Ahip 2027 Actual Exam Complete Questions & Correct Detailed Answers

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1. Mrs. Andrews is comparing her employer's retiree insurance to Origin
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al Medicare and would like to know which of the following services Origin
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al Medicare will cover if the appropriate criteria are met. What could you
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tell her?: Original Medicare covers ambulance services.
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2. What impact, if any, have recent regulatory changes had on Medigap plans rl rl rl rl rl rl rl rl rl rl rl




?-
: The Part B deductible is no longer covered for individuals newly eligible for Medicare starting January 1, 2020.
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3. Joan and Loretta are both enrolled in Medicare. Joan pays a premium for P
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art A coverage. Loretta does not. Which of the following statements best explains
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this difference?: Joan worked only a short time and did not accumulate suflcient work credits. Loretta wor
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ked for well over 10 years accumulating credit for more than 40 quarters of contributions to the Medicare p
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rogram.
4. Larry Miller is an Original Medicare beneficiary with Parts A and B coverag rl rl rl rl rl rl rl rl rl rl rl rl



e. Larry is admitted to Good Care Hospital in January with pneumonia and st
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ays for three days before being discharged. Six months later in July, Larry ta
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kes a bad fall and is admitted to Good Care Hospital with a broken leg. After
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emergency surgery to repair his broken leg, Larry is hospitalized for a week rl rl rl rl rl rl rl rl rl rl rl rl



before being discharged home. In December, Larry is admitted to Mount W
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ellness Hospital once again with a serious case of the flu. For how many Part
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A deductibles will Larry be responsible for?: Larry will be responsible for three Part A ded
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uctibles.
5. Kevin Birch enrolled in Original Medicare (Parts A and B). Mr. Birch has been rl rl rl rl rl rl rl rl rl rl rl rl rl



receiving rehabilitation services in a skilled nursing facility. He calls you to say
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that he has just received a notice that Medicare will no longer cover his stay an
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d he still cannot walk properly. He thinks they are ending his services too soon.
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What do you tell him?: He should follow the directions on the notice to file a fast appeal. Mr. Birch sh
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ould file it by noon of the calendar day following receipt of the provider's notice of termination of services.
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6. Mr. Ray would like drug coverage but does not want to be enrolled in a
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Medicare Advantage plan. What should you tell him?: Mr. Ray can enroll in a stand-
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alone prescription drug plan and continue to be covered for Part A and Part B services through Original Fe
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e-for-Service Medicare. rl



7. Mrs. Sanders will be 65 soon, has been a citizen for twelve years, has bee
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n employed full-
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time, and paid taxes during that entire period. She is concerned that she will n
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ot qualify for coverage under Part A because she was not born
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in the United States. What should you tell her?: Most individuals who are citizens and age
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65 or over are covered under Part A by virtue of having paid Medicare taxes while working, though some may be
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covered as a result of paying monthly premiums. rl rl rl rl rl rl rl



8. Mrs. Carpenter is enrolled in Original Medicare Parts A and B. She has recen rl rl rl rl rl rl rl rl rl rl rl rl rl



tly reviewed her Medicare Summary Notice (MSN) and disagrees with a deter
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mination that partially denied one of her claims for services. What advice would rl rl rl rl rl rl rl rl rl rl rl rl rl



you give her?: Mrs. Carpenter should file an appeal of this initial determination within 120 days of th
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e date she received the MSN in the mail.
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9. Mr. Hoffman receives some help paying for his two generic prescriptio
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n drugs from his employer's retiree coverage, but he wants to compare it
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to a Part D prescription drug plan. He asks you what costs he would general
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ly
expect to encounter when enrolling into a standard Medicare Part D prescrip- rl rl rl rl rl rl rl rl rl rl rl



tion drug plan. What should you tell him?: He generally would pay a monthly premium, ann
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ual
deductible, and per-prescription cost-sharing. rl rl rl



10. Mrs. Larson is enrolled in Original Medicare and has a Medigap policy rl rl rl rl rl rl rl rl rl rl rl



as well, but it provides no drug coverage. She would like to keep the coverag
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e she has but replace her existing Medigap plan with one that provides drug
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coverage. What should you tell her?: Mrs. Larson cannot purchase a Medigap plan that co rl rl rl rl rl rl rl rl rl rl rl rl rl rl



vers drugs, but she could keep her Medigap policy and enroll in a Part D prescription drug plan.
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11. Mary Alice is covered by Original Medicare Parts A and B. During her ini rl rl rl rl rl rl rl rl rl rl rl rl rl



tial enrollment period she purchased a standard Medigap Plan A policy from y
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ou because of its relatively low cost. After speaking to her friend Stan, she ask
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s whether any of the following are "core benefits" covered in her plan?: I. Covera
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ge for Part A hospital coinsurance amount
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II. Coverage for 365 additional days during an insured's lifetime after Medicare benefits end
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III. Coverage for 3 pints of blood
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12. Mr. Ellis continued working with his company and was insured unde rl rl rl rl rl rl rl rl rl rl


r his employer's group plan until he reached age 68 when he retired. Five m
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onths later Mr. Ellis enrolled in Part B. He has heard that there is a premium p
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enalty for those who did not sign up for Part B when first eligible and wants to
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know how much he will have to pay. What should you tell him?: Mr. Ellis will not pay any
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penalty




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because he had continuous coverage under his employer's plan and he enrolled in Part B within the 8-
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month period immediately following the last month he had group coverage.
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13. Mrs. Georgia is concerned about the deductibles and co- rl rl rl rl rl rl rl rl


payments associ- rl



ated with Original Medicare. What can you tell her about Medigap as an option t
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o address this concern?: Medigap plans do not cover Original Medicare benefits, but they coordina
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te
with Original Medicare coverage. rl rl rl



14. Mr. Turner will soon turn age 65 and has come to you for advice as t rl rl rl rl rl rl rl rl rl rl rl rl rl rl rl


o what services are provided under Original Medicare. What should you tell
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Mr. Turner that best describes the health coverage provided to Medicare b
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eneficiaries?: Beneficiaries under Original Medicare have no cost- r l rl rl rl rl rl rl



sharing for most preventive services. rl rl rl rl



15. Mr. Harvey would like to purchase a Medicare Advantage (MA) plan an rl rl rl rl rl rl rl rl rl rl rl


d a Medigap plan to pick up costs not covered by that plan. What should you te
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ll him?: It is illegal for you to sell Mr. Harvey a Medigap plan if he is enrolled in an MA plan, and besides, Me
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digap
only works with Original Medicare.
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16. Annie Mills will turn age 65 in August 2026. Annie intends to enroll in O rl rl rl rl rl rl rl rl rl rl rl rl rl rl




riginal Medicare Part A and Part B. She would also like to enroll in a Medicare Su
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pplement (Medigap) plan. Annie's older neighbor John, has told her about the rl rl rl rl rl rl rl rl rl rl rl rl




Medigap Plan F in which he is enrolled. It not only provides foreign travel emer rl rl rl rl rl rl rl rl rl rl rl rl rl rl




gency benefits but also covers his Medicare Part B deductible. Annie comes to y
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ou for advice. What should you tell her?: You are sorry to disappoint Annie, but a Medigap
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F plan is no longer available to those who turn 65 after January 1, 2020. Annie might instead consider othe
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r Medigap plans that otter foreign travel benefits but do not cover the Part B deductible.
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17. Mr. Bell is 52 years old and has recently been diagnosed with end- rl rl rl rl rl rl rl rl rl rl rl rl



stage renal disease (ESRD) and will soon begin dialysis. He is wondering if h
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e can obtain coverage under Medicare. What should you tell him?: He may si
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gn up for Medicare at any time; however, coverage usually begins on the fourth month after dialysis tr
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eatments start. rl



18. Jason is experiencing paranoid delusions and his physician feels that rl rl rl rl rl rl rl rl rl


he should be hospitalized. What should you tell Jason (or his representative)
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about the length of an inpatient psychiatric hospital stay that Medicare will c
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over?: Medicare will cover a total of 190 days of inpatient psychiatric care during Jason's entire lifetime.
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19. Lucas Fields, who is turning age 65 next month, intends to work for rl rl rl rl rl rl rl rl rl rl rl rl rl



sev-
eral more years at Smallcap, Incorporated. Smallcap has a workforce of 1
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