AHIP 2027
Final Exam
AHIP 2027 Final Exam set 2 –
Medicare Certification – Actual
Questions & Answers (AHIP)
Guarantee Pass
50 VERIFIED QUIZ AND CORRECT ANSWERS AND RATIONALES
1. Larry Miller is an Original Medicare beneficiary with Parts A and B coverage. Larry is
admitted to Good Care Hospital in January with pneumonia and stays for three days before
being discharged. Six months later in July, Larry takes a bad fall and is admitted to Good Care
Hospital with a broken leg. After emergency surgery to repair his broken leg, Larry is
hospitalized for a week before being discharged home. In December, Larry is admitted to
Mount Wellness Hospital once again with a serious case of the flu. For how many Part A
deductibles will Larry be responsible for?
A. One Part A deductible
B. Two Part A deductibles
C. Three Part A deductibles
D. Larry will not have to pay any Part A deductibles
Correct Answer: C. Three Part A deductibles
Expert Rationale:
The Medicare Part A inpatient hospital deductible applies to each benefit period, rather than
once per calendar year. A benefit period begins when the beneficiary is admitted as an inpatient
and ends after the beneficiary has been out of inpatient hospital or skilled nursing care for 60
consecutive days. Larry's January, July, and December hospitalizations are separated sufficiently
to create three separate benefit periods. Therefore, he is responsible for three Part A
deductibles.
,2. Kevin Birch is enrolled in Original Medicare (Parts A and B) and has been receiving
rehabilitation services in a skilled nursing facility. He receives a notice that Medicare will no
longer cover his stay, but he believes he still needs rehabilitation. What should you tell him?
A. He should accept the decision and prepare for discharge immediately.
B. He should follow the directions on the notice to request a fast appeal of the termination of
services.
C. He should ask his physician to write a new order automatically extending Medicare coverage.
D. He should wait until after discharge and then file a standard appeal.
Correct Answer: B. He should follow the directions on the notice to request a fast appeal of
the termination of services.
Expert Rationale:
When Medicare-covered services in a skilled nursing facility are being terminated, the
beneficiary receives a notice explaining the termination and appeal rights. If the beneficiary
believes services are ending too soon, he or she can request an expedited appeal according to
the instructions and deadline on the notice. A fast appeal allows an independent review of
whether Medicare coverage should continue. The beneficiary should follow the specific
instructions and deadlines contained in the notice.
3. Mrs. Andrews is comparing her employer's retiree insurance with Original Medicare. Which
of the following services may Original Medicare cover when the appropriate Medicare criteria
are met?
A. Routine cosmetic surgery
B. Ambulance services
C. Routine long-term custodial care
D. Experimental services that Medicare does not cover
Correct Answer: B. Ambulance services
Expert Rationale:
Original Medicare Part B can cover certain ambulance services when Medicare's coverage
requirements are met. Generally, the transportation must be medically necessary and other
applicable conditions must be satisfied. Medicare does not automatically cover every
transportation service or every type of medical care. Coverage therefore depends on the
specific circumstances and Medicare's requirements.
, 4. What impact did the regulatory changes beginning January 1, 2020 have on Medigap plans?
A. All Medigap plans were eliminated.
B. Newly eligible Medicare beneficiaries can purchase Plan F with Part B deductible coverage.
C. Medigap plans can no longer cover the Part B deductible for people newly eligible for
Medicare beginning January 1, 2020.
D. Medigap policies can no longer cover hospital coinsurance.
Correct Answer: C. Medigap plans can no longer cover the Part B deductible for people newly
eligible for Medicare beginning January 1, 2020.
Expert Rationale:
Federal law prohibits Medigap policies sold to people who became eligible for Medicare on or
after January 1, 2020 from covering the Part B deductible. Plans such as Plan F that cover the
Part B deductible are therefore not available to newly eligible beneficiaries. People who were
eligible for Medicare before 2020 may have different options depending on their circumstances.
The change was intended to prevent first-dollar coverage of the Part B deductible for newly
eligible beneficiaries.
5. Joan and Loretta are both enrolled in Medicare. Joan pays a premium for Part A coverage,
while Loretta does not. Which statement best explains this difference?
A. Joan is younger than Loretta.
B. Joan did not accumulate enough qualifying work credits to receive premium-free Part A,
while Loretta accumulated sufficient work credits.
C. Loretta has Medicare Part B and therefore does not need Part A.
D. Everyone must pay a Part A premium during the first year of Medicare.
Correct Answer: B. Joan did not accumulate enough qualifying work credits to receive
premium-free Part A, while Loretta accumulated sufficient work credits.
Expert Rationale:
Most people receive Medicare Part A without a monthly premium because they or a qualifying
spouse paid Medicare taxes for the required number of work quarters. Generally, 40 quarters of
qualifying work are needed for premium-free Part A. Individuals who do not have enough
qualifying work credits may still be able to obtain Part A by paying a monthly premium. Thus,
Joan and Loretta can have different Part A premium obligations based on their work histories.
Final Exam
AHIP 2027 Final Exam set 2 –
Medicare Certification – Actual
Questions & Answers (AHIP)
Guarantee Pass
50 VERIFIED QUIZ AND CORRECT ANSWERS AND RATIONALES
1. Larry Miller is an Original Medicare beneficiary with Parts A and B coverage. Larry is
admitted to Good Care Hospital in January with pneumonia and stays for three days before
being discharged. Six months later in July, Larry takes a bad fall and is admitted to Good Care
Hospital with a broken leg. After emergency surgery to repair his broken leg, Larry is
hospitalized for a week before being discharged home. In December, Larry is admitted to
Mount Wellness Hospital once again with a serious case of the flu. For how many Part A
deductibles will Larry be responsible for?
A. One Part A deductible
B. Two Part A deductibles
C. Three Part A deductibles
D. Larry will not have to pay any Part A deductibles
Correct Answer: C. Three Part A deductibles
Expert Rationale:
The Medicare Part A inpatient hospital deductible applies to each benefit period, rather than
once per calendar year. A benefit period begins when the beneficiary is admitted as an inpatient
and ends after the beneficiary has been out of inpatient hospital or skilled nursing care for 60
consecutive days. Larry's January, July, and December hospitalizations are separated sufficiently
to create three separate benefit periods. Therefore, he is responsible for three Part A
deductibles.
,2. Kevin Birch is enrolled in Original Medicare (Parts A and B) and has been receiving
rehabilitation services in a skilled nursing facility. He receives a notice that Medicare will no
longer cover his stay, but he believes he still needs rehabilitation. What should you tell him?
A. He should accept the decision and prepare for discharge immediately.
B. He should follow the directions on the notice to request a fast appeal of the termination of
services.
C. He should ask his physician to write a new order automatically extending Medicare coverage.
D. He should wait until after discharge and then file a standard appeal.
Correct Answer: B. He should follow the directions on the notice to request a fast appeal of
the termination of services.
Expert Rationale:
When Medicare-covered services in a skilled nursing facility are being terminated, the
beneficiary receives a notice explaining the termination and appeal rights. If the beneficiary
believes services are ending too soon, he or she can request an expedited appeal according to
the instructions and deadline on the notice. A fast appeal allows an independent review of
whether Medicare coverage should continue. The beneficiary should follow the specific
instructions and deadlines contained in the notice.
3. Mrs. Andrews is comparing her employer's retiree insurance with Original Medicare. Which
of the following services may Original Medicare cover when the appropriate Medicare criteria
are met?
A. Routine cosmetic surgery
B. Ambulance services
C. Routine long-term custodial care
D. Experimental services that Medicare does not cover
Correct Answer: B. Ambulance services
Expert Rationale:
Original Medicare Part B can cover certain ambulance services when Medicare's coverage
requirements are met. Generally, the transportation must be medically necessary and other
applicable conditions must be satisfied. Medicare does not automatically cover every
transportation service or every type of medical care. Coverage therefore depends on the
specific circumstances and Medicare's requirements.
, 4. What impact did the regulatory changes beginning January 1, 2020 have on Medigap plans?
A. All Medigap plans were eliminated.
B. Newly eligible Medicare beneficiaries can purchase Plan F with Part B deductible coverage.
C. Medigap plans can no longer cover the Part B deductible for people newly eligible for
Medicare beginning January 1, 2020.
D. Medigap policies can no longer cover hospital coinsurance.
Correct Answer: C. Medigap plans can no longer cover the Part B deductible for people newly
eligible for Medicare beginning January 1, 2020.
Expert Rationale:
Federal law prohibits Medigap policies sold to people who became eligible for Medicare on or
after January 1, 2020 from covering the Part B deductible. Plans such as Plan F that cover the
Part B deductible are therefore not available to newly eligible beneficiaries. People who were
eligible for Medicare before 2020 may have different options depending on their circumstances.
The change was intended to prevent first-dollar coverage of the Part B deductible for newly
eligible beneficiaries.
5. Joan and Loretta are both enrolled in Medicare. Joan pays a premium for Part A coverage,
while Loretta does not. Which statement best explains this difference?
A. Joan is younger than Loretta.
B. Joan did not accumulate enough qualifying work credits to receive premium-free Part A,
while Loretta accumulated sufficient work credits.
C. Loretta has Medicare Part B and therefore does not need Part A.
D. Everyone must pay a Part A premium during the first year of Medicare.
Correct Answer: B. Joan did not accumulate enough qualifying work credits to receive
premium-free Part A, while Loretta accumulated sufficient work credits.
Expert Rationale:
Most people receive Medicare Part A without a monthly premium because they or a qualifying
spouse paid Medicare taxes for the required number of work quarters. Generally, 40 quarters of
qualifying work are needed for premium-free Part A. Individuals who do not have enough
qualifying work credits may still be able to obtain Part A by paying a monthly premium. Thus,
Joan and Loretta can have different Part A premium obligations based on their work histories.
