AHIP Final Exam 2025/2026 – Updated Questions and Revised Answers | 100% Guarantee Pass

AHIP2025Final ExamUpdatedQuestionsand
Verified Answers, 100% Guarantee Pass



Mrs. Shields is covered by Original Medicare. She sustained a hip fracture
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s and is being successfully treated for that condition. However, she and her
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s physiciansfeelthatafterherlengthyhospitalstay,shewillneed amonthor two
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sof nursing and rehabilitative care. What should you tell them about Original
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sMedicare's coverage of care in a skilled nursing facility?
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- correct answer - Medicare will cover Mrs. Shield's skilled nursing services
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provided during the first 20 days of her stay, after which she would have a copay
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suntil she has been in the facility for 100 days.
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Mrs. West wears glasses and dentures and has enjoyed considerable pain relief
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s from arthritis through massage therapy. She is concerned about
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whether ornotMedicarewillcovertheseitems andservices. Whatshould you
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s tell her?s




- correct answer -Medicaredoesnotcovermassagetherapy,or,ingeneral,
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s glasses or dentures. s s




Mrs.Parkisanelderlyretiree.Mrs.Parkhasalowfixedincome.Whatcould you
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s tell Mrs. Park that might be of assistance?
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- correct answer - She should contact her state Medicaid agency to see if
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she qualifiesforoneofseveral programsthatcanhelp with Medicare costs for
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s which she is responsible. s s s




Mr. Alonso receives some help paying for his two generic prescription
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s drugsfromhisemployer'sretireecoverage, buthewantstocompareit toa Part
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sD prescription drug plan. He asks you what costs he would generally expect
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sto encounter when enrolling into a standard Medicare Part D prescription
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s drug plan. What should you tell him?
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- correct answer -Hegenerally wouldpayamonthlypremium,annual
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s deductible, and per-prescription cost-sharing. s s s




Mrs.Gonzalezisenrolledin OriginalMedicareandhasa Medigappolicyas
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s well,butit providesno drugcoverage. Shewould like tokeep the coverage
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she hasbutreplace herexisting Medigapplan with onethatprovides drug
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coverage. What should you tell her? s s s s s




- correct answer - Mrs. Gonzalez cannot purchase a Medigap plan that
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coversdrugs,butshecouldkeepherMedigap policy andenrollinaPart D
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s prescription drug plan. s s




Mr. Davis is 52 years old and has recently been diagnosed with end-stage
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s renal disease (ESRD) and will soon begin dialysis. He is wondering if he can
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s obtain coverage under Medicare. What should you tell him?
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- correct answer - He may sign-up for Medicare at any time however
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coverageusually begins on the fourth month after dialysis treatmentsstart.
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Mrs.DuarteisenrolledinOriginalMedicarePartsAandB.Shehasrecently
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s reviewed her Medicare Summary Notice (MSN) and disagrees with a
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s determination that partially denied one of her claims for services. What s s s s s s s s s s




s advice would you give her?
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- correct answer - Mrs. Duarte should file an appeal of this initial
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determinationwithin120daysofthedateshereceivedtheMSNinthemail. s s s s s s s s s s s




Mrs. Geisler's neighbor told her she should look at her Part D options
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s during the annualMedicare enrollment period because the features of Part
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,


D might have changed. Mrs. Geisler can't remember what Part D is so she
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called youtoaskwhatherneighborwastalking about.Whatcould you tell her?
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- correct answer - Part D coversprescription drugs andshe should lookat
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her premiums,formulary, and cost-sharing among other factors to see if
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s they have changed.
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Mr.Raineyisexperiencingparanoiddelusionsandhisphysicianfeelsthat he
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s should be hospitalized. What should you tell Mr. Rainey (or his
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s representative) about the length of an inpatient psychiatric hospital stay that
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s Medicare will cover? s s




- correct answer -Medicarewillcoveratotalof190 daysofinpatient
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s psychiatric care during Mr. Rainey's entire lifetime.
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Mr. Xi will soon turn age 65 and has come to you for advice as to what services
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sare provided under Original Medicare. What should you tell Mr. Xi thatbest
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describesthehealthcoverageprovidedtoMedicarebeneficiaries?
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- correctanswer-Beneficiaries underOriginalMedicarehaveno
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s cost-sharing for most preventive services. s s s s




Mr.Singhwould like drug coverage butdoesnotwanttobe enrolled in a
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