concerned about the
deductibles and co-payments associated with Original Medicare. What can you tell
her about Medigap as an option to address this concern?
17. Original Medicare covers ambulance services.: 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?
18. Medicare covers hospice services, and they will be available for her.: Ms.
Brooks has aggressive cancer and would like to know if Medicare will cover hospice
services in case she needs them. What should you tell her?
19. Mr. Diaz will not pay any penalty because he had continuous coverage
under his employer's plan.: Mr. Diaz continued working with his company and was
insured under his employer's group plan until he reached age 68. He has heard that
there is a premium penalty for those who did not sign up for Part B when first eligible
and wants to know how much he will have to pay. What should you tell him?
20. 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.: 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?
21. Hank's can continue to offer William the same employee health benefit
plan, or, if William enrolls in Medicare Part B, it can enroll him in a Medicare
Advantage plan that is offered to the public.: Hank's Fish Store, Inc. is a small
company with just 15 employees located in Florida. Hank, the store owner, has
provided excellent health benefits to the store's workforce. William, one of the store's
long-time employees, will soon be reaching age 65 and eligible for Medicare. William
is in good health. He intends to remain an active full-time employee, working several
years after becoming eligible for Medicare. What type(s) of retiree health benefit will
Hank's Fish Store be able to offer William?
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