AHIP 2025 Final Exam Updated Questions and Verified Answers, 100% Gua
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rantee Pass v
Mrs. Chenwill be65soon, has been acitizenfor twelveyears, has been employedfull tim
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e,andpaidtaxesduringthatentireperiod.Sheisconcernedthatshewillnotqualifyfor cover
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ageunderpartAbecauseshewasnotbornintheUnited States. What should you tell her AN
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S Mostindividualswhoarecitizensandage65oroverarecoveredunderPartAby virtueofhaving
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paidMedicaretaxeswhileworking,thoughsomemaybecoveredasaresultof payingmonthlypr
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emiums.
Mrs.GonzalezisenrolledinOriginal MedicareandhasaMedigappolicyaswell, but it pr
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ovides nodrugcoverage. Shewouldliketokeepthecoverageshehas but replaceher existi
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ng Medigap plan with one that provides drug coverage.What should youtell her ANS Mrs.
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Gonzalezcannot purchaseaMedigap
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,planthatcoversdrugs,butshecouldkeepherMedigappolicyandenrollinaPartD prescriptiondr
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ugplan. v
Mrs. West wears glasses anddentures and has enjoyedconsiderable pain relieffrom ar
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thritisthroughmassagetherapy.Sheisconcernedaboutwhetheror not Medicare will cov
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er theseitems and services. What shouldyou tell her ANS Medicaredoesnotcover massag
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etherapy,or,ingeneral,glassesordentures.
Mr. Davisis52 yearsoldand has recentlybeendiagnosedwith end-
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stagerenal disease (ESRD) andwill soon begin dialysis. Heiswonderingif hecanobtaincov
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erageunder Medicare. What should you tell him ANS Hemaysign-
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upforMedicareatanytimehowever coverageusuallybeginsonthefourthmonthafterdialysis tre
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atments start. v
Juan Perez, who is turning age65next month, intends toworkfor several moreyears atS
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mallcap,Incorporated.Smallcaphasaworkforceof15employ-eesandoffersemployer- v
sponsoredhealthcarecoverage.Juanisanaturalizedcitizen andhas contributedtothe Med
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icaresystemfor over 20years. Juan asksyouifhewillbeentitledtoMedicareandifhe enrolls
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howthatwillimpacthisemployer- v v v
sponsoredhealthcarecoverage.Howwouldyou respond ANS JuanislikelytobeeligibleforMe
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dicareonceheturnsage65andifheenrolls Medicarewouldbecometheprimarypayorofhishealth
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careclaimsandSmallcapdoesnothave tocontinuetoofferhimcoveragecomparabletothoseunde
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rage65underitsemployer- sponsoredgrouphealthplan.
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, Mr.Moy's wife has aMedicareAdvantageplan,buthe wants tounder-
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stand what coverageMedicareSupplemental Insurance provides since his health care nee
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dsaredifferentfromhiswife'sneeds.What couldyoutell Mr.Moy ANS Medicare Supplemen
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talInsurancewouldhelpcoverhisPartAandPartBdeductiblesorcoinsurancein OriginalFee-for-
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Service(FFS)MedicareaswellaspossiblysomeservicesthatMedicaredoes not cover.
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Mrs.PeHais66yearsold,hascoverageunderanemployer plan,andwillretirenext year. v v v
Sheheardshemust enroll in Part B at thebeginning of theyear to ensurenogapin coverag
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e. What can you tell her ANS Shemayenrollatanytimewhilesheiscoveredunderher employerpl
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an,butshewillhaveaspecialeight-
monthenrollmentperiodafterthelastmonthon heremployerplanthatdiffersfromthe standard
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general enrollment period, during whichshe mayenroll in MedicarePartB.
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Mr. Patel is in good health and is preparing abudget in anticipation of his retirementwhenhe tu
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ns66.Hewantstounderstandthehealthcarecostshemight beexposed tounder Medicare ifhew
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eretorequirehospitalization asaresult of anillness. Ingeneral terms, what couldyou tell him
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bout his costsfor inpatient hospital services
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underOriginalMedicare ANS UnderOriginalMedicare,thereisasingledeductibleamountduef
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orthefirst60daysofanyinpatienthospitalstay,afterwhichitconvertsinto aper- v v v
day coinsuranceamountthroughday90.Afterday90,hewouldpayadailyamountupto60days
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overhislifetime,afterwhichhewouldberesponsibleforallcosts. v v
Ms. Henderson believes that she will qualify for Medicare Coverage when she turns 65,
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, without paying any premiums, because she has been working for 40 years and paying M
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edicare taxes. What should you tell her ANS To obtain Part B coverage, shemust paya stan
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dardmonthlypremium,thoughitishigherforindividualswithhigherincomes.
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Mr. Alonso receives some help paying for his two generic prescription drugs from his e
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mployer's retireecoverage, but hewants to compareit to aPart Dprescriptiondrug plan.H
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easksyouwhatcosts hewouldgenerallyex-
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pecttoencounterwhenenrollinginto astandardMedicarePart Dprescriptiondrugplan.Wh
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atshouldyoutellhim ANS He generallywouldpayamonthlypremium,annualdeductible,andp
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er-prescriptioncost-sharing. v
Ms. Moore plans to retire when she turns 65 in a few months. She is inexcellent he
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alth and will have considerable income when she retires. Sheis concerned that her inco
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me will make it impossible for her to qualify forMedicare.What could you tell her toadd
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ress her concern ANS Medicareisa
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programfor peopleage65or older and those under age65with certain disabilities,end-
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stagerenaldisease,andLouGehrig'sdiseasesoshewillbeeligibleforMedicare.
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Mr. Xi will soon turn age65andhas cometo you for adviceasto what servicesare provi
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dedunderOriginalMedicare.WhatshouldyoutellMr.Xithatbestdescribesthehealth covera
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geprovided toMedicarebeneficiaries ANS Ben-eficiariesunderOriginalMedicarehave nocost-
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sharingformostpreventiveserviceswhich includeimmunizationssuch as annual flu shots. v v v v v v v
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rantee Pass v
Mrs. Chenwill be65soon, has been acitizenfor twelveyears, has been employedfull tim
v v v v v v v v v v v v v v v v v
e,andpaidtaxesduringthatentireperiod.Sheisconcernedthatshewillnotqualifyfor cover
v v v v v v v v v v v v v v
ageunderpartAbecauseshewasnotbornintheUnited States. What should you tell her AN
v v v v v v v v v v v v
S Mostindividualswhoarecitizensandage65oroverarecoveredunderPartAby virtueofhaving
v v v v v v v v v v v v v v v v v v v v
paidMedicaretaxeswhileworking,thoughsomemaybecoveredasaresultof payingmonthlypr
v v v v v v v v v v v v v v v v
emiums.
Mrs.GonzalezisenrolledinOriginal MedicareandhasaMedigappolicyaswell, but it pr
v v v v v v v v v v v v v v v
ovides nodrugcoverage. Shewouldliketokeepthecoverageshehas but replaceher existi
v v v v v v v v v v v v v v v v
ng Medigap plan with one that provides drug coverage.What should youtell her ANS Mrs.
v v v v v v v v v v v v v v
Gonzalezcannot purchaseaMedigap
v v v
,planthatcoversdrugs,butshecouldkeepherMedigappolicyandenrollinaPartD prescriptiondr
v v v v v v v v v v v v v v v v
ugplan. v
Mrs. West wears glasses anddentures and has enjoyedconsiderable pain relieffrom ar
v v v v v v v v v v v v
thritisthroughmassagetherapy.Sheisconcernedaboutwhetheror not Medicare will cov
v v v v v v
er theseitems and services. What shouldyou tell her ANS Medicaredoesnotcover massag
v v v v v v v v v v v v
etherapy,or,ingeneral,glassesordentures.
Mr. Davisis52 yearsoldand has recentlybeendiagnosedwith end-
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stagerenal disease (ESRD) andwill soon begin dialysis. Heiswonderingif hecanobtaincov
v v v v v v v v v v v v v v v
erageunder Medicare. What should you tell him ANS Hemaysign-
v v v v v v v v v v v
upforMedicareatanytimehowever coverageusuallybeginsonthefourthmonthafterdialysis tre
v v v v v
atments start. v
Juan Perez, who is turning age65next month, intends toworkfor several moreyears atS
v v v v v v v v v v v v v v v v
mallcap,Incorporated.Smallcaphasaworkforceof15employ-eesandoffersemployer- v
sponsoredhealthcarecoverage.Juanisanaturalizedcitizen andhas contributedtothe Med
v v v v v v v v
icaresystemfor over 20years. Juan asksyouifhewillbeentitledtoMedicareandifhe enrolls
v v v v v v v v v v v v v v v v v
howthatwillimpacthisemployer- v v v
sponsoredhealthcarecoverage.Howwouldyou respond ANS JuanislikelytobeeligibleforMe
v v v v v v v v v v v
dicareonceheturnsage65andifheenrolls Medicarewouldbecometheprimarypayorofhishealth
v v v v v v v v v v v v v v v v v
careclaimsandSmallcapdoesnothave tocontinuetoofferhimcoveragecomparabletothoseunde
v v v v v v v v v v v v v v
rage65underitsemployer- sponsoredgrouphealthplan.
v v v v v v v v
, Mr.Moy's wife has aMedicareAdvantageplan,buthe wants tounder-
v v v v v v v v v v v v
stand what coverageMedicareSupplemental Insurance provides since his health care nee
v v v v v v v v v v v
dsaredifferentfromhiswife'sneeds.What couldyoutell Mr.Moy ANS Medicare Supplemen
v v v v v v v v v v v v v
talInsurancewouldhelpcoverhisPartAandPartBdeductiblesorcoinsurancein OriginalFee-for-
v v v v v v v v v v v v v v v v
Service(FFS)MedicareaswellaspossiblysomeservicesthatMedicaredoes not cover.
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Mrs.PeHais66yearsold,hascoverageunderanemployer plan,andwillretirenext year. v v v
Sheheardshemust enroll in Part B at thebeginning of theyear to ensurenogapin coverag
v v v v v v v v v v v v v v v v v v v
e. What can you tell her ANS Shemayenrollatanytimewhilesheiscoveredunderher employerpl
v v v v v v v v v v v v v v
an,butshewillhaveaspecialeight-
monthenrollmentperiodafterthelastmonthon heremployerplanthatdiffersfromthe standard
v v v v v v v v v v v v v v v
general enrollment period, during whichshe mayenroll in MedicarePartB.
v v v v v v v v v v v v
Mr. Patel is in good health and is preparing abudget in anticipation of his retirementwhenhe tu
v v v v v v v v v v v v v v v v v v
ns66.Hewantstounderstandthehealthcarecostshemight beexposed tounder Medicare ifhew
v v v v v v v v v v v v v v v v v v
eretorequirehospitalization asaresult of anillness. Ingeneral terms, what couldyou tell him
v v v v v v v v v v v v v v v
bout his costsfor inpatient hospital services
v v v v v
underOriginalMedicare ANS UnderOriginalMedicare,thereisasingledeductibleamountduef
v v v v v v v v v v v v v
orthefirst60daysofanyinpatienthospitalstay,afterwhichitconvertsinto aper- v v v
day coinsuranceamountthroughday90.Afterday90,hewouldpayadailyamountupto60days
v v v v v v v v v v v v v v
overhislifetime,afterwhichhewouldberesponsibleforallcosts. v v
Ms. Henderson believes that she will qualify for Medicare Coverage when she turns 65,
v v v v v v v v v v v v v
, without paying any premiums, because she has been working for 40 years and paying M
v v v v v v v v v v v v v v
edicare taxes. What should you tell her ANS To obtain Part B coverage, shemust paya stan
v v v v v v v v v v v v v v v
dardmonthlypremium,thoughitishigherforindividualswithhigherincomes.
v v v v v v v v v v
Mr. Alonso receives some help paying for his two generic prescription drugs from his e
v v v v v v v v v v v v v v
mployer's retireecoverage, but hewants to compareit to aPart Dprescriptiondrug plan.H
v v v v v v v v v v v v v v v v
easksyouwhatcosts hewouldgenerallyex-
v v v v v v v v
pecttoencounterwhenenrollinginto astandardMedicarePart Dprescriptiondrugplan.Wh
v v v v v v v v v
atshouldyoutellhim ANS He generallywouldpayamonthlypremium,annualdeductible,andp
v v v v v v v v v
er-prescriptioncost-sharing. v
Ms. Moore plans to retire when she turns 65 in a few months. She is inexcellent he
v v v v v v v v v v v v v v v v
alth and will have considerable income when she retires. Sheis concerned that her inco
v v v v v v v v v v v v v
me will make it impossible for her to qualify forMedicare.What could you tell her toadd
v v v v v v v v v v v v v v v
ress her concern ANS Medicareisa
v v v v v v
programfor peopleage65or older and those under age65with certain disabilities,end-
v v v v v v v v
stagerenaldisease,andLouGehrig'sdiseasesoshewillbeeligibleforMedicare.
v v v v v v v v v v v v v
Mr. Xi will soon turn age65andhas cometo you for adviceasto what servicesare provi
v v v v v v v v v v v v v v v v v v
dedunderOriginalMedicare.WhatshouldyoutellMr.Xithatbestdescribesthehealth covera
v v v v v v v
geprovided toMedicarebeneficiaries ANS Ben-eficiariesunderOriginalMedicarehave nocost-
v v v v v v v
sharingformostpreventiveserviceswhich includeimmunizationssuch as annual flu shots. v v v v v v v
