America's Health Insurance Plans 2027/2028 CERTIFICATION.
AHIP EXAM QUESTIONS AND ANSWERS.
c c c c
LATEST 2027/2028 A+ UPDATE (REAL
c c c c c
EXAM UPDATE)
c c
Davis cis c52 cyears cold cand chas crecently cbeen cdiagnosed cwith cend-stage crenal cdisease c(ESRD) cand
cwill csoon cbegin cdialysis. cHe cis cwondering cif che ccan cobtain ccoverage cunder cMedicare. cWhat cshould
cyou ctell chim? c- cCORRECT cANS>>He cmay csign-up cfor cMedicare cat cany ctime chowever ccoverage
cusually cbegins con cthe cfourth cmonth cafter cdialysis ctreatments cstart.
Juan cPerez, cwho cis cturning cage c65 cnext cmonth, cintends cto cwork cfor cseveral cmore cyears cat
cSmallcap, cIncorporated. cSmallcap chas ca cworkforce cof15 cemployees cand coffers cemployer-
sponsored chealthcare ccoverage. cJuan cis ca cnaturalized ccitizen cand chas ccontributed cto cthe cMedicare
csystem cfor cover c20 cyears. cJuan casks cyou cif che cwill cbe centitled cto cMedicare cand cif che cenrolls chow
cthat cwill cimpact chis cemployer-sponsored chealthcare ccoverage. cHow cwould cyou crespond? c-
ccorrect canswer
- CORRECT cANS>>Juan cis clikely cto cbe celigible cfor cMedicare conce che cturns cage c65 cand cif che
cenrolls cMedicare cwould cbecome cthe cprimary cpayor cof chis chealthcare cclaims cand cSmallcap cdoes
cnot chave cto ccontinue cto coffer chim ccoverage ccomparable cto cthose cunder cage c65 cunder cits
cemployer-sponsored cgroup chealth cplan.
Moy's cwife chas ca cMedicare cAdvantage cplan, cbut che cwants cto cunderstand cwhat ccoverage cMedicare
cSupplemental cInsurance cprovides csince chis chealth ccare cneeds care cdifferent cfrom chis cwife's cneeds.
cWhat ccould cyou ctell cMr. cMoy? c- ccorrect canswer
- CORRECT cANS>>Medicare cSupplemental cInsurance cwould chelp ccover chis cPart cA cand cPart cB
cdeductibles cor ccoinsurance cin cOriginal cFee-for-Service c(FFS) cMedicare cas cwell cas cpossibly csome
cservices cthat cMedicare cdoes cnot ccover.
Peňa cis c66 cyears cold, chas ccoverage cunder can cemployer cplan, cand cwill cretire cnext cyear. cShe cheard
cshe cmust cenroll cin cPart cB cat cthe cbeginning cof cthe cyear cto censure cno cgap cin ccoverage. cWhat ccan
cyou ctell cher?
- CORRECT cANS>>She cmay cenroll cat cany ctime cwhile cshe cis ccovered cunder cher cemployer cplan, cbut
cshe cwill chave ca cspecial ceight-month cenrollment cperiod cafter cthe clast cmonth con cher cemployer
cplan cthat cdiffers cfrom cthe cstandard cgeneral cenrollment cperiod, cduring cwhich cshe cmay cenroll cin
cMedicare cPart cB.
Chen cwill cbe c65 csoon, chas cbeen ca ccitizen cfor ctwelve cyears, chas cbeen cemployed cfull ctime, cand cpaid
ctaxes cduring cthat centire cperiod. cShe cis cconcerned cthat cshe cwill cnot cqualify cfor ccoverage cunder cpart
cA cbecause cshe cwas cnot cborn cin cthe cUnited cStates. cWhat cshould cyou ctell cher? c- cCORRECT
cANS>>Most cindividuals cwho care ccitizens cand cage c65 cor cover care ccovered cunder cPart cA cby cvirtue cof
chaving cpaid cMedicare ctaxes cwhile cworking, cthough csome cmay cbe ccovered cas ca cresult cof cpaying
cmonthly cpremiums.
Gonzalez cis cenrolled cin cOriginal cMedicare cand chas ca cMedigap cpolicy cas cwell, cbut cit cprovides cno
cdrug ccoverage. cShe cwould clike cto ckeep cthe ccoverage cshe chas cbut creplace cher cexisting cMedigap
,America's Health Insurance Plans 2027/2028 CERTIFICATION.
cplan cwith cone cthat cprovides cdrug ccoverage. cWhat cshould cyou ctell cher? c- cCORRECT cANS>>Mrs.
cGonzalez ccannot cpurchase ca cMedigap cplan cthat ccovers cdrugs, cbut cshe ccould ckeep cher cMedigap
cpolicy cand cenroll cin ca cPart cD cprescription cdrug cplan.
,America's Health Insurance Plans 2027/2028 CERTIFICATION.
West cwears cglasses cand cdentures cand chas cenjoyed cconsiderable cpain crelief cfrom carthritis cthrough
cmassage ctherapy. cShe cis cconcerned cabout cwhether cor cnot cMedicare cwill ccover cthese citems cand
cservices. cWhat cshould cyou ctell cher? c- cCORRECT cANS>>Medicare cdoes cnot ccover cmassage ctherapy,
cor, cin cgeneral, cglasses cor cdentures.
Patel cis cin cgood chealth cand cis cpreparing ca cbudget cin canticipation cof chis cretirement cwhen che cturns
c66. cHe cwants cto cunderstand cthe chealth ccare ccosts che cmight cbe cexposed cto cunder cMedicare cif che
cwere cto crequire chospitalization cas ca cresult cof can cillness. cIn cgeneral cterms, cwhat ccould cyou ctell chim
cabout chis ccosts cfor cinpatient chospital cservices
under cOriginal cMedicare? c- cCORRECT cANS>>Under cOriginal cMedicare, cthere cis ca csingle cdeductible
camount cdue cfor cthe cfirst c60 cdays cof cany cinpatient chospital cstay, cafter cwhich cit cconverts cinto ca
cper-day ccoinsurance camount cthrough cday c90. cAfter cday c90, che cwould cpay ca cdaily camount cup cto c60
cdays cover chis clifetime, cafter cwhich che cwould cbe cresponsible cfor call ccosts.
Henderson cbelieves cthat cshe cwill cqualify cfor cMedicare cCoverage cwhen cshe cturns c65, cwithout
cpaying cany cpremiums, cbecause cshe chas cbeen cworking cfor c40 cyears cand cpaying cMedicare ctaxes.
cWhat cshould cyou ctell cher? c- cCORRECT cANS>>To cobtain cPart cB ccoverage, cshe cmust cpay ca cstandard
cmonthly cpremium, cthough cit cis chigher cfor cindividuals cwith chigher cincomes.
Alonso creceives csome chelp cpaying cfor chis ctwo cgeneric cprescription cdrugs cfrom chis cemployer's
cretiree ccoverage, cbut che cwants cto ccompare cit cto ca cPart cD cprescription cdrug cplan. cHe casks cyou
cwhat ccosts che cwould cgenerally cexpect cto cencounter cwhen cenrolling cinto ca cstandard cMedicare
cPart cD cprescription cdrug cplan. cWhat cshould cyou ctell chim? c- cCORRECT cANS>>He cgenerally cwould
cpay ca cmonthly cpremium, cannual cdeductible, cand cper-prescription ccost-sharing.
Moore cplans cto cretire cwhen cshe cturns c65 cin ca cfew cmonths. cShe cis cin cexcellent chealth cand cwill
chave cconsiderable cincome cwhen cshe cretires. cShe cis cconcerned cthat cher cincome cwill cmake cit
cimpossible cfor cher cto cqualify cfor cMedicare. cWhat ccould cyou ctell cher cto caddress cher cconcern? c-
cCORRECT cANS>>Medicare cis ca cprogram cfor cpeople cage c65 cor colder cand cthose cunder cage c65 cwith
ccertain cdisabilities, cend-stage crenal cdisease, cand cLou cGehrig's cdisease cso cshe cwill cbe celigible cfor
cMedicare.
Xi cwill csoon cturn cage c65 cand chas ccome cto cyou cfor cadvice cas cto cwhat cservices care cprovided cunder
cOriginal cMedicare. cWhat cshould cyou ctell cMr. cXi cthat cbest cdescribes cthe chealth ccoverage cprovided
cto cMedicare cbeneficiaries? c - cCORRECT cANS>>Beneficiaries cunder cOriginal cMedicare chave cno ccost-
sharing cfor cmost cpreventive cservices cwhich cinclude cimmunizations csuch cas cannual cflu cshots.
, America's Health Insurance Plans 2027/2028 CERTIFICATION.
Duarte cis cenrolled cin cOriginal cMedicare cParts cA cand cB. cShe chas crecently creviewed cher cMedicare
cSummary cNotice c(MSN) cand cdisagrees cwith ca cdetermination cthat cpartially cdenied cone cof cher cclaims
cfor cservices. cWhat cadvice cwould cyou cgive cher? c- cCORRECT cANS>>Mrs. cDuarte cshould cfile can cappeal
cof cthis cinitial cdetermination cwithin c120 cdays cof cthe cdate cshe creceived cthe cMSN cin cthe cmail.
Capadona cwould clike cto cpurchase ca cMedicare cAdvantage c(MA) cplan cand ca cMedigap cplan cto cpick
cup ccosts cnot ccovered cby cthat cplan.
What cshould cyou ctell chim? c- cCORRECT cANS>>It cis cillegal cfor cyou cto csell cMr. cCapadona ca cMedigap
cplan cif che cis cenrolled cin can cMA cplan, cand cbesides, cMedigap conly cworks cwith cOriginal cMedicare.
Park cis can celderly cretiree. cMrs. cPark chas ca clow cfixed cincome. cWhat ccould cyou ctell cMrs. cPark cthat
cmight cbe cof cassistance? c- cCORRECT cANS>>She cshould ccontact cher cstate cMedicaid cagency cto csee cif
cshe cqualifies cfor cone cof cseveral cprograms cthat ccan chelp cwith cMedicare ccosts cfor cwhich cshe cis
cresponsible.
Rainey cis cexperiencing cparanoid cdelusions cand chis cphysician cfeels cthat che cshould cbe chospitalized.
cWhat cshould cyou ctell cMr. cRainey c(or chis crepresentative) cabout cthe clength cof can cinpatient
cpsychiatric chospital cstay cthat cMedicare cwill ccover? c - cCORRECT cANS>>Medicare cwill ccover ca ctotal
cof c190 cdays cof cinpatient cpsychiatric ccare cduring cMr. cRainey's centire clifetime.
Schmidt cwould clike cto cplan cfor cretirement cand chas casked cyou cwhat cis ccovered cunder cOriginal
cFee-for-Service c(FFS) cMedicare? cWhat ccould cyou ctell chim? c- cCORRECT cANS>>Part cA, cwhich
ccovers chospital, cskilled cnursing cfacility, chospice, cand chome chealth cservices cand cPart cB, cwhich
ccovers cprofessional cservices csuch cas cthose cprovided cby ca cdoctor care ccovered cunder cOriginal
cMedicare.
Agent cJohn cMiller cis cmeeting cwith cJerry cSmith, ca cnew cprospect. cJerry cis ccurrently cenrolled cin
cMedicare cParts cA cand cB. cJerry chas calso cpurchased ca cMedicare cSupplement c(Medigap) cplan cwhich
che chas chad cfor cseveral cyears. cHowever, cthe cplan cdoes cnot cprovide cdrug cbenefits. cHow cwould cyou
cadvise cAgent cJohn cMiller cto cproceed? c- cCORRECT cANS>>Tell cprospect cJerry cSmith cthat che cshould
cconsider cadding ca cstandalone cPart cD cprescription cdrug ccoverage cpolicy cto chis cpresent ccoverage.
Bauer cis c49 cyears cold, cbut ceighteen cmonths cago che cwas cdeclared cdisabled cby cthe cSocial cSecurity
cAdministration cand chas cbeen creceiving cdisability cpayments. cHe cis cwondering cwhether che ccan
cobtain ccoverage cunder cMedicare. cWhat cshould cyou ctell chim? c- cCORRECT cANS>>After creceiving
csuch cdisability cpayments cfor c24 cmonths, che cwill cbe cautomatically cenrolled cin cMedicare,
cregardless cof cage.
AHIP EXAM QUESTIONS AND ANSWERS.
c c c c
LATEST 2027/2028 A+ UPDATE (REAL
c c c c c
EXAM UPDATE)
c c
Davis cis c52 cyears cold cand chas crecently cbeen cdiagnosed cwith cend-stage crenal cdisease c(ESRD) cand
cwill csoon cbegin cdialysis. cHe cis cwondering cif che ccan cobtain ccoverage cunder cMedicare. cWhat cshould
cyou ctell chim? c- cCORRECT cANS>>He cmay csign-up cfor cMedicare cat cany ctime chowever ccoverage
cusually cbegins con cthe cfourth cmonth cafter cdialysis ctreatments cstart.
Juan cPerez, cwho cis cturning cage c65 cnext cmonth, cintends cto cwork cfor cseveral cmore cyears cat
cSmallcap, cIncorporated. cSmallcap chas ca cworkforce cof15 cemployees cand coffers cemployer-
sponsored chealthcare ccoverage. cJuan cis ca cnaturalized ccitizen cand chas ccontributed cto cthe cMedicare
csystem cfor cover c20 cyears. cJuan casks cyou cif che cwill cbe centitled cto cMedicare cand cif che cenrolls chow
cthat cwill cimpact chis cemployer-sponsored chealthcare ccoverage. cHow cwould cyou crespond? c-
ccorrect canswer
- CORRECT cANS>>Juan cis clikely cto cbe celigible cfor cMedicare conce che cturns cage c65 cand cif che
cenrolls cMedicare cwould cbecome cthe cprimary cpayor cof chis chealthcare cclaims cand cSmallcap cdoes
cnot chave cto ccontinue cto coffer chim ccoverage ccomparable cto cthose cunder cage c65 cunder cits
cemployer-sponsored cgroup chealth cplan.
Moy's cwife chas ca cMedicare cAdvantage cplan, cbut che cwants cto cunderstand cwhat ccoverage cMedicare
cSupplemental cInsurance cprovides csince chis chealth ccare cneeds care cdifferent cfrom chis cwife's cneeds.
cWhat ccould cyou ctell cMr. cMoy? c- ccorrect canswer
- CORRECT cANS>>Medicare cSupplemental cInsurance cwould chelp ccover chis cPart cA cand cPart cB
cdeductibles cor ccoinsurance cin cOriginal cFee-for-Service c(FFS) cMedicare cas cwell cas cpossibly csome
cservices cthat cMedicare cdoes cnot ccover.
Peňa cis c66 cyears cold, chas ccoverage cunder can cemployer cplan, cand cwill cretire cnext cyear. cShe cheard
cshe cmust cenroll cin cPart cB cat cthe cbeginning cof cthe cyear cto censure cno cgap cin ccoverage. cWhat ccan
cyou ctell cher?
- CORRECT cANS>>She cmay cenroll cat cany ctime cwhile cshe cis ccovered cunder cher cemployer cplan, cbut
cshe cwill chave ca cspecial ceight-month cenrollment cperiod cafter cthe clast cmonth con cher cemployer
cplan cthat cdiffers cfrom cthe cstandard cgeneral cenrollment cperiod, cduring cwhich cshe cmay cenroll cin
cMedicare cPart cB.
Chen cwill cbe c65 csoon, chas cbeen ca ccitizen cfor ctwelve cyears, chas cbeen cemployed cfull ctime, cand cpaid
ctaxes cduring cthat centire cperiod. cShe cis cconcerned cthat cshe cwill cnot cqualify cfor ccoverage cunder cpart
cA cbecause cshe cwas cnot cborn cin cthe cUnited cStates. cWhat cshould cyou ctell cher? c- cCORRECT
cANS>>Most cindividuals cwho care ccitizens cand cage c65 cor cover care ccovered cunder cPart cA cby cvirtue cof
chaving cpaid cMedicare ctaxes cwhile cworking, cthough csome cmay cbe ccovered cas ca cresult cof cpaying
cmonthly cpremiums.
Gonzalez cis cenrolled cin cOriginal cMedicare cand chas ca cMedigap cpolicy cas cwell, cbut cit cprovides cno
cdrug ccoverage. cShe cwould clike cto ckeep cthe ccoverage cshe chas cbut creplace cher cexisting cMedigap
,America's Health Insurance Plans 2027/2028 CERTIFICATION.
cplan cwith cone cthat cprovides cdrug ccoverage. cWhat cshould cyou ctell cher? c- cCORRECT cANS>>Mrs.
cGonzalez ccannot cpurchase ca cMedigap cplan cthat ccovers cdrugs, cbut cshe ccould ckeep cher cMedigap
cpolicy cand cenroll cin ca cPart cD cprescription cdrug cplan.
,America's Health Insurance Plans 2027/2028 CERTIFICATION.
West cwears cglasses cand cdentures cand chas cenjoyed cconsiderable cpain crelief cfrom carthritis cthrough
cmassage ctherapy. cShe cis cconcerned cabout cwhether cor cnot cMedicare cwill ccover cthese citems cand
cservices. cWhat cshould cyou ctell cher? c- cCORRECT cANS>>Medicare cdoes cnot ccover cmassage ctherapy,
cor, cin cgeneral, cglasses cor cdentures.
Patel cis cin cgood chealth cand cis cpreparing ca cbudget cin canticipation cof chis cretirement cwhen che cturns
c66. cHe cwants cto cunderstand cthe chealth ccare ccosts che cmight cbe cexposed cto cunder cMedicare cif che
cwere cto crequire chospitalization cas ca cresult cof can cillness. cIn cgeneral cterms, cwhat ccould cyou ctell chim
cabout chis ccosts cfor cinpatient chospital cservices
under cOriginal cMedicare? c- cCORRECT cANS>>Under cOriginal cMedicare, cthere cis ca csingle cdeductible
camount cdue cfor cthe cfirst c60 cdays cof cany cinpatient chospital cstay, cafter cwhich cit cconverts cinto ca
cper-day ccoinsurance camount cthrough cday c90. cAfter cday c90, che cwould cpay ca cdaily camount cup cto c60
cdays cover chis clifetime, cafter cwhich che cwould cbe cresponsible cfor call ccosts.
Henderson cbelieves cthat cshe cwill cqualify cfor cMedicare cCoverage cwhen cshe cturns c65, cwithout
cpaying cany cpremiums, cbecause cshe chas cbeen cworking cfor c40 cyears cand cpaying cMedicare ctaxes.
cWhat cshould cyou ctell cher? c- cCORRECT cANS>>To cobtain cPart cB ccoverage, cshe cmust cpay ca cstandard
cmonthly cpremium, cthough cit cis chigher cfor cindividuals cwith chigher cincomes.
Alonso creceives csome chelp cpaying cfor chis ctwo cgeneric cprescription cdrugs cfrom chis cemployer's
cretiree ccoverage, cbut che cwants cto ccompare cit cto ca cPart cD cprescription cdrug cplan. cHe casks cyou
cwhat ccosts che cwould cgenerally cexpect cto cencounter cwhen cenrolling cinto ca cstandard cMedicare
cPart cD cprescription cdrug cplan. cWhat cshould cyou ctell chim? c- cCORRECT cANS>>He cgenerally cwould
cpay ca cmonthly cpremium, cannual cdeductible, cand cper-prescription ccost-sharing.
Moore cplans cto cretire cwhen cshe cturns c65 cin ca cfew cmonths. cShe cis cin cexcellent chealth cand cwill
chave cconsiderable cincome cwhen cshe cretires. cShe cis cconcerned cthat cher cincome cwill cmake cit
cimpossible cfor cher cto cqualify cfor cMedicare. cWhat ccould cyou ctell cher cto caddress cher cconcern? c-
cCORRECT cANS>>Medicare cis ca cprogram cfor cpeople cage c65 cor colder cand cthose cunder cage c65 cwith
ccertain cdisabilities, cend-stage crenal cdisease, cand cLou cGehrig's cdisease cso cshe cwill cbe celigible cfor
cMedicare.
Xi cwill csoon cturn cage c65 cand chas ccome cto cyou cfor cadvice cas cto cwhat cservices care cprovided cunder
cOriginal cMedicare. cWhat cshould cyou ctell cMr. cXi cthat cbest cdescribes cthe chealth ccoverage cprovided
cto cMedicare cbeneficiaries? c - cCORRECT cANS>>Beneficiaries cunder cOriginal cMedicare chave cno ccost-
sharing cfor cmost cpreventive cservices cwhich cinclude cimmunizations csuch cas cannual cflu cshots.
, America's Health Insurance Plans 2027/2028 CERTIFICATION.
Duarte cis cenrolled cin cOriginal cMedicare cParts cA cand cB. cShe chas crecently creviewed cher cMedicare
cSummary cNotice c(MSN) cand cdisagrees cwith ca cdetermination cthat cpartially cdenied cone cof cher cclaims
cfor cservices. cWhat cadvice cwould cyou cgive cher? c- cCORRECT cANS>>Mrs. cDuarte cshould cfile can cappeal
cof cthis cinitial cdetermination cwithin c120 cdays cof cthe cdate cshe creceived cthe cMSN cin cthe cmail.
Capadona cwould clike cto cpurchase ca cMedicare cAdvantage c(MA) cplan cand ca cMedigap cplan cto cpick
cup ccosts cnot ccovered cby cthat cplan.
What cshould cyou ctell chim? c- cCORRECT cANS>>It cis cillegal cfor cyou cto csell cMr. cCapadona ca cMedigap
cplan cif che cis cenrolled cin can cMA cplan, cand cbesides, cMedigap conly cworks cwith cOriginal cMedicare.
Park cis can celderly cretiree. cMrs. cPark chas ca clow cfixed cincome. cWhat ccould cyou ctell cMrs. cPark cthat
cmight cbe cof cassistance? c- cCORRECT cANS>>She cshould ccontact cher cstate cMedicaid cagency cto csee cif
cshe cqualifies cfor cone cof cseveral cprograms cthat ccan chelp cwith cMedicare ccosts cfor cwhich cshe cis
cresponsible.
Rainey cis cexperiencing cparanoid cdelusions cand chis cphysician cfeels cthat che cshould cbe chospitalized.
cWhat cshould cyou ctell cMr. cRainey c(or chis crepresentative) cabout cthe clength cof can cinpatient
cpsychiatric chospital cstay cthat cMedicare cwill ccover? c - cCORRECT cANS>>Medicare cwill ccover ca ctotal
cof c190 cdays cof cinpatient cpsychiatric ccare cduring cMr. cRainey's centire clifetime.
Schmidt cwould clike cto cplan cfor cretirement cand chas casked cyou cwhat cis ccovered cunder cOriginal
cFee-for-Service c(FFS) cMedicare? cWhat ccould cyou ctell chim? c- cCORRECT cANS>>Part cA, cwhich
ccovers chospital, cskilled cnursing cfacility, chospice, cand chome chealth cservices cand cPart cB, cwhich
ccovers cprofessional cservices csuch cas cthose cprovided cby ca cdoctor care ccovered cunder cOriginal
cMedicare.
Agent cJohn cMiller cis cmeeting cwith cJerry cSmith, ca cnew cprospect. cJerry cis ccurrently cenrolled cin
cMedicare cParts cA cand cB. cJerry chas calso cpurchased ca cMedicare cSupplement c(Medigap) cplan cwhich
che chas chad cfor cseveral cyears. cHowever, cthe cplan cdoes cnot cprovide cdrug cbenefits. cHow cwould cyou
cadvise cAgent cJohn cMiller cto cproceed? c- cCORRECT cANS>>Tell cprospect cJerry cSmith cthat che cshould
cconsider cadding ca cstandalone cPart cD cprescription cdrug ccoverage cpolicy cto chis cpresent ccoverage.
Bauer cis c49 cyears cold, cbut ceighteen cmonths cago che cwas cdeclared cdisabled cby cthe cSocial cSecurity
cAdministration cand chas cbeen creceiving cdisability cpayments. cHe cis cwondering cwhether che ccan
cobtain ccoverage cunder cMedicare. cWhat cshould cyou ctell chim? c- cCORRECT cANS>>After creceiving
csuch cdisability cpayments cfor c24 cmonths, che cwill cbe cautomatically cenrolled cin cMedicare,
cregardless cof cage.
