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2025 AHIP TRAINING New Full Questions and Answers ( Included ) 100% Correct
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2025 AHIP TRAINING New Full Questions and Answers ( Included ) 100% Correct
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AHIP TRAININGBy ExamNavigator
, AHIP TRAINING
1. 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 wouldyou give her?
Answer: Mrs. Duarte should file an appeal of this initial determination within120 days of the
date she received the MSN in the mail.
2. 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 canobtain coverage under
Medicare. What should you tell him?
Answer: He may sign-up for Medicare at any time however coverage usually begins on the
fourth month afterdialysis treatments start.
3. Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and would
like to know which of the following services OriginalMedicare will cover if the appropriate
criteria are met. What could you tellher?
Answer: Original Medicare covers ambulance services.
4. 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 illness. In general terms, what
could you tell him about his costs for inpatient hospital services under Original Medicare?
Answer: Under OriginalMedicare, there is a single deductible amount due for the first 60 days of
any inpatienthospital 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, afterwhich
he would be responsible for all costs.
5. Mrs. Shields is covered by Original Medicare. She sustained a hip fractureand 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?
Answer: Medicare will cover Mrs. Shield's skilled nursing services provided during the first
20 days ofher stay, after which she would have a copay until she has been in the facility for 100
days.
6. Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare
Advantage plan. What should you tell him?
Answer: Mr. Singh can enroll in astand-alone prescription drug plan and continue to be
covered for Part A and PartB services through Original Fee-for-Service Medicare.
7. Mrs. Paterson is concerned about the deductibles and co-payments associated with Original
Medicare. What can you tell her about Medigap as an optionto address this concern?
Answer: Medigap plans do not cover Original Medicare benefits,but they coordinate with
, Original Medicare coverage.
8. 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 concernedthat she will not qualify for
coverage under part A because she was not born inthe United States. What should you tell her?
Answer: 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.
9. Mr. Alonso receives some help paying for his two generic prescription drugsfrom 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 toencounter when enrolling into a standard
Medicare Part D prescription drug plan. What should you tell him?
Answer: He generally would pay a monthly premium, annual deductible, and per-prescription
cost-sharing.
10. 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 coverageshe has but replace her existing
Medigap plan with one that provides drug coverage. What should you tell her?
Answer: Mrs. Gonzalez cannot purchase a Medigapplan that covers drugs, but she could keep
her Medigap policy and enroll in a Part D prescription drug plan.
11. 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 MedicareSupplement (Medigap) plan.
Anita's older neighbor Mel has told her about theMedigap 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?
Answer: You are sorry to disappointAnita, 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 foreigntravel benefits but do not cover the Part B deductible.
12. 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 enrolledin Medicare Part B. She wants to understand what
this means. What should you tell Mrs. Quinn?
Answer: Part B primarily covers physician services. She will be payinga monthly premium and,
except for many preventive and screening tests, generallywill have 20% co-payments for these
services, in addition to an annual deductible.
13. 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 thereis 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?
Answer: Mr. Diaz will not pay any penalty because he had continuous coverage under his
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