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2025 AHIP Final Exam questions with correct answers verified 100%2025 AHIP Final Exam questions with correct answers verified 100% 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 fe...

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  • October 11, 2024
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2025 AHIP Final Exam questions with co
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Mrs.olsShieldsolsisolscoveredolsbyolsOriginalolsMedicare.olsSheolssustainedolsaolshipolsfractureolsandolsisolsbeingolssuccess
fullyolstreatedolsforolsthatolscondition.olsHowever,olssheolsandolsherolsphysiciansolsfeelolsthatolsafterolsherolslengthyolsho
spitalolsstay,olssheolswillolsneedolsaolsmontholsorolstwoolsofolsnursingolsandolsrehabilitativeolscare.olsWhatolsshouldolsyouols
tellolsthemolsaboutolsOriginalolsMedicare'solscoverageolsofolscareolsinolsaolsskilledolsnursingolsfacility?ols-
olscorrectolsanswers-

MedicareolswillolscoverolsMrs.olsShield'solsskilledolsnursingolsservicesolsprovidedolsduringolstheolsfirstols20olsdaysolsofolsh
erolsstay,olsafterolswhicholssheolswouldolshaveolsaolscopayolsuntilolssheolshasolsbeenolsinolstheolsfacilityolsforols100olsdays.

Mrs.olsWestolswearsolsglassesolsandolsdenturesolsandolshasolsenjoyedolsconsiderableolspainolsreliefolsfromolsarthritisolst
hrougholsmassageolstherapy.olsSheolsisolsconcernedolsaboutolswhetherolsorolsnotolsMedicareolswillolscoverolstheseolsite
msolsandolsservices.olsWhatolsshouldolsyouolstellolsher?ols-olscorrectolsanswers-
Medicareolsdoesolsnotolscoverolsmassageolstherapy,olsor,olsinolsgeneral,olsglassesolsorolsdentures.

Mrs.olsParkolsisolsanolselderlyolsretiree.olsMrs.olsParkolshasolsaolslowolsfixedolsincome.olsWhatolscouldolsyouolstellolsMrs.olsP
arkolsthatolsmightolsbeolsofolsassistance?ols-olscorrectolsanswers-
SheolsshouldolscontactolsherolsstateolsMedicaidolsagencyolstoolsseeolsifolssheolsqualifiesolsforolsoneolsofolsseveralolsprogra
msolsthatolscanolshelpolswitholsMedicareolscostsolsforolswhicholssheolsisolsresponsible.

Mr.olsAlonsoolsreceivesolssomeolshelpolspayingolsforolshisolstwoolsgenericolsprescriptionolsdrugsolsfromolshisolsemployer
'solsretireeolscoverage,olsbutolsheolswantsolstoolscompareolsitolstoolsaolsPartolsDolsprescriptionolsdrugolsplan.olsHeolsasksolsy
ouolswhatolscostsolsheolswouldolsgenerallyolsexpectolstoolsencounterolswhenolsenrollingolsintoolsaolsstandardolsMedicar
eolsPartolsDolsprescriptionolsdrugolsplan.olsWhatolsshouldolsyouolstellolshim?ols-olscorrectolsanswers-
Heolsgenerallyolswouldolspayolsaolsmonthlyolspremium,olsannualolsdeductible,olsandolsper-prescriptionolscost-
sharing.

Mrs.olsGonzalezolsisolsenrolledolsinolsOriginalolsMedicareolsandolshasolsaolsMedigapolspolicyolsasolswell,olsbutolsitolsprovid
esolsnoolsdrugolscoverage.olsSheolswouldolslikeolstoolskeepolstheolscoverageolssheolshasolsbutolsreplaceolsherolsexistingolsM
edigapolsplanolswitholsoneolsthatolsprovidesolsdrugolscoverage.olsWhatolsshouldolsyouolstellolsher?ols-
olscorrectolsanswers-

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digapolspolicyolsandolsenrollolsinolsaolsPartolsDolsprescriptionolsdrugolsplan.

Mr.olsDavisolsisols52olsyearsolsoldolsandolshasolsrecentlyolsbeenolsdiagnosedolswitholsend-
stageolsrenalolsdiseaseols(ESRD)olsandolswillolssoonolsbeginolsdialysis.olsHeolsisolswonderingolsifolsheolscanolsobtainolscover
ageolsunderolsMedicare.olsWhatolsshouldolsyouolstellolshim?ols-olscorrectolsanswers-Heolsmayolssign-
upolsforolsMedicareolsatolsanyolstimeolshoweverolscoverageolsusuallyolsbeginsolsonolstheolsfourtholsmontholsafterolsdialys
isolstreatmentsolsstart.

Mrs.olsDuarteolsisolsenrolledolsinolsOriginalolsMedicareolsPartsolsAolsandolsB.olsSheolshasolsrecentlyolsreviewedolsherolsMe
dicareolsSummaryolsNoticeols(MSN)olsandolsdisagreesolswitholsaolsdeterminationolsthatolspartiallyolsdeniedolsoneolsofols

,herolsclaimsolsforolsservices.olsWhatolsadviceolswouldolsyouolsgiveolsher?ols-olscorrectolsanswers-
Mrs.olsDuarteolsshouldolsfileolsanolsappealolsofolsthisolsinitialolsdeterminationolswithinols120olsdaysolsofolstheolsdateolsshe
olsreceivedolstheolsMSNolsinolstheolsmail.



Mrs.olsGeisler'solsneighborolstoldolsherolssheolsshouldolslookolsatolsherolsPartolsDolsoptionsolsduringolstheolsannualolsMedi
careolsenrollmentolsperiodolsbecauseolstheolsfeaturesolsofolsPartolsDolsmightolshaveolschanged.olsMrs.olsGeislerolscan'tols
rememberolswhatolsPartolsDolsisolssoolssheolscalledolsyouolstoolsaskolswhatolsherolsneighborolswasolstalkingolsabout.olsWha
tolscouldolsyouolstellolsher?ols-olscorrectolsanswers-
PartolsDolscoversolsprescriptionolsdrugsolsandolssheolsshouldolslookolsatolsherolspremiums,olsformulary,olsandolscost-
sharingolsamongolsotherolsfactorsolstoolsseeolsifolstheyolshaveolschanged.

Mr.olsRaineyolsisolsexperiencingolsparanoidolsdelusionsolsandolshisolsphysicianolsfeelsolsthatolsheolsshouldolsbeolshospita
lized.olsWhatolsshouldolsyouolstellolsMr.olsRaineyols(orolshisolsrepresentative)olsaboutolstheolslengtholsofolsanolsinpatientol
spsychiatricolshospitalolsstayolsthatolsMedicareolswillolscover?ols-olscorrectolsanswers-

Medicareolswillolscoverolsaolstotalolsofols190olsdaysolsofolsinpatientolspsychiatricolscareolsduringolsMr.olsRainey'solsentireol
slifetime.



Mr.olsXiolswillolssoonolsturnolsageols65olsandolshasolscomeolstoolsyouolsforolsadviceolsasolstoolswhatolsservicesolsareolsprovide
dolsunderolsOriginalolsMedicare.olsWhatolsshouldolsyouolstellolsMr.olsXiolsthatolsbestolsdescribesolstheolshealtholscoverag
eolsprovidedolstoolsMedicareolsbeneficiaries?ols-olscorrectolsanswers-
BeneficiariesolsunderolsOriginalolsMedicareolshaveolsnoolscost-sharingolsforolsmostolspreventiveolsservices.

Mr.olsSingholswouldolslikeolsdrugolscoverageolsbutolsdoesolsnotolswantolstoolsbeolsenrolledolsinolsaolsMedicareolsAdvantag
eolsplan.olsWhatolsshouldolsyouolstellolshim?ols-olscorrectolsanswers-Mr.olsSingholscanolsenrollolsinolsaolsstand-
aloneolsprescriptionolsdrugolsplanolsandolscontinueolstoolsbeolscoveredolsforolsPartolsAolsandolsPartolsBolsservicesolsthroug
holsOriginalolsFee-for-ServiceolsMedicare.

Mrs.olsChenolswillolsbeols65olssoon,olshasolsbeenolsaolscitizenolsforolstwelveolsyears,olshasolsbeenolsemployedolsfullolstime,ol
sandolspaidolstaxesolsduringolsthatolsentireolsperiod.olsSheolsisolsconcernedolsthatolssheolswillolsnotolsqualifyolsforolscovera

geolsunderolspartolsAolsbecauseolssheolswasolsnotolsbornolsinolstheolsUnitedolsStates.olsWhatolsshouldolsyouolstellolsher?ols-
olscorrectolsanswers-

Mostolsindividualsolswhoolsareolscitizensolsandolsageols65olsorolsoverolsareolscoveredolsunderolsPartolsAolsbyolsvirtueolsofolsh
avingolspaidolsMedicareolstaxesolswhileolsworking,olsthougholssomeolsmayolsbeolscoveredolsasolsaolsresultolsofolspayingols
monthlyolspremiums.

Mrs.olsQuinnolsrecentlyolsturnedols66olsandolsdecidedolsafterolsmanyolsyearsolsofolsworkolstoolsretireolsandolsbeginolsrecei
vingolsSocialolsSecurityolsbenefits.olsShortlyolsthereafterolsMrs.olsQuinnolsreceivedolsaolsletterolsinformingolsherolsthatols
sheolshadolsbeenolsautomaticallyolsenrolledolsinolsMedicareolsPartolsB.olsSheolswantsolstoolsunderstandolswhatolsthisolsm
eans.olsWhatolsshouldolsyouolstellolsMrs.olsQuinn?ols-olscorrectolsanswers-
PartolsBolsprimarilyolscoversolsphysicianolsservices.olsSheolswillolsbeolspayingolsaolsmonthlyolspremiumolsand,olsexceptolsf
orolsmanyolspreventiveolsandolsscreeningolstests,olsgenerallyolswillolshaveols20%olsco-
paymentsolsforolstheseolsservices,olsinolsadditionolstoolsanolsannualolsdeductible.

Mr.olsPatelolsisolsinolsgoodolshealtholsandolsisolspreparingolsaolsbudgetolsinolsanticipationolsofolshisolsretirementolswhenolsh
eolsturnsols66.olsHeolswantsolstoolsunderstandolstheolshealtholscareolscostsolsheolsmightolsbeolsexposedolstoolsunderolsMed
icareolsifolsheolswereolstoolsrequireolshospitalizationolsbecauseolsofolsanolsillness.olsInolsgeneralolsterms,olswhatolscouldols
youolstellolshimolsaboutolshisolscostsolsforolsinpatientolshospitalolsservicesolsunderolsOriginalolsMedicare?ols-

, olscorrectolsanswers-
UnderolsOriginalolsMedicare,olsthereolsisolsaolssingleolsdeductibleolsamountolsdueolsforolstheolsfirstols60olsdaysolsofolsanyols
inpatientolshospitalolsstay,olsafterolswhicholsitolsconvertsolsintoolsaolsper-
dayolscoinsuranceolsamountolsthrougholsdayols90.olsAfterolsdayols90,olsheolswouldolspayolsaolsdailyolsamountolsupolstools60
olsdaysolsoverolshisolslifetime,olsafterolswhicholsheolswouldolsbeolsresponsibleolsforolsallolscosts.



Whatolsimpact,olsifolsany,olshaveolsrecentolsregulatoryolschangesolshadolsonolsMedigapolsplans?ols-olscorrectolsanswers-
TheolsPartolsBolsdeductibleolsisolsnoolslongerolscoveredolsforolsindividualsolsnewlyolseligibleolsforolsMedicareolsstartingols
Januaryols1,ols2020.

Mrs.olsPatersonolsisolsconcernedolsaboutolstheolsdeductiblesolsandolsco-
paymentsolsassociatedolswitholsOriginalolsMedicare.olsWhatolscanolsyouolstellolsherolsaboutolsMedigapolsasolsanolsoptio
nolstoolsaddressolsthisolsconcern?ols-olscorrectolsanswers-
MedigapolsplansolsdoolsnotolscoverolsOriginalolsMedicareolsbenefits,olsbutolstheyolscoordinateolswitholsOriginalolsMedi
careolscoverage.

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toolsknowolswhicholsofolstheolsfollowingolsservicesolsOriginalolsMedicareolswillolscoverolsifolstheolsappropriateolscriteriaol
sareolsmet.olsWhatolscouldolsyouolstellolsher?ols-olscorrectolsanswers-

OriginalolsMedicareolscoversolsambulanceolsservices.

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esolsinolscaseolssheolsneedsolsthem.olsWhatolsshouldolsyouolstellolsher?ols-olscorrectolsanswers-
Medicareolscoversolshospiceolsservices,olsandolstheyolswillolsbeolsavailableolsforolsher.

Mr.olsDiazolscontinuedolsworkingolswitholshisolscompanyolsandolswasolsinsuredolsunderolshisolsemployer'solsgroupolspla
nolsuntilolsheolsreachedolsageols68.olsHeolshasolsheardolsthatolsthereolsisolsaolspremiumolspenaltyolsforolsthoseolswhoolsdidols
notolssignolsupolsforolsPartolsBolswhenolsfirstolseligibleolsandolswantsolstoolsknowolshowolsmucholsheolswillolshaveolstoolspay.ols
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an.

AnitaolsMagriolswillolsturnolsageols65olsinolsAugustols2023.olsAnitaolsintendsolstoolsenrollolsinolsOriginalolsMedicareolsPartol
sAolsandolsPartolsB.olsSheolswouldolsalsoolslikeolstoolsenrollolsinolsaolsMedicareolsSupplementols(Medigap)olsplan.olsAnita'sol

solderolsneighborolsMelolshasolstoldolsherolsaboutolstheolsMedigapolsPlanolsFolsinolswhicholsheolsisolsenrolled.olsItolsnotolsonl

yolsprovidesolsforeignolstravelolsemergencyolsbenefitsolsbutolsalsoolscoversolshisolsMedicareolsPartolsBolsdeductible.olsA
nitaolscomesolstoolsyouolsforolsadvice.olsWhatolsshouldolsyouolstellolsher?ols-olscorrectolsanswers-
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urnolsageols65olsafterolsJanuaryols1,ols2020.olsAnitaolsmightolsinsteadolsconsiderolsotherolsMedigapolsplansolsthatolsoffero
lsforeignolstravelolsbenefitsolsbutolsdoolsnotolscoverolstheolsPartolsBolsdeductible.



Hank'solsFisholsStore,olsInc.olsisolsaolssmallolscompanyolswitholsjustols15olsemployeesolslocatedolsinolsFlorida.olsHank,olsth
eolsstoreolsowner,olshasolsprovidedolsexcellentolshealtholsbenefitsolstoolstheolsstore'solsworkforce.olsWilliam,olsoneolsofol
stheolsstore'solslong-

timeolsemployees,olswillolssoonolsbeolsreachingolsageols65olsandolseligibleolsforolsMedicare.olsWilliamolsisolsinolsgoodolshe
alth.olsHeolsintendsolstoolsremainolsanolsactiveolsfull-
timeolsemployee,olsworkingolsseveralolsyearsolsafterolsbecomingolseligibleolsforolsMedicare.olsWhatolstype(s)olsofolsreti

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