2025 AHIP Module 1 Exam Questions and
Verified Answers, 100% Guarantee
1.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?: 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.
2.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?: Medicare
does not cover massage therapy, or, in general, glasses or dentures.
3.Mrs. Park is an elderly retiree. Mrs. Park has a low fixed
income. What could you tell Mrs. Park that might be of
assistance?: 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.
4.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?: He generally would pay a monthly
premium, annual deductible, and per-prescription cost-sharing.
5.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?: 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.
6.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?: He may sign-up for Medicare
at any time however coverage usually begins on the fourth month after
dialysis treatments start.
7.Mrs. Duarte is enrolled in Original Medicare Parts A and B.
She has recently reviewed her Medicare Summary Notice (MSN)
and disagrees with a determi- nation that partially denied one
of her claims for services. What advice would you give her?:
Mrs. Duarte should file an appeal of this initial determination within 120
days of the date she received the MSN in the mail.
Verified Answers, 100% Guarantee
1.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?: 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.
2.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?: Medicare
does not cover massage therapy, or, in general, glasses or dentures.
3.Mrs. Park is an elderly retiree. Mrs. Park has a low fixed
income. What could you tell Mrs. Park that might be of
assistance?: 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.
4.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?: He generally would pay a monthly
premium, annual deductible, and per-prescription cost-sharing.
5.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?: 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.
6.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?: He may sign-up for Medicare
at any time however coverage usually begins on the fourth month after
dialysis treatments start.
7.Mrs. Duarte is enrolled in Original Medicare Parts A and B.
She has recently reviewed her Medicare Summary Notice (MSN)
and disagrees with a determi- nation that partially denied one
of her claims for services. What advice would you give her?:
Mrs. Duarte should file an appeal of this initial determination within 120
days of the date she received the MSN in the mail.
