AHIP FWA EXAM REVIEW 2026 SOLVED
QUESTIONS AND CORRECT ANSWERS
VERIFIED
●● 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. 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?
Answer: 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.
●● Madeline Martinez was widowed several years ago. Her husband
worked for many years and contributed into the Medicare system. He
also left a substantial estate which provides Madeline with an annual
income of approximately $130,000. Madeline, who has only worked
part-time for the last three years, will soon turn age 65 and hopes to
,enroll in Original Medicare. She comes to you for advice. What should
you tell her?
Answer: You should tell Madeline that she will be able to enroll in
Medicare Part A without paying monthly premiums due to her husband's
long work record and participation in the Medicare system. You should
also tell Madeline that she will pay Part B premiums at more than the
standard lowest rate but less than the highest rate due her substantial
income.
●● 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. Quinn recently turned 66 and decided after many years of work
to begin receiving Social Security benefits. Shortly thereafter Mrs.
Quinn 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?
Answer: 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% coinsurance for these services,
in addition to an annual deductible.
,●● Mrs. Geisler's neighbor told her she should look at her Part D options
during the annual Medicare enrollment period because 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.
●● 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.
●● 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.
●● 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.
●● Anita Magri will turn age 65 in August 2022. Anita intends to enroll
in Original Medicare Part A and Part B. She would also like to enroll in
a Medicare Supplement (Medigap) plan. Anita's older neighbor Mel has
told her about the Medigap Part F plan in which he is enrolled. It not
only provides foreign travel emergency benefits but also covers his
Medicare Part B deductible. Anita comes to you for advice. What should
you tell her?
Answer: You are sorry to disappoint Anita but a Medigap Part F plan is
no longer available to those who turn age 65 after January 1,2020. Anita
might instead consider other Medigap plans that offer foreign travel
benefits but do not cover the Part B deductible.
●● 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?
Answer: To obtain Part B coverage, she must pay a standard monthly
premium, though it is higher for individuals with higher incomes.
●● 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
QUESTIONS AND CORRECT ANSWERS
VERIFIED
●● 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. 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?
Answer: 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.
●● Madeline Martinez was widowed several years ago. Her husband
worked for many years and contributed into the Medicare system. He
also left a substantial estate which provides Madeline with an annual
income of approximately $130,000. Madeline, who has only worked
part-time for the last three years, will soon turn age 65 and hopes to
,enroll in Original Medicare. She comes to you for advice. What should
you tell her?
Answer: You should tell Madeline that she will be able to enroll in
Medicare Part A without paying monthly premiums due to her husband's
long work record and participation in the Medicare system. You should
also tell Madeline that she will pay Part B premiums at more than the
standard lowest rate but less than the highest rate due her substantial
income.
●● 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. Quinn recently turned 66 and decided after many years of work
to begin receiving Social Security benefits. Shortly thereafter Mrs.
Quinn 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?
Answer: 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% coinsurance for these services,
in addition to an annual deductible.
,●● Mrs. Geisler's neighbor told her she should look at her Part D options
during the annual Medicare enrollment period because 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.
●● 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.
●● 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.
●● 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.
●● Anita Magri will turn age 65 in August 2022. Anita intends to enroll
in Original Medicare Part A and Part B. She would also like to enroll in
a Medicare Supplement (Medigap) plan. Anita's older neighbor Mel has
told her about the Medigap Part F plan in which he is enrolled. It not
only provides foreign travel emergency benefits but also covers his
Medicare Part B deductible. Anita comes to you for advice. What should
you tell her?
Answer: You are sorry to disappoint Anita but a Medigap Part F plan is
no longer available to those who turn age 65 after January 1,2020. Anita
might instead consider other Medigap plans that offer foreign travel
benefits but do not cover the Part B deductible.
●● 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?
Answer: To obtain Part B coverage, she must pay a standard monthly
premium, though it is higher for individuals with higher incomes.
●● 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
