AHIP 2023 FINAL EXAM PRACTICE TEST
2026 QUESTIONS WITH SOLUTIONS
GRADED A+
◉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? ANSWER: - 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? ANSWER: -
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? ANSWER: -
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? ANSWER: - 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? ANSWER: - 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? ANSWER: - 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? ANSWER: - 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? ANSWER: - 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? ANSWER: - 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? ANSWER: -
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?
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.
◉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
2026 QUESTIONS WITH SOLUTIONS
GRADED A+
◉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? ANSWER: - 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? ANSWER: -
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? ANSWER: -
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? ANSWER: - 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? ANSWER: - 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? ANSWER: - 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? ANSWER: - 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? ANSWER: - 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? ANSWER: - 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? ANSWER: -
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?
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.
◉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
