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2025 AHIP Final Exam QUESTIONS AND ANSWERS (2025/2026) (VERIFIED ANSWERS)
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2025 AHIP Final Exam QUESTIONS AND ANSWERS (2025/2026) (VERIFIED ANSWERS)
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2025 AHIP Final ExamMrs. Shields is included with the aid of Original Medicare. She sustained a hip fracture and is
being correctly treated for that circumstance. However, she and her physicians sense that
after her lengthy sanatorium live, she will be able to need a month or of nursing and
rehabilitative care. What need to you tell them approximately Original Medicare's insurance
of care in a professional nursing facility? - ANSMedicare will cowl Mrs. Shield's skilled
nursing services supplied during the primary 20 days of her live, and then she would have a
copay till she has been in the facility for 100 days.
Mrs. West wears glasses and dentures and has enjoyed widespread ache 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? - ANSMedicare does no longer cowl massage
therapy, or, in preferred, glasses or dentures.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed profits. What could you inform Mrs.
Park that might be of assistance? - ANSShe have to contact her state Medicaid business
enterprise to peer if she qualifies for certainly one of several packages that could help with
Medicare expenses for which she is responsible.
Mr. Alonso gets a few help deciding to buy his two normal pharmaceuticals from his agency's
retiree coverage, but he desires to evaluate it to a Part D prescription drug plan. He asks you
what charges he might generally count on to come upon whilst enrolling right into a
widespread Medicare Part D prescription drug plan. What should you tell him? - ANSHe
generally might pay a month-to-month top class, annual deductible, and in keeping
with-prescription price-sharing.
Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap coverage as properly,
however it offers no drug coverage. She would love to maintain the coverage she has
however update her present Medigap plan with one that gives drug insurance. What should
you inform her? - ANSMrs. Gonzalez can't buy a Medigap plan that covers pills, however
she may want to hold her Medigap coverage and sign up in a Part D prescription drug plan.
Mr. Davis is fifty two years antique and has currently been diagnosed with end-degree renal
disorder (ESRD) and could quickly start dialysis. He is thinking if he can obtain insurance
below Medicare. What ought to you inform him? - ANSHe might also sign-up for Medicare at
any time however coverage generally starts offevolved at the fourth month after dialysis
treatments start.
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has lately reviewed her
Medicare Summary Notice (MSN) and disagrees with a willpower that partly denied one
among her claims for services. What advice might you provide her? - ANSMrs. Duarte ought
to document an enchantment of this initial willpower inside a hundred and twenty days of the
date she acquired the MSN inside the mail.
,Mrs. Geisler's neighbor advised her she have to study her Part D options for the duration of
the annual Medicare enrollment length because the functions of Part D would possibly have
modified. Mrs. Geisler cannot don't forget what Part D is so she referred to as you to ask
what her neighbor became speaking approximately. What may want to you tell her? -
ANSPart D covers prescription drugs and he or she must study her premiums, formulary,
and cost-sharing amongst other elements to look if they have modified.
Mr. Rainey is experiencing paranoid delusions and his doctor feels that he must be
hospitalized. What have to you inform Mr. Rainey (or his representative) about the duration
of an inpatient psychiatric sanatorium live that Medicare will cover? - ANSMedicare will cowl
a complete of one hundred ninety days of inpatient psychiatric care during Mr. Rainey's
entire lifetime.
Mr. Xi will soon turn age sixty five and has come to you for advice as to what services are
provided beneath Original Medicare. What ought to you tell Mr. Xi that excellent describes
the health insurance furnished to Medicare beneficiaries? - ANSBeneficiaries underneath
Original Medicare haven't any price-sharing for most preventive offerings.
Mr. Singh would really like drug insurance however does not want to be enrolled in a
Medicare Advantage plan. What have to you tell him? - ANSMr. Singh can enroll in a
stand-on my own prescription drug plan and stay included for Part A and Part B services thru
Original Fee-for-Service Medicare.
Mrs. Chen might be sixty five quickly, has been a citizen for twelve years, has been hired full
time, and paid taxes throughout that entire length. She is involved that she will be able to not
qualify for insurance underneath element A due to the fact she become no longer born within
the United States. What must you inform her? - ANSMost people who are residents and age
sixty five or over are protected underneath Part A with the aid of virtue of having paid
Medicare taxes even as operating, though a few may be included due to paying monthly
rates.
Mrs. Quinn these days became sixty six and decided after many years of labor to retire and
begin receiving Social Security advantages. Shortly thereafter Mrs. Quinn acquired a letter
informing her that she had been mechanically enrolled in Medicare Part B. She wants to
understand what this indicates. What must you inform Mrs. Quinn? - ANSPart B in general
covers doctor offerings. She will be paying a monthly top rate and, except for plenty
preventive and screening exams, commonly could have 20% co-payments for these
offerings, similarly to an annual deductible.
Mr. Patel is in precise fitness and is getting ready a finances in anticipation of his retirement
while he turns 66. He desires to recognize the health care charges he is probably uncovered
to beneath Medicare if he were to require hospitalization due to an contamination. In popular
phrases, what may want to you tell him about his prices for inpatient medical institution
services beneath Original Medicare? - ANSUnder Original Medicare, there may be a single
deductible amount due for the first 60 days of any inpatient clinic live, after which it converts
right into a per-day coinsurance amount through day ninety. After day 90, he might pay a
, every day amount as much as 60 days over his lifetime, and then he could be chargeable for
all costs.
What effect, if any, have recent regulatory modifications had on Medigap plans? - ANSThe
Part B deductible is no longer included for individuals newly eligible for Medicare beginning
January 1, 2020.
Mrs. Paterson is concerned approximately the deductibles and co-payments associated with
Original Medicare. What are you able to tell her approximately Medigap as an choice to cope
with this difficulty? - ANSMedigap plans do no longer cover Original Medicare benefits,
however they coordinate with Original Medicare insurance.
Mrs. Turner is evaluating her company's retiree coverage to Original Medicare and would
like to recognize which of the following offerings Original Medicare will cover if an
appropriate criteria are met. What could you inform her? - ANSOriginal Medicare covers
ambulance offerings.
Ms. Brooks has aggressive cancer and would really like to know if Medicare will cover
hospice services in case she desires them. What need to you inform her? - ANSMedicare
covers hospice services, and they may be available for her.
Mr. Diaz continued operating with his organization and became insured underneath his
business enterprise's group plan until he reached age sixty eight. He has heard that there
may be a top rate penalty for folks who did now not sign on for Part B whilst first eligible and
wants to recognize how lots he's going to have to pay. What should you inform him? -
ANSMr. Diaz will now not pay any penalty due to the fact he had continuous coverage below
his agency's plan.
Anita Magri will flip age sixty five in August 2023. Anita intends to enroll in Original Medicare
Part A and Part B. She would additionally like to join a Medicare Supplement (Medigap)
plan. Anita's older neighbor Mel has instructed her about the Medigap Plan F in which he's
enrolled. It no longer best offers overseas tour emergency benefits but additionally covers
his Medicare Part B deductible. Anita comes to you for recommendation. What must you
inform her? - ANSYou are sorry to disappoint Anita, but a Medigap F plan is no longer
available to people who flip age 65 after January 1, 2020. Anita might as a substitute
recollect different Medigap plans that provide overseas travel benefits but do now not cowl
the Part B deductible.
Hank's Fish Store, Inc. Is a small business enterprise with just 15 personnel placed in
Florida. Hank, the shop proprietor, has supplied extraordinary fitness benefits to the store's
group of workers. William, one in every of the shop's long-time employees, will soon be
accomplishing age 65 and eligible for Medicare. William is in true health. He intends to
remain an active full-time employee, running several years after turning into eligible for
Medicare. What kind(s) of retiree fitness benefit will Hank's Fish Store be able to provide
William? - ANSHank's can maintain to provide William the identical employee health gain
plan, or, if William enrolls in Medicare Part B, it may join him in a Medicare Advantage plan
this is presented to the public.
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