AHIP Test Review 2025 | Real
Exam Questions, Verified Answers
& Updated Study Materials for
Easy Certification Success
Mr. Hernandez is concerned that if he signs up for a Medicare Advantage plan, the health plan may, at
some time in the future, reduce his benefits below what is available in Original Medicare. What should
you tell him about his concern? - ANSW✔ -b. Medicare health plans must cover all benefits available
under Medicare Part A and Part B. Many also cover Part D prescription drugs. Correct
Mrs. Roberts has just received a new Medicare identity card in the mail. She is concerned that it is a
forgery since it does not have her Social Security number on it. What should you tell her? - ANSW✔ -b.
The card she received I valid, the change has been made to protect Medicare beneficiaries from
identity theft, and she should now destroy her old card. Correct
Mrs. Willard wants to know generally how the benefits under Original Medicare might compare to the
benefit package of a Medicare Health Plan before she starts looking at specific plans. What could you
tell her? - ANSW✔ -d. Medicare Health Plans may offer extra benefits that Original Medicare does not
offer such as vision, hearing, and dental services and must include a maximum out-of-pocket limit on
Part A and Part B services. Correct
Mr. Meoni's wife has a Medicare Advantage plan, but he wants to understand what coverage
Medicare Supplemental Insurance provides since his health care needs are different from his wife's
needs. What could you tell Mr.Meoni? - ANSW✔ -b. Medicare Supplemental Insurance would help
cover his Part A and Part B cost sharing in Original Fee-for-Service (FFS) Medicare as well as possibly
some services that Medicare does not cover. Correct
,Mr. Denton 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? - ANSW✔ -a. He may sign-up for Medicare at any time however coverage usually begins on the
fourth month after dialysis treatments start. Correct
Ms. Henderson believes that she will qualify for Medicare coverage when she turns 65, without paying
any premiums, because she has been working for 40 years and paying Medicare taxes. What should
you tell her? - ANSW✔ -a. In order to obtain Part B coverage, she must pay a standard monthly
premium, though it is higher for individuals with higher incomes. Correct
Mrs. Peňa is 66 years old, has coverage under an employer plan and will retire next year. She heard she
must enroll in Part B at the beginning of the year to ensure no gap in coverage. What can you tell her? -
ANSW✔ -a. She may enroll at any time while she is covered under her employer plan, but she will have
a special eight-month enrollment period that differs from the standard general enrollment period,
during which she may enroll in Medicare Part B. Correct
Mrs. Kelly, age 65, is entitled to Part A, but has not yet enrolled in Part B. She is considering enrollment
in a Medicare health plan (Part C). What should you advise her to do before she will be able to enroll
into a Medicare health plan? - ANSW✔ -a. In order to join a Medicare health plan, she also must enroll
in Part B. Correct
Mrs. Park is an elderly retiree. She has a low, fixed income. What could you tell Mrs. Park that might be
of assistance? - ANSW✔ -b. 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. Correct
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 as a result of an illness. In general terms, what could you tell him about his costs
for inpatient hospital services under Original Medicare? - ANSW✔ -c. 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 Correct
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? - ANSW✔ -c. Medicare will cover a total of 190 days of inpatient
psychiatric care during Mr. Rainey's entire lifetime. Correct
,Mrs. Quinn has recently turned 66 and decided after many years of work to begin receiving Social
Security benefits. Shortly thereafter Mrs. Quinn and received a letter informing her that she has been
automatically enrolled in Medicare Part B. She wants to understand what this means. What should you
tell Mrs. Quinn? - ANSW✔ -a. Part B primarily covers physician services. She will be paying a monthly
premium and, with the exception of many preventive and screening tests, generally will have 20% co-
payments for these services, in addition to an annual deductible. Correct
Mr. Buck has several family members who died from different cancers. He wants to know if Medicare
covers cancer screening. What should you tell him? - ANSW✔ -b. Medicare covers periodic performance
of a range of screening tests that are meant to provide early detection of disease. Mr. Buck will need to
check specific tests before obtaining them to see if they will be covered. Correct
Mrs. Wolf wears glasses and dentures and has enjoyed considerable pain relief from arthritis through
acupuncture. She is concerned about whether or not Medicare will cover these items and services. What
should you tell her? - ANSW✔ -a. Medicare does not cover acupuncture, or, in general, glasses or
dentures. Correct
Mr. Singh would like drug coverage, but does not want to be enrolled into a health plan. What should
you tell him? - ANSW✔ -b. 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. Correct
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? - ANSW✔ -d. He generally would pay a monthly premium, annual
deductible, and per-prescription cost sharing. Correct
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? - ANSW✔ -d. 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. Correct
Mr. Kelly has substantial financial means. He enrolled in Original Medicare and purchased a Medigap
policy many years ago that offered prescription drug coverage. The prescription drug coverage has not
, been comparable to that offered by Medicare Part D for several years and despite notification, Mr. Kelly
took no action. Which of the following statements best describes what will occur if Mr. Kelly now
decides to enroll in Medicare Part D? - ANSW✔ -a. He will incur a late enrollment penalty. Correct
What impact, if any, will the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) have upon
Medigap plans? - ANSW✔ -a. The Part B deductible will no longer be covered for individuals newly
eligible for Medicare starting January 1, 2020. Correct
Mrs. Lyons is in good health, uses a single prescription, and lives independently in her own home. She is
attracted by the idea of maintaining control over a Medical Savings Account (MSA), but is not sure if the
plan associated with the account will fit her needs. What specific piece of information about a
Medicare MSA plan would it be important for her to know, prior to enrolling in such a plan? - ANSW✔ -
c. All MSAs cover Part A and Part B benefits, but not Part D prescription drug benefits, which could be
obtained by also enrolling in a separate prescription drug plan. Correct
Mrs. Parker likes to handle most of her business matters through telephone calls. She currently is
enrolled in Original Medicare Parts A and B but has heard about a Medicare Advantage plan offered by
Senior Health from a neighbor. Mrs. Parker asks you whether she can enroll in Senior Health's MA plan
over the telephone. What can tell her?
I. Enrollment requests can only be made in face-to-face interviews or by mail.
II. Telephone enrollment request calls must be recorded.
III. Telephonic enrollments must include all required elements necessary to complete an enrollment.
IV. The signature element must be completed via certified mail. - ANSW✔ -II and III only
Which of the following statement is/are correct about a Medicare Savings Account (MSA) Plans?
I. MSAs may have either a partial network, full network, or no network of providers.
II. MSA plans cover Part A and Part B benefits but not Part D prescription drug benefits.
III. An individual who is enrolled in an MSA plan is responsible for a minimal deductible of $500 indexed
for inflation.
Exam Questions, Verified Answers
& Updated Study Materials for
Easy Certification Success
Mr. Hernandez is concerned that if he signs up for a Medicare Advantage plan, the health plan may, at
some time in the future, reduce his benefits below what is available in Original Medicare. What should
you tell him about his concern? - ANSW✔ -b. Medicare health plans must cover all benefits available
under Medicare Part A and Part B. Many also cover Part D prescription drugs. Correct
Mrs. Roberts has just received a new Medicare identity card in the mail. She is concerned that it is a
forgery since it does not have her Social Security number on it. What should you tell her? - ANSW✔ -b.
The card she received I valid, the change has been made to protect Medicare beneficiaries from
identity theft, and she should now destroy her old card. Correct
Mrs. Willard wants to know generally how the benefits under Original Medicare might compare to the
benefit package of a Medicare Health Plan before she starts looking at specific plans. What could you
tell her? - ANSW✔ -d. Medicare Health Plans may offer extra benefits that Original Medicare does not
offer such as vision, hearing, and dental services and must include a maximum out-of-pocket limit on
Part A and Part B services. Correct
Mr. Meoni's wife has a Medicare Advantage plan, but he wants to understand what coverage
Medicare Supplemental Insurance provides since his health care needs are different from his wife's
needs. What could you tell Mr.Meoni? - ANSW✔ -b. Medicare Supplemental Insurance would help
cover his Part A and Part B cost sharing in Original Fee-for-Service (FFS) Medicare as well as possibly
some services that Medicare does not cover. Correct
,Mr. Denton 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? - ANSW✔ -a. He may sign-up for Medicare at any time however coverage usually begins on the
fourth month after dialysis treatments start. Correct
Ms. Henderson believes that she will qualify for Medicare coverage when she turns 65, without paying
any premiums, because she has been working for 40 years and paying Medicare taxes. What should
you tell her? - ANSW✔ -a. In order to obtain Part B coverage, she must pay a standard monthly
premium, though it is higher for individuals with higher incomes. Correct
Mrs. Peňa is 66 years old, has coverage under an employer plan and will retire next year. She heard she
must enroll in Part B at the beginning of the year to ensure no gap in coverage. What can you tell her? -
ANSW✔ -a. She may enroll at any time while she is covered under her employer plan, but she will have
a special eight-month enrollment period that differs from the standard general enrollment period,
during which she may enroll in Medicare Part B. Correct
Mrs. Kelly, age 65, is entitled to Part A, but has not yet enrolled in Part B. She is considering enrollment
in a Medicare health plan (Part C). What should you advise her to do before she will be able to enroll
into a Medicare health plan? - ANSW✔ -a. In order to join a Medicare health plan, she also must enroll
in Part B. Correct
Mrs. Park is an elderly retiree. She has a low, fixed income. What could you tell Mrs. Park that might be
of assistance? - ANSW✔ -b. 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. Correct
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 as a result of an illness. In general terms, what could you tell him about his costs
for inpatient hospital services under Original Medicare? - ANSW✔ -c. 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 Correct
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? - ANSW✔ -c. Medicare will cover a total of 190 days of inpatient
psychiatric care during Mr. Rainey's entire lifetime. Correct
,Mrs. Quinn has recently turned 66 and decided after many years of work to begin receiving Social
Security benefits. Shortly thereafter Mrs. Quinn and received a letter informing her that she has been
automatically enrolled in Medicare Part B. She wants to understand what this means. What should you
tell Mrs. Quinn? - ANSW✔ -a. Part B primarily covers physician services. She will be paying a monthly
premium and, with the exception of many preventive and screening tests, generally will have 20% co-
payments for these services, in addition to an annual deductible. Correct
Mr. Buck has several family members who died from different cancers. He wants to know if Medicare
covers cancer screening. What should you tell him? - ANSW✔ -b. Medicare covers periodic performance
of a range of screening tests that are meant to provide early detection of disease. Mr. Buck will need to
check specific tests before obtaining them to see if they will be covered. Correct
Mrs. Wolf wears glasses and dentures and has enjoyed considerable pain relief from arthritis through
acupuncture. She is concerned about whether or not Medicare will cover these items and services. What
should you tell her? - ANSW✔ -a. Medicare does not cover acupuncture, or, in general, glasses or
dentures. Correct
Mr. Singh would like drug coverage, but does not want to be enrolled into a health plan. What should
you tell him? - ANSW✔ -b. 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. Correct
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? - ANSW✔ -d. He generally would pay a monthly premium, annual
deductible, and per-prescription cost sharing. Correct
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? - ANSW✔ -d. 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. Correct
Mr. Kelly has substantial financial means. He enrolled in Original Medicare and purchased a Medigap
policy many years ago that offered prescription drug coverage. The prescription drug coverage has not
, been comparable to that offered by Medicare Part D for several years and despite notification, Mr. Kelly
took no action. Which of the following statements best describes what will occur if Mr. Kelly now
decides to enroll in Medicare Part D? - ANSW✔ -a. He will incur a late enrollment penalty. Correct
What impact, if any, will the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) have upon
Medigap plans? - ANSW✔ -a. The Part B deductible will no longer be covered for individuals newly
eligible for Medicare starting January 1, 2020. Correct
Mrs. Lyons is in good health, uses a single prescription, and lives independently in her own home. She is
attracted by the idea of maintaining control over a Medical Savings Account (MSA), but is not sure if the
plan associated with the account will fit her needs. What specific piece of information about a
Medicare MSA plan would it be important for her to know, prior to enrolling in such a plan? - ANSW✔ -
c. All MSAs cover Part A and Part B benefits, but not Part D prescription drug benefits, which could be
obtained by also enrolling in a separate prescription drug plan. Correct
Mrs. Parker likes to handle most of her business matters through telephone calls. She currently is
enrolled in Original Medicare Parts A and B but has heard about a Medicare Advantage plan offered by
Senior Health from a neighbor. Mrs. Parker asks you whether she can enroll in Senior Health's MA plan
over the telephone. What can tell her?
I. Enrollment requests can only be made in face-to-face interviews or by mail.
II. Telephone enrollment request calls must be recorded.
III. Telephonic enrollments must include all required elements necessary to complete an enrollment.
IV. The signature element must be completed via certified mail. - ANSW✔ -II and III only
Which of the following statement is/are correct about a Medicare Savings Account (MSA) Plans?
I. MSAs may have either a partial network, full network, or no network of providers.
II. MSA plans cover Part A and Part B benefits but not Part D prescription drug benefits.
III. An individual who is enrolled in an MSA plan is responsible for a minimal deductible of $500 indexed
for inflation.
