2026 AHIP Final Exam Questions and Answers Updated 2026

2026 AHIP Final Exam
Questions and Answers
Updated 2026
Mrs.BShieldsBisBcoveredBbyBOriginalBMedicare.BSheBsustainedBaBhipBfractureBandBisBb
eingBsuccessfullyBtreatedBforBthatBcondition.BHowever,BsheBandBherBphysiciansBfeelBth
atBafterBherBlengthyBhospitalBstay,BsheBwillBneedBaBmonthBorBtwoBofBnursingBandBre
habilitativeBcare.BWhatBshouldByouBtellBthemBaboutBOriginalBMedicare'sBcoverageBofB
careBinBaBskilledBnursingBfacility?B-
BAnswerBMedicareBwillBcoverBMrs.BShield'sBskilledBnursingBservicesBprovidedBduringBt
heBfirstB20BdaysBofBherBstay,BafterBwhichBsheBwouldBhaveBaBcopayBuntilBsheBhasBbe
enBinBtheBfacilityBforB100Bdays.



Mrs.BWestBwearsBglassesBandBdenturesBandBhasBenjoyedBconsiderableBpainBreliefBfro
mBarthritisBthroughBmassageBtherapy.BSheBisBconcernedBaboutBwhetherBorBnotBMedic
areBwillBcoverBtheseBitemsBandBservices.BWhatBshouldByouBtellBher?B-
BAnswerBMedicareBdoesBnotBcoverBmassageBtherapy,Bor,BinBgeneral,BglassesBorBdentu
res.



Mrs.BParkBisBanBelderlyBretiree.BMrs.BParkBhasBaBlowBfixedBincome.BWhatBcouldByou
BtellBMrs.BParkBthatBmightBbeBofBassistance?B-
BAnswerBSheBshouldBcontactBherBstateBMedicaidBagencyBtoBseeBifBsheBqualifiesBforB
oneBofBseveralBprogramsBthatBcanBhelpBwithBMedicareBcostsBforBwhichBsheBisBrespo
nsible.



Mr.BAlonsoBreceivesBsomeBhelpBpayingBforBhisBtwoBgenericBprescriptionBdrugsBfromB
hisBemployer'sBretireeBcoverage,BbutBheBwantsBtoBcompareBitBtoBaBPartBDBprescripti
onBdrugBplan.BHeBasksByouBwhatBcostsBheBwouldBgenerallyBexpectBtoBencounterBwh
enBenrollingBintoBaBstandardBMedicareBPartBDBprescriptionBdrugBplan.BWhatBshouldBy
ouBtellBhim?B-
BAnswerBHeBgenerallyBwouldBpayBaBmonthlyBpremium,BannualBdeductible,BandBper-
prescriptionBcost-sharing.

,Mrs.BGonzalezBisBenrolledBinBOriginalBMedicareBandBhasBaBMedigapBpolicyBasBwell,Bb
utBitBprovidesBnoBdrugBcoverage.BSheBwouldBlikeBtoBkeepBtheBcoverageBsheBhasBbut
BreplaceBherBexistingBMedigapBplanBwithBoneBthatBprovidesBdrugBcoverage.BWhatBsh
ouldByouBtellBher?B-
BAnswerBMrs.BGonzalezBcannotBpurchaseBaBMedigapBplanBthatBcoversBdrugs,BbutBshe
BcouldBkeepBherBMedigapBpolicyBandBenrollBinBaBPartBDBprescriptionBdrugBplan.



Mr.BDavisBisB52ByearsBoldBandBhasBrecentlyBbeenBdiagnosedBwithBend-
stageBrenalBdiseaseB(ESRD)BandBwillBsoonBbeginBdialysis.BHeBisBwonderingBifBheBcanB
obtainBcoverageBunderBMedicare.BWhatBshouldByouBtellBhim?B-
BAnswerBHeBmayBsign-
upBforBMedicareBatBanyBtimeBhoweverBcoverageBusuallyBbeginsBonBtheBfourthBmonth
BafterBdialysisBtreatmentsBstart.



Mrs.BDuarteBisBenrolledBinBOriginalBMedicareBPartsBABandBB.BSheBhasBrecentlyBrevie
wedBherBMedicareBSummaryBNoticeB(MSN)BandBdisagreesBwithBaBdeterminationBthat
BpartiallyBdeniedBoneBofBherBclaimsBforBservices.BWhatBadviceBwouldByouBgiveBher?B
-
BAnswerBMrs.BDuarteBshouldBfileBanBappealBofBthisBinitialBdeterminationBwithinB120B
daysBofBtheBdateBsheBreceivedBtheBMSNBinBtheBmail.



Mrs.BGeisler'sBneighborBtoldBherBsheBshouldBlookBatBherBPartBDBoptionsBduringBtheB
annualBMedicareBenrollmentBperiodBbecauseBtheBfeaturesBofBPartBDBmightBhaveBchan
ged.BMrs.BGeislerBcan'tBrememberBwhatBPartBDBisBsoBsheBcalledByouBtoBaskBwhatBh
erBneighborBwasBtalkingBabout.BWhatBcouldByouBtellBher?B-
BAnswerBPartBDBcoversBprescriptionBdrugsBandBsheBshouldBlookBatBherBpremiums,Bfo
rmulary,BandBcost-sharingBamongBotherBfactorsBtoBseeBifBtheyBhaveBchanged.



Mr.BRaineyBisBexperiencingBparanoidBdelusionsBandBhisBphysicianBfeelsBthatBheBshould
BbeBhospitalized.BWhatBshouldByouBtellBMr.BRaineyB(orBhisBrepresentative)BaboutBthe
BlengthBofBanBinpatientBpsychiatricBhospitalBstayBthatBMedicareBwillBcover?B-
BAnswerBMedicareBwillBcoverBaBtotalBofB190BdaysBofBinpatientBpsychiatricBcareBdurin
gBMr.BRainey'sBentireBlifetime.



Mr.BXiBwillBsoonBturnBageB65BandBhasBcomeBtoByouBforBadviceBasBtoBwhatBservices
BareBprovidedBunderBOriginalBMedicare.BWhatBshouldByouBtellBMr.BXiBthatBbestBdescr

, ibesBtheBhealthBcoverageBprovidedBtoBMedicareBbeneficiaries?B-
BAnswerBBeneficiariesBunderBOriginalBMedicareBhaveBnoBcost-
sharingBforBmostBpreventiveBservices.



Mr.BSinghBwouldBlikeBdrugBcoverageBbutBdoesBnotBwantBtoBbeBenrolledBinBaBMedica
reBAdvantageBplan.BWhatBshouldByouBtellBhim?B-
BAnswerBMr.BSinghBcanBenrollBinBaBstand-
aloneBprescriptionBdrugBplanBandBcontinueBtoBbeBcoveredBforBPartBABandBPartBBBser
vicesBthroughBOriginalBFee-for-ServiceBMedicare.



Mrs.BChenBwillBbeB65Bsoon,BhasBbeenBaBcitizenBforBtwelveByears,BhasBbeenBemploye
dBfullBtime,BandBpaidBtaxesBduringBthatBentireBperiod.BSheBisBconcernedBthatBsheBwi
llBnotBqualifyBforBcoverageBunderBpartBABbecauseBsheBwasBnotBbornBinBtheBUnitedB
States.BWhatBshouldByouBtellBher?B-
BAnswerBMostBindividualsBwhoBareBcitizensBandBageB65BorBoverBareBcoveredBunderB
PartBABbyBvirtueBofBhavingBpaidBMedicareBtaxesBwhileBworking,BthoughBsomeBmayBb
eBcoveredBasBaBresultBofBpayingBmonthlyBpremiums.



Mrs.BQuinnBrecentlyBturnedB66BandBdecidedBafterBmanyByearsBofBworkBtoBretireBand
BbeginBreceivingBSocialBSecurityBbenefits.BShortlyBthereafterBMrs.BQuinnBreceivedBaBle
tterBinformingBherBthatBsheBhadBbeenBautomaticallyBenrolledBinBMedicareBPartBB.BSh
eBwantsBtoBunderstandBwhatBthisBmeans.BWhatBshouldByouBtellBMrs.BQuinn?B-
BAnswerBPartBBBprimarilyBcoversBphysicianBservices.BSheBwillBbeBpayingBaBmonthlyBp
remiumBand,BexceptBforBmanyBpreventiveBandBscreeningBtests,BgenerallyBwillBhaveB20
%Bco-paymentsBforBtheseBservices,BinBadditionBtoBanBannualBdeductible.



Mr.BPatelBisBinBgoodBhealthBandBisBpreparingBaBbudgetBinBanticipationBofBhisBretirem
entBwhenBheBturnsB66.BHeBwantsBtoBunderstandBtheBhealthBcareBcostsBheBmightBbe
BexposedBtoBunderBMedicareBifBheBwereBtoBrequireBhospitalizationBbecauseBofBanBill
ness.BInBgeneralBterms,BwhatBcouldByouBtellBhimBaboutBhisBcostsBforBinpatientBhospit
alBservicesBunderBOriginalBMedicare?B-
BAnswerBUnderBOriginalBMedicare,BthereBisBaBsingleBdeductibleBamountBdueBforBthe
BfirstB60BdaysBofBanyBinpatientBhospitalBstay,BafterBwhichBitBconvertsBintoBaBper-
dayBcoinsuranceBamountBthroughBdayB90.BAfterBdayB90,BheBwouldBpayBaBdailyBamou
ntBupBtoB60BdaysBoverBhisBlifetime,BafterBwhichBheBwouldBbeBresponsibleBforBallBcos
ts.