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AHIP Certification – 2025 Final Exam Questions and Answers – Medicare Training Compliance Review

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This document contains the complete set of final exam questions and answers for the 2025 AHIP (America’s Health Insurance Plans) certification. It covers essential topics such as Medicare Advantage, Part D, fraud and abuse prevention, enrollment procedures, and CMS regulations. Designed for agents and brokers, this review supports accurate exam preparation and ensures compliance with Medicare marketing guidelines.

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2025 AHIP - Final Exam
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?
Question 1Answera.Medicare will cover a total of 190 days of inpatient psychiatric care
during Mr. Rainey's entire lifetime.b.Medicare will cover, at its allowable amount, as
many stays as are needed throughout Mr. Rainey's life, as long as no single stay
exceeds 190 days.c.Medicare inpatient psychiatric coverage is limited to the same
number of days covered for typical inpatient stays.d.Inpatient psychiatric services are
not covered under Original Medicare. - *answers *a

Mrs. Geisler's neighbor told her she should look at her Part D options during the annual
Medicare enrollment period because the 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?
Question 2Answera.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.b.Part D covers physician and non-physician practitioner services and the
deductible has not changed this year, but the physician charges may go up.c.Part D
covers long-term care services, and she should not worry because there has been no
change in coverage. d.Part D covers hospital and home health services and the cost-
sharing has changed this year. - *answers *a

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?
Question 3Answera.Medigap is a replacement for Original Medicare and she has been
paying for double coverage. She should simply drop her Medigap policy.b.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.c.Mrs. Gonzalez can
purchase a Medigap plan that covers drugs, but it likely will not offer coverage that is
equivalent to that provided under Part D.d.Mrs. Gonzalez should purchase a K or L
Medigap plan. - *answers *b

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?
Question 4Answera.He may not sign-up for Medicare until he reaches age 62, the date
he first becomes eligible for Social Security benefits.b.He may sign-up for Medicare at
any time however coverage usually begins on the fourth month after dialysis treatments
start.c.He may sign-up for Medicare at any time however coverage usually begins on
the sixth month after dialysis treatments start.d.He may sign-up for Medicare at any time
and coverage usually begins immediately. - *answers *b

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

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