AHIP FINAL EXAM, PRACTICE EXAM AND STUDY GUIDE
LATEST 2025/2026 ACTUAL EXAM 135 QUESTIONS WITH
CORRECT ANSWERS 100% VERIFIED GRADED A+
Terms in this set (100)
Mrs. Shields is covered by Medicare will cover Mrs. Shield's skilled nursing services
Original provided during the first 20 days of her stay, after which she
Medicare. She sustained a hip would have a copay until she has been in the facility for 100
fracture and is being days.
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?
Mrs. West wears glasses and Medicare does not cover massage therapy, or, in general, glasses or
dentures and has enjoyed dentures.
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?
Mrs. Park is an elderly retiree. She should contact her state Medicaid agency to see if she
Mrs. Park has a low fixed qualifies for one of several programs that can help with
income. What could you tell Medicare costs for which she is responsible.
Mrs. Park that might be of
assistance?
,Mr. Alonso receives some help He generally would pay a monthly premium, annual deductible,
paying for his two generic and per-prescription cost-sharing.
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?
Mrs. Gonzalez is enrolled in Mrs. Gonzalez cannot purchase a Medigap plan that covers
Original Medicare and has a drugs, but she could keep her Medigap policy and enroll in a
Medigap policy as Part D prescription drug plan.
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?
Mr. Davis is 52 years old and He may sign-up for Medicare at any time however coverage
has recently been diagnosed usually begins on the fourth month after dialysis treatments
with end-stage renal disease start.
(ESRD) and will soon begin
dialysis. He is wondering if he
can obtain coverage under
Medicare. What should you tell
him?
Mrs. Duarte is enrolled in Mrs. Duarte should file an appeal of this initial determination
Original within 120 days of the date she received the MSN in the
Medicare Parts A and B. She mail.
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?
Mrs. Geisler's neighbor told her Part D covers prescription drugs and she should look at her
she should look at her Part D premiums, formulary, and cost-sharing among other factors
options during the annual to see if they have changed.
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?
Mr. Rainey is experiencing Medicare will cover a total of 190 days of inpatient psychiatric
paranoid care during Mr. Rainey's entire lifetime.
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?
Mr. Xi will soon turn age 65 Beneficiaries under Original Medicare have no cost-sharing
and has come to you for for most preventive services.
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?
Mr. Singh would like drug Mr. Singh can enroll in a stand-alone prescription drug plan
coverage but does not want to be and continue to be covered for Part A and Part B services
enrolled in a Medicare Advantage through Original Fee-for-Service Medicare.
plan. What should you tell him?
, Mrs. Chen will be 65 soon, has Most individuals who are citizens and age 65 or over are
been a citizen for twelve years, covered under Part A by virtue of having paid Medicare taxes
has been while working, though some may be covered as a result of
employed full time, and paid paying monthly premiums.
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?
Mrs. Quinn recently turned 66 Part B primarily covers physician services. She will be
and decided after many years paying a monthly premium and, except for many
of work to retire and begin preventive and screening tests, generally will have 20% co-
receiving Social Security payments for these services, in addition to an annual
benefits. deductible.
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?
Mr. Patel is in good health and Under Original Medicare, there is a single deductible amount due for
is preparing a budget in the first 60
anticipation of his retirement days of any inpatient hospital stay, after which it converts into a
when he turns 66. He wants to per-day coinsurance amount through day 90. After day 90, he
understand the health care would pay a daily amount up to 60 days over his lifetime,
costs he might be exposed to after which he would be responsible for all costs.
under Medicare if he were to
require
hospitalization because of an
illness. In general terms, what
could you tell him about his
costs for inpatient hospital
services under Original
Medicare?
What impact, if any, have recent The Part B deductible is no longer covered for individuals
regulatory changes had on
LATEST 2025/2026 ACTUAL EXAM 135 QUESTIONS WITH
CORRECT ANSWERS 100% VERIFIED GRADED A+
Terms in this set (100)
Mrs. Shields is covered by Medicare will cover Mrs. Shield's skilled nursing services
Original provided during the first 20 days of her stay, after which she
Medicare. She sustained a hip would have a copay until she has been in the facility for 100
fracture and is being days.
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?
Mrs. West wears glasses and Medicare does not cover massage therapy, or, in general, glasses or
dentures and has enjoyed dentures.
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?
Mrs. Park is an elderly retiree. She should contact her state Medicaid agency to see if she
Mrs. Park has a low fixed qualifies for one of several programs that can help with
income. What could you tell Medicare costs for which she is responsible.
Mrs. Park that might be of
assistance?
,Mr. Alonso receives some help He generally would pay a monthly premium, annual deductible,
paying for his two generic and per-prescription cost-sharing.
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?
Mrs. Gonzalez is enrolled in Mrs. Gonzalez cannot purchase a Medigap plan that covers
Original Medicare and has a drugs, but she could keep her Medigap policy and enroll in a
Medigap policy as Part D prescription drug plan.
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?
Mr. Davis is 52 years old and He may sign-up for Medicare at any time however coverage
has recently been diagnosed usually begins on the fourth month after dialysis treatments
with end-stage renal disease start.
(ESRD) and will soon begin
dialysis. He is wondering if he
can obtain coverage under
Medicare. What should you tell
him?
Mrs. Duarte is enrolled in Mrs. Duarte should file an appeal of this initial determination
Original within 120 days of the date she received the MSN in the
Medicare Parts A and B. She mail.
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?
Mrs. Geisler's neighbor told her Part D covers prescription drugs and she should look at her
she should look at her Part D premiums, formulary, and cost-sharing among other factors
options during the annual to see if they have changed.
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?
Mr. Rainey is experiencing Medicare will cover a total of 190 days of inpatient psychiatric
paranoid care during Mr. Rainey's entire lifetime.
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?
Mr. Xi will soon turn age 65 Beneficiaries under Original Medicare have no cost-sharing
and has come to you for for most preventive services.
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?
Mr. Singh would like drug Mr. Singh can enroll in a stand-alone prescription drug plan
coverage but does not want to be and continue to be covered for Part A and Part B services
enrolled in a Medicare Advantage through Original Fee-for-Service Medicare.
plan. What should you tell him?
, Mrs. Chen will be 65 soon, has Most individuals who are citizens and age 65 or over are
been a citizen for twelve years, covered under Part A by virtue of having paid Medicare taxes
has been while working, though some may be covered as a result of
employed full time, and paid paying monthly premiums.
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?
Mrs. Quinn recently turned 66 Part B primarily covers physician services. She will be
and decided after many years paying a monthly premium and, except for many
of work to retire and begin preventive and screening tests, generally will have 20% co-
receiving Social Security payments for these services, in addition to an annual
benefits. deductible.
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?
Mr. Patel is in good health and Under Original Medicare, there is a single deductible amount due for
is preparing a budget in the first 60
anticipation of his retirement days of any inpatient hospital stay, after which it converts into a
when he turns 66. He wants to per-day coinsurance amount through day 90. After day 90, he
understand the health care would pay a daily amount up to 60 days over his lifetime,
costs he might be exposed to after which he would be responsible for all costs.
under Medicare if he were to
require
hospitalization because of an
illness. In general terms, what
could you tell him about his
costs for inpatient hospital
services under Original
Medicare?
What impact, if any, have recent The Part B deductible is no longer covered for individuals
regulatory changes had on
