AHIP 2 FINAL EXAM FINAL STUDY PAPER 2026
COMPLETE QUESTIONS AND ANSWERS
◉ 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 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? 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.
,◉ 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?
Answer: 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.
◉ Mr. Patel is in good health and is preparing a budget in
anticipation of his retirement when he turns 66. He wants to
understand the health care costs he might be exposed to 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? Answer: Under
Original Medicare, there is a single deductible amount due for the
first 60 days of any inpatient hospital stay, after which it converts
into a per-day coinsurance amount through day 90. After day 90, he
would pay a daily amount up to 60 days over his lifetime, after which
he would be responsible for all costs.
◉ What impact, if any, have recent regulatory changes had on
Medigap plans? Answer: The Part B deductible is no longer covered
for individuals newly eligible for Medicare starting January 1, 2020.
, ◉ Mrs. Paterson is concerned about the deductibles and co-
payments associated with Original Medicare. What can you tell her
about Medigap as an option to address this concern? Answer:
Medigap plans do not cover Original Medicare benefits, but they
coordinate with Original Medicare coverage.
◉ Mrs. Turner is comparing her employer's retiree insurance to
Original Medicare and would like to know which of the following
services Original Medicare will cover if the appropriate criteria are
met. What could you tell her? Answer: Original Medicare covers
ambulance services.
◉ Ms. Brooks has aggressive cancer and would like to know if
Medicare will cover hospice services in case she needs them. What
should you tell her? Answer: Medicare covers hospice services, and
they will be available for her.
◉ Mr. Diaz continued working with his company and was insured
under his employer's group plan until he reached age 68. He has
heard that there is a premium penalty for those who did not sign up
for Part B when first eligible and wants to know how much he will
have to pay. What should you tell him? Answer: Mr. Diaz will not pay
any penalty because he had continuous coverage under his
employer's plan.
◉ 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
COMPLETE QUESTIONS AND ANSWERS
◉ 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 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? 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.
,◉ 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?
Answer: 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.
◉ Mr. Patel is in good health and is preparing a budget in
anticipation of his retirement when he turns 66. He wants to
understand the health care costs he might be exposed to 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? Answer: Under
Original Medicare, there is a single deductible amount due for the
first 60 days of any inpatient hospital stay, after which it converts
into a per-day coinsurance amount through day 90. After day 90, he
would pay a daily amount up to 60 days over his lifetime, after which
he would be responsible for all costs.
◉ What impact, if any, have recent regulatory changes had on
Medigap plans? Answer: The Part B deductible is no longer covered
for individuals newly eligible for Medicare starting January 1, 2020.
, ◉ Mrs. Paterson is concerned about the deductibles and co-
payments associated with Original Medicare. What can you tell her
about Medigap as an option to address this concern? Answer:
Medigap plans do not cover Original Medicare benefits, but they
coordinate with Original Medicare coverage.
◉ Mrs. Turner is comparing her employer's retiree insurance to
Original Medicare and would like to know which of the following
services Original Medicare will cover if the appropriate criteria are
met. What could you tell her? Answer: Original Medicare covers
ambulance services.
◉ Ms. Brooks has aggressive cancer and would like to know if
Medicare will cover hospice services in case she needs them. What
should you tell her? Answer: Medicare covers hospice services, and
they will be available for her.
◉ Mr. Diaz continued working with his company and was insured
under his employer's group plan until he reached age 68. He has
heard that there is a premium penalty for those who did not sign up
for Part B when first eligible and wants to know how much he will
have to pay. What should you tell him? Answer: Mr. Diaz will not pay
any penalty because he had continuous coverage under his
employer's plan.
◉ 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
