2025 AHIP Final Exam Questions And Answers
2025 AHIP Final Exam Questions And Answers
2025 AHIP Final Exam Questions And Answers
2025 AHIP Final Exam Questions And Answers
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? - correct
Answers ✔✔ -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. 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? - correct Answers ✔✔ -Medicare does not cover massage
therapy, or, in general, glasses or dentures.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What
could you tell Mrs. Park that might be of assistance? - correct Answers ✔✔
-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.
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? - correct Answers
✔✔ -He generally would pay a monthly premium, annual deductible, and
per-prescription cost-sharing.
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? - correct Answers ✔✔ -
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.
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? - correct
Answers ✔✔ -He may sign-up for Medicare at any time however coverage
usually begins on the fourth month after dialysis treatments start.
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? - correct Answers ✔✔ -Mrs. Duarte
should file an appeal of this initial determination within 120 days of the
date she received the MSN in the mail.
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? - correct Answers ✔✔ -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.
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? - correct Answers ✔✔ -Medicare will cover a total
of 190 days of inpatient psychiatric care during Mr. Rainey's entire
lifetime.
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? - correct Answers ✔✔ -Beneficiaries under Original Medicare
have no cost-sharing for most preventive services.
Mr. Singh would like drug coverage but does not want to be enrolled in a
Medicare Advantage plan. What should you tell him? - correct Answers ✔✔
-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.
, 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? - correct
Answers ✔✔ -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. 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? - correct Answers ✔✔ -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.
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? - correct Answers ✔✔ -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.
What impact, if any, have recent regulatory changes had on Medigap
plans? - correct Answers ✔✔ -The Part B deductible is no longer covered
for individuals newly eligible for Medicare starting January 1, 2020.
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? - correct Answers ✔✔ -Medigap plans
do not cover Original Medicare benefits, but they coordinate with Original
Medicare coverage.
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? - correct Answers ✔✔ -Original Medicare covers ambulance services.
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