AHIP FINAL EXAM 2026 | 100% VERIFIED
QUESTIONS & ACCURATE ANSWERS – PASS
WITH CONFIDENCE
1. In order for an insured under Medicare Part A to receive benefits for
care in a skilled nursing facility, which of the following conditions must
be met? (Choose from the following options)
The insured must have first been hospitalized for 3 consecutive
days.
There is no benefit provided under Medicare Part A for skilled
nursing care.
The insured must cover daily copayments.
The insured must have a Medicare supplement insurance policy.
2. 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?
Medigap plans are not sold by private companies and are a
government insurance product.
All costs not covered by Medicare are covered by some
Medigap plans.
Medigap plans help beneficiaries cover coinsurance, co-
payments, and/or deductibles for medically necessary
services.
If Mrs. Paterson applies during the Medigap open enrollment
period, she will have to undergo a medical review to determine if
she has a pre-existing condition that would increase the premium
for a Medigap policy.
,3. What is the special enrollment period for Medicare Part B after
retirement?
, months
Eight months
Twelve months
Six months
4. Describe the conditions under which Medicare will cover skilled nursing
facility care for a patient like Mrs. Shields.
Medicare does not cover any skilled nursing facility care unless
the patient is enrolled in Medicaid.
Medicare only covers skilled nursing facility care for patients with
long-term care needs.
Medicare covers skilled nursing facility care for up to 100 days
if the patient has had a qualifying hospital stay of at least three
days.
Medicare covers skilled nursing facility care for an unlimited
duration as long as a physician certifies the need.
5. Describe the cost-sharing structure associated with Medicare Part B
coverage.
There are no costs associated with Medicare Part B.
Enrollees pay a monthly premium and generally have 20%
coinsurance for services, along with an annual deductible.
Enrollees pay a flat fee for all services without any coinsurance.
Enrollees only pay for preventive services.
6. What is the time frame within which a beneficiary must file an appeal for
a Part A or Part B service determination after receiving the Medicare
Summary Notice?
60 days
QUESTIONS & ACCURATE ANSWERS – PASS
WITH CONFIDENCE
1. In order for an insured under Medicare Part A to receive benefits for
care in a skilled nursing facility, which of the following conditions must
be met? (Choose from the following options)
The insured must have first been hospitalized for 3 consecutive
days.
There is no benefit provided under Medicare Part A for skilled
nursing care.
The insured must cover daily copayments.
The insured must have a Medicare supplement insurance policy.
2. 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?
Medigap plans are not sold by private companies and are a
government insurance product.
All costs not covered by Medicare are covered by some
Medigap plans.
Medigap plans help beneficiaries cover coinsurance, co-
payments, and/or deductibles for medically necessary
services.
If Mrs. Paterson applies during the Medigap open enrollment
period, she will have to undergo a medical review to determine if
she has a pre-existing condition that would increase the premium
for a Medigap policy.
,3. What is the special enrollment period for Medicare Part B after
retirement?
, months
Eight months
Twelve months
Six months
4. Describe the conditions under which Medicare will cover skilled nursing
facility care for a patient like Mrs. Shields.
Medicare does not cover any skilled nursing facility care unless
the patient is enrolled in Medicaid.
Medicare only covers skilled nursing facility care for patients with
long-term care needs.
Medicare covers skilled nursing facility care for up to 100 days
if the patient has had a qualifying hospital stay of at least three
days.
Medicare covers skilled nursing facility care for an unlimited
duration as long as a physician certifies the need.
5. Describe the cost-sharing structure associated with Medicare Part B
coverage.
There are no costs associated with Medicare Part B.
Enrollees pay a monthly premium and generally have 20%
coinsurance for services, along with an annual deductible.
Enrollees pay a flat fee for all services without any coinsurance.
Enrollees only pay for preventive services.
6. What is the time frame within which a beneficiary must file an appeal for
a Part A or Part B service determination after receiving the Medicare
Summary Notice?
60 days
