1|Page
2025 AHIP Final Exam ( Updated 2025
) 1-100 Complete Questions &
Answers (Solved) 100% Correct
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? -
ANSWER-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.
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? - ANSWER-
,2|Page
Medicare does not cover massage therapy, or, in general, glasses
or dentures.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed
income. What could you tell Mrs. Park that might be of
assistance? - ANSWER-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.
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? - ANSWER-He generally would pay
a monthly premium, annual deductible, and per-prescription
cost-sharing.
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? - ANSWER-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.
,3|Page
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? - ANSWER-He may sign-up for Medicare
at any time however coverage usually begins on the fourth
month after dialysis treatments start.
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?
- ANSWER-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? -
ANSWER-Part D covers prescription drugs and she should look
at her premiums, formulary, and costsharing among other factors
to see if they have changed.
Mr. Rainey is experiencing paranoid delusions and his physician
feels that he should be hospitalized. What should you tell Mr.
, 4|Page
Rainey (or his representative) about the length of an inpatient
psychiatric hospital stay that Medicare will cover? - ANSWER-
Medicare will cover a total of 190 days of inpatient psychiatric
care during Mr. Rainey's entire lifetime.
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? - ANSWER-Beneficiaries
under Original Medicare have no cost-sharing for most
preventive services.
Mr. Singh would like drug coverage but does not want to be
enrolled in a Medicare Advantage plan. What should you tell
him? - ANSWER-Mr. Singh can enroll in a standalone
prescription drug plan and continue to be covered for Part A and
Part B services through Original Fee-forService 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? - ANSWER-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.
2025 AHIP Final Exam ( Updated 2025
) 1-100 Complete Questions &
Answers (Solved) 100% Correct
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? -
ANSWER-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.
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? - ANSWER-
,2|Page
Medicare does not cover massage therapy, or, in general, glasses
or dentures.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed
income. What could you tell Mrs. Park that might be of
assistance? - ANSWER-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.
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? - ANSWER-He generally would pay
a monthly premium, annual deductible, and per-prescription
cost-sharing.
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? - ANSWER-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.
,3|Page
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? - ANSWER-He may sign-up for Medicare
at any time however coverage usually begins on the fourth
month after dialysis treatments start.
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?
- ANSWER-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? -
ANSWER-Part D covers prescription drugs and she should look
at her premiums, formulary, and costsharing among other factors
to see if they have changed.
Mr. Rainey is experiencing paranoid delusions and his physician
feels that he should be hospitalized. What should you tell Mr.
, 4|Page
Rainey (or his representative) about the length of an inpatient
psychiatric hospital stay that Medicare will cover? - ANSWER-
Medicare will cover a total of 190 days of inpatient psychiatric
care during Mr. Rainey's entire lifetime.
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? - ANSWER-Beneficiaries
under Original Medicare have no cost-sharing for most
preventive services.
Mr. Singh would like drug coverage but does not want to be
enrolled in a Medicare Advantage plan. What should you tell
him? - ANSWER-Mr. Singh can enroll in a standalone
prescription drug plan and continue to be covered for Part A and
Part B services through Original Fee-forService 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? - ANSWER-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.
