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2025 AHIP FINAL EXAM QUESTIONS AND ANSWER | LATEST UPDATE
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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 the...

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  • 17 september 2024
  • 37
  • 2024/2025
  • Tentamen (uitwerkingen)
  • Vragen en antwoorden

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  • 2025 ahip final exam questions and answer lates
  • mrs shields is covered by original medicare she

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Voorbeeld van de inhoud

2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!




2025 AHIP FINAL EXAM QUESTIONS AND
ANSWER | LATEST UPDATE
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?


✓ -:- Medicare will cover Mrs. Shield's skilled nursing servic es 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?


✓ -:- 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?


✓ -:- 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.



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,2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!




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?


✓ -:- 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?


✓ -:- 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?


✓ -:- He may sign-up for Medicare at any time however coverage usually

begins on the fourth month after dialysis treatments start.




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,2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!


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?


✓ -:- 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?


✓ -:- 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?


✓ -:- Medicare will cover a total of 190 days of inpatient psychiatric care

during Mr. Rainey's entire lifetime.




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, 2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!


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?


✓ -:- 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?


✓ -:- 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?


✓ -:- 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.




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