AHIP 2025 Final Exam 2 LATEST VERSIONS WITH
CORRECT QUESTIONS & ANSWERS 2025/26 GRADED A+
Which of the following individuals is most likely to be eligible to enroll in a part d plan? correct answers ;
Jose, a grandfather who was granted asylum and has worked in the United States for many years.
When Myra first became eligible for Medicare, she enrolled in Original Medicare (Parts A and B). She is now 67 and
will turn 68 on July 1. She would now like to enroll in a Medicare Advantage (MA) plan and approaches you about
her options. What advice would you give her? correct answers ;
She should remain in Original Medicare until the annual election period running from October 15 to December 7,
during which she can select an MA plan.
Mr. Chen has heard about Medical Savings Account (MSA), but wants to know if it is just about saving money, or if
he will get insurance coverage for his health care expenditures as well. What should you tell him? correct answers
;
Under the Medicare Advantage program. an MSA plan involves the combination of high deductible health plan and
savings account for health expenses. Medicare will make contributions to this savings account to help him pay his
health care expenses while in the deductible.
.
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full time, and paid taxes during
that entire period. She is concerned that she will not qualify for coverage under part A because she was not born in
the United States. What should you tell her? correct answers ;
Most individuals who are citizens and over age 65 are covered under Part A by virtue of having paid Medicare
taxes while working, though some may be covered as a result of paying monthly premiums.
Ms. Edwards is enrolled in a Medicare Advantage plan that includes prescription drug plan (PDP) coverage. She is
traveling and wishes to fill two of her prescriptions that she has lost. How would you advise her? correct answers ;
,She may fill prescriptions for covered drugs at non-network pharmacies, but likely at a higher cost than paid at an
in-network pharmacy.
Mr. Rockwell, age 67, is enrolled in Medicare Part A, but because he continues to work and is covered by an
employer health plan, he has not enrolled in Part B or Part D. He receives a notice on June 1 that his employer is
cutting back on prescription drug benefits and that as of July 1 his coverage will no longer be creditable. He has
come to you for advice. What advice would you give Mr. Rockwell about special enrollment periods (SEPs)? correct
answers ;
Mr. Rockwell is eligible for a SEP due to his involuntary loss of creditable drug coverage; the SEP begins in June and
ends September 1 - two months after the loss of creditable coverage.
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? correct answers ;
Mrs. Duarte should file an appeal of this initial determination within 120 days of the date she received the MSN in
the mail.
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? correct answers ;
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. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park that might be of
assistance? correct answers ;
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.
Mrs. Quinn recently turned 66 and decided after many years of work to retire and begin receiving Social Security
benefits. Shortly thereafter Mrs. Quinn received a letter informing her that she had been automatically enrolled in
Medicare Part B. She wants to understand what this means. What should you tell Mrs. Quinn? correct answers ;
, Part B primarily covers physician services. She will be paying a monthly premium and, except for many preventive
and screening tests, generally will have 20% co-payments for these services, in addition to an annual deductible.
Anita Magri will turn age 65 in August 2023. 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 Plan F 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? correct answers ;
You are sorry to disappoint Anita, but a Medigap 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.
.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage plan. What should
you tell him? correct answers ;
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. Chen will be 65 soon, has been a citizen for twelve years, has been employed full time, and paid taxes during
that entire period. She is concerned that she will not qualify for coverage under part A because she was not born in
the United States. What should you tell her? correct answers ;
Most individuals who are citizens and age 65 or over are covered under Part A by virtue of having paid Medicare
taxes while working, though some may be covered as a result of paying monthly premiums.
Mr. Xi will soon turn age 65 and has come to you for advice as to what services are provided under Original
Medicare. What should you tell Mr. Xi that best describes the health coverage provided to Medicare beneficiaries?
correct answers ;
Beneficiaries under Original Medicare have no cost-sharing for most preventive services.
Mr. Barker enjoys a comfortable retirement income. He recently had surgery and expected that he would have
certain services and items covered by the plan with minimal out-of-pocket costs because his MA-PD coverage has
been very good. However, when he received the bill, he was surprised to see large charges in excess of his
CORRECT QUESTIONS & ANSWERS 2025/26 GRADED A+
Which of the following individuals is most likely to be eligible to enroll in a part d plan? correct answers ;
Jose, a grandfather who was granted asylum and has worked in the United States for many years.
When Myra first became eligible for Medicare, she enrolled in Original Medicare (Parts A and B). She is now 67 and
will turn 68 on July 1. She would now like to enroll in a Medicare Advantage (MA) plan and approaches you about
her options. What advice would you give her? correct answers ;
She should remain in Original Medicare until the annual election period running from October 15 to December 7,
during which she can select an MA plan.
Mr. Chen has heard about Medical Savings Account (MSA), but wants to know if it is just about saving money, or if
he will get insurance coverage for his health care expenditures as well. What should you tell him? correct answers
;
Under the Medicare Advantage program. an MSA plan involves the combination of high deductible health plan and
savings account for health expenses. Medicare will make contributions to this savings account to help him pay his
health care expenses while in the deductible.
.
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full time, and paid taxes during
that entire period. She is concerned that she will not qualify for coverage under part A because she was not born in
the United States. What should you tell her? correct answers ;
Most individuals who are citizens and over age 65 are covered under Part A by virtue of having paid Medicare
taxes while working, though some may be covered as a result of paying monthly premiums.
Ms. Edwards is enrolled in a Medicare Advantage plan that includes prescription drug plan (PDP) coverage. She is
traveling and wishes to fill two of her prescriptions that she has lost. How would you advise her? correct answers ;
,She may fill prescriptions for covered drugs at non-network pharmacies, but likely at a higher cost than paid at an
in-network pharmacy.
Mr. Rockwell, age 67, is enrolled in Medicare Part A, but because he continues to work and is covered by an
employer health plan, he has not enrolled in Part B or Part D. He receives a notice on June 1 that his employer is
cutting back on prescription drug benefits and that as of July 1 his coverage will no longer be creditable. He has
come to you for advice. What advice would you give Mr. Rockwell about special enrollment periods (SEPs)? correct
answers ;
Mr. Rockwell is eligible for a SEP due to his involuntary loss of creditable drug coverage; the SEP begins in June and
ends September 1 - two months after the loss of creditable coverage.
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? correct answers ;
Mrs. Duarte should file an appeal of this initial determination within 120 days of the date she received the MSN in
the mail.
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? correct answers ;
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. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park that might be of
assistance? correct answers ;
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.
Mrs. Quinn recently turned 66 and decided after many years of work to retire and begin receiving Social Security
benefits. Shortly thereafter Mrs. Quinn received a letter informing her that she had been automatically enrolled in
Medicare Part B. She wants to understand what this means. What should you tell Mrs. Quinn? correct answers ;
, Part B primarily covers physician services. She will be paying a monthly premium and, except for many preventive
and screening tests, generally will have 20% co-payments for these services, in addition to an annual deductible.
Anita Magri will turn age 65 in August 2023. 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 Plan F 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? correct answers ;
You are sorry to disappoint Anita, but a Medigap 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.
.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage plan. What should
you tell him? correct answers ;
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. Chen will be 65 soon, has been a citizen for twelve years, has been employed full time, and paid taxes during
that entire period. She is concerned that she will not qualify for coverage under part A because she was not born in
the United States. What should you tell her? correct answers ;
Most individuals who are citizens and age 65 or over are covered under Part A by virtue of having paid Medicare
taxes while working, though some may be covered as a result of paying monthly premiums.
Mr. Xi will soon turn age 65 and has come to you for advice as to what services are provided under Original
Medicare. What should you tell Mr. Xi that best describes the health coverage provided to Medicare beneficiaries?
correct answers ;
Beneficiaries under Original Medicare have no cost-sharing for most preventive services.
Mr. Barker enjoys a comfortable retirement income. He recently had surgery and expected that he would have
certain services and items covered by the plan with minimal out-of-pocket costs because his MA-PD coverage has
been very good. However, when he received the bill, he was surprised to see large charges in excess of his
