AHIP
Final Exam
AHIP 2027 Final Exam set 1,2,&3
Medicare Certification – Actual
Questions & Answers (AHIP)
Guarantee Pass
150 + VERIFIED QUIZ AND CORRECT ANSWERS AND
RATIONALES
Question 1
Mrs. Andrews 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?
A. Routine dental cleanings
B. Long-term custodial care
C. Medically necessary ambulance services
D. Routine physical examinations
Correct Answer: C. Medically necessary ambulance services
Rationale: Medicare Part B covers medically necessary ambulance transportation when other
transportation could endanger the patient's health. Coverage generally applies to
transportation to or from certain medical facilities and must meet Medicare's requirements.
Routine dental
care, long-term care, and routine physical examinations are generally not covered by Original
Medicare. (Medicare)
Question 2
,What impact, if any, have recent regulatory changes had on Medigap plans?
A. All Medigap plans must now cover the Part B deductible.
B. The Part B deductible can no longer be covered by Medigap plans for people newly
eligible for Medicare beginning January 1, 2020.
C. Medigap plans are no longer allowed to cover Part A coinsurance.
D. Medigap plans were eliminated for people turning 65 after 2020.
Correct Answer: B. The Part B deductible can no longer be covered by Medigap plans for
people newly eligible for Medicare beginning January 1, 2020.
Rationale: Plans such as Medigap Plan F and Plan C cover the Part B deductible, but they
generally aren't available to people who first became eligible for Medicare on or after January
1, 2020. Existing eligible beneficiaries may still have access to these plans depending on their
circumstances. (Medicare)
Question 3
Joan and Loretta are both enrolled in Medicare. Joan pays a premium for Part A coverage.
Loretta does not. Which statement best explains this difference?
A. Joan is under age 65 while Loretta is over age 65.
B. Joan worked only a short time and did not accumulate sufficient work credits, while
Loretta accumulated enough credits through Medicare-covered employment.
C. Joan lives in a different state from Loretta.
D. Loretta automatically receives free Part A because she has Part B.
Correct Answer: B. Joan worked only a short time and did not accumulate sufficient work
credits, while Loretta accumulated enough credits through Medicare-covered employment.
Rationale: Most people don't pay a monthly premium for Part A because they or their spouse
paid Medicare taxes while working for a sufficient period. People who don't qualify for
premium-free Part A may be able to purchase Part A by paying a monthly premium. (Medicare)
Question 4
Larry Miller has Original Medicare Parts A and B. He is hospitalized for pneumonia in January for
three days. Six months later, he is hospitalized again for a broken leg. In December, he is
admitted to a different hospital with the flu. Assuming each hospitalization begins a separate
benefit period, for how many Part A deductibles will Larry be responsible?
,A. One
B. Two
C. Three
D. Four
Correct Answer: C. Three
Rationale: The Part A inpatient hospital deductible applies for each benefit period. There is no
annual limit on the number of Part A benefit periods, so a beneficiary can pay the deductible
more than once in a year if separate benefit periods occur. (Medicare)
Question 5
Kevin Birch is enrolled in Original Medicare and has been receiving rehabilitation services in a
skilled nursing facility. He receives a notice that Medicare coverage will end, but he believes he
still needs the services. What should he do?
A. Wait until Medicare sends another notice.
B. Immediately enroll in Medicare Advantage.
C. Follow the instructions on the notice to request a fast appeal.
D. File a standard appeal after his services have ended.
Correct Answer: C. Follow the instructions on the notice to request a fast appeal.
Rationale: When Medicare-covered services are being terminated and the beneficiary believes
coverage is ending too soon, the beneficiary may have the right to request a fast appeal. The
notice provides instructions and deadlines that must be followed. The exact deadline depends
on the type of termination notice received. (Medicare)
Question 6
Mr. Ray wants prescription drug coverage but does not want to enroll in a Medicare Advantage
plan. What should you tell him?
A. He must enroll in Medicare Advantage to obtain Part D.
B. He can enroll in a stand-alone Medicare Part D prescription drug plan while remaining
in Original Medicare.
C. He can obtain prescription coverage through Medigap.
D. Original Medicare automatically includes outpatient prescription drug coverage.
, Correct Answer: B. He can enroll in a stand-alone Medicare Part D prescription drug plan
while remaining in Original Medicare.
Rationale: A person with Original Medicare can enroll in a separate Medicare prescription drug
plan for Part D coverage. Medigap policies sold after 2005 generally don't include prescription
drug coverage. (Medicare)
Question 7
Mrs. Sanders will soon turn 65. She has been a U.S. citizen for twelve years, has worked full-
time, and has paid Medicare taxes. She is concerned that she will not qualify for Part A
because she was not born in the United States. What should you tell her?
A. She must have been born in the United States to qualify for Part A.
B. Citizenship alone automatically provides premium-free Part A regardless of work history.
C. Many people qualify for premium-free Part A through their Medicare-covered work
history; others may qualify by paying a Part A premium.
D. Only people born in the United States can receive Medicare.
Correct Answer: C. Many people qualify for premium-free Part A through their
Medicare-covered work history; others may qualify by paying a Part A premium.
Rationale: Birth in the United States is not the requirement for premium-free Part A. Eligibility
can be based on Medicare-covered work credits or other qualifying circumstances. People
who don't qualify for premium-free Part A may be able to purchase Part A. (Medicare)
Question 8
Mrs. Carpenter is enrolled in Original Medicare Parts A and B. She reviews her Medicare
Summary Notice (MSN) and disagrees with a determination that partially denied one of her
claims. What should she do?
A. Ignore the MSN unless Medicare sends another notice.
B. File an appeal using the instructions and deadline stated on the MSN.
C. Contact a Medigap insurer instead of Medicare.
D. Wait until the next annual enrollment period.
Correct Answer: B. File an appeal using the instructions and deadline stated on the MSN.
Final Exam
AHIP 2027 Final Exam set 1,2,&3
Medicare Certification – Actual
Questions & Answers (AHIP)
Guarantee Pass
150 + VERIFIED QUIZ AND CORRECT ANSWERS AND
RATIONALES
Question 1
Mrs. Andrews 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?
A. Routine dental cleanings
B. Long-term custodial care
C. Medically necessary ambulance services
D. Routine physical examinations
Correct Answer: C. Medically necessary ambulance services
Rationale: Medicare Part B covers medically necessary ambulance transportation when other
transportation could endanger the patient's health. Coverage generally applies to
transportation to or from certain medical facilities and must meet Medicare's requirements.
Routine dental
care, long-term care, and routine physical examinations are generally not covered by Original
Medicare. (Medicare)
Question 2
,What impact, if any, have recent regulatory changes had on Medigap plans?
A. All Medigap plans must now cover the Part B deductible.
B. The Part B deductible can no longer be covered by Medigap plans for people newly
eligible for Medicare beginning January 1, 2020.
C. Medigap plans are no longer allowed to cover Part A coinsurance.
D. Medigap plans were eliminated for people turning 65 after 2020.
Correct Answer: B. The Part B deductible can no longer be covered by Medigap plans for
people newly eligible for Medicare beginning January 1, 2020.
Rationale: Plans such as Medigap Plan F and Plan C cover the Part B deductible, but they
generally aren't available to people who first became eligible for Medicare on or after January
1, 2020. Existing eligible beneficiaries may still have access to these plans depending on their
circumstances. (Medicare)
Question 3
Joan and Loretta are both enrolled in Medicare. Joan pays a premium for Part A coverage.
Loretta does not. Which statement best explains this difference?
A. Joan is under age 65 while Loretta is over age 65.
B. Joan worked only a short time and did not accumulate sufficient work credits, while
Loretta accumulated enough credits through Medicare-covered employment.
C. Joan lives in a different state from Loretta.
D. Loretta automatically receives free Part A because she has Part B.
Correct Answer: B. Joan worked only a short time and did not accumulate sufficient work
credits, while Loretta accumulated enough credits through Medicare-covered employment.
Rationale: Most people don't pay a monthly premium for Part A because they or their spouse
paid Medicare taxes while working for a sufficient period. People who don't qualify for
premium-free Part A may be able to purchase Part A by paying a monthly premium. (Medicare)
Question 4
Larry Miller has Original Medicare Parts A and B. He is hospitalized for pneumonia in January for
three days. Six months later, he is hospitalized again for a broken leg. In December, he is
admitted to a different hospital with the flu. Assuming each hospitalization begins a separate
benefit period, for how many Part A deductibles will Larry be responsible?
,A. One
B. Two
C. Three
D. Four
Correct Answer: C. Three
Rationale: The Part A inpatient hospital deductible applies for each benefit period. There is no
annual limit on the number of Part A benefit periods, so a beneficiary can pay the deductible
more than once in a year if separate benefit periods occur. (Medicare)
Question 5
Kevin Birch is enrolled in Original Medicare and has been receiving rehabilitation services in a
skilled nursing facility. He receives a notice that Medicare coverage will end, but he believes he
still needs the services. What should he do?
A. Wait until Medicare sends another notice.
B. Immediately enroll in Medicare Advantage.
C. Follow the instructions on the notice to request a fast appeal.
D. File a standard appeal after his services have ended.
Correct Answer: C. Follow the instructions on the notice to request a fast appeal.
Rationale: When Medicare-covered services are being terminated and the beneficiary believes
coverage is ending too soon, the beneficiary may have the right to request a fast appeal. The
notice provides instructions and deadlines that must be followed. The exact deadline depends
on the type of termination notice received. (Medicare)
Question 6
Mr. Ray wants prescription drug coverage but does not want to enroll in a Medicare Advantage
plan. What should you tell him?
A. He must enroll in Medicare Advantage to obtain Part D.
B. He can enroll in a stand-alone Medicare Part D prescription drug plan while remaining
in Original Medicare.
C. He can obtain prescription coverage through Medigap.
D. Original Medicare automatically includes outpatient prescription drug coverage.
, Correct Answer: B. He can enroll in a stand-alone Medicare Part D prescription drug plan
while remaining in Original Medicare.
Rationale: A person with Original Medicare can enroll in a separate Medicare prescription drug
plan for Part D coverage. Medigap policies sold after 2005 generally don't include prescription
drug coverage. (Medicare)
Question 7
Mrs. Sanders will soon turn 65. She has been a U.S. citizen for twelve years, has worked full-
time, and has paid Medicare taxes. She is concerned that she will not qualify for Part A
because she was not born in the United States. What should you tell her?
A. She must have been born in the United States to qualify for Part A.
B. Citizenship alone automatically provides premium-free Part A regardless of work history.
C. Many people qualify for premium-free Part A through their Medicare-covered work
history; others may qualify by paying a Part A premium.
D. Only people born in the United States can receive Medicare.
Correct Answer: C. Many people qualify for premium-free Part A through their
Medicare-covered work history; others may qualify by paying a Part A premium.
Rationale: Birth in the United States is not the requirement for premium-free Part A. Eligibility
can be based on Medicare-covered work credits or other qualifying circumstances. People
who don't qualify for premium-free Part A may be able to purchase Part A. (Medicare)
Question 8
Mrs. Carpenter is enrolled in Original Medicare Parts A and B. She reviews her Medicare
Summary Notice (MSN) and disagrees with a determination that partially denied one of her
claims. What should she do?
A. Ignore the MSN unless Medicare sends another notice.
B. File an appeal using the instructions and deadline stated on the MSN.
C. Contact a Medigap insurer instead of Medicare.
D. Wait until the next annual enrollment period.
Correct Answer: B. File an appeal using the instructions and deadline stated on the MSN.
