EXAM, PRACTICE EXAM AND STUDY GUIDE LATEST ACTUAL EXAM 135 QUESTIONS WITH CORRECT ANSWERS 100_ VERIFIED
Mrs. Shields is covered by Original Medicare. She Medicare will cover Mrs. Shield's skilled nursing services provided during the first 20
sustained a hip fracture and is being successfully treated days of her stay, after which she would have a copay until she has been in the
for that condition. However, she and her physicians feel facility for 100 days.
that after her lengthy hospital stay, she will need a month
or two of nursing and rehabilitative care. What should you
tell them about Original Medicare's coverage of care in a
skilled nursing facility?
Mrs. West wears glasses and dentures and has enjoyed Medicare does not cover massage therapy, or, in general, glasses or dentures.
considerable pain relief from arthritis through massage
therapy. She is concerned about whether or not Medicare
will cover these items and services. What should you tell
her?
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed She should contact her state Medicaid agency to see if she qualifies for one of
income. What could you tell Mrs. Park that might be of several programs that can help with Medicare costs for which she is responsible.
assistance?
Mr. Alonso receives some help paying for his two generic He generally would pay a monthly premium, annual deductible, and per-prescription
prescription drugs from his employer's retiree coverage, cost-sharing.
but he wants to compare it to a Part D prescription drug
plan. He asks you what costs he would generally expect to
encounter when enrolling into a standard Medicare Part D
prescription drug plan. What should you tell him?
Mrs. Gonzalez is enrolled in Original Medicare and has a Mrs. Gonzalez cannot purchase a Medigap plan that covers drugs, but she could
Medigap policy as well, but it provides no drug coverage. keep her Medigap policy and enroll in a Part D prescription drug plan.
She would like to keep the coverage she has but replace
her existing Medigap plan with one that provides drug
coverage. What should you tell her?
Mr. Davis is 52 years old and has recently been diagnosed He may sign-up for Medicare at any time however coverage usually begins on the
with end-stage renal disease (ESRD) and will soon begin fourth month after dialysis treatments start.
dialysis. He is wondering if he can obtain coverage under
Medicare. What should you tell him?
Mrs. Duarte is enrolled in Original Medicare Parts A and B. Mrs. Duarte should file an appeal of this initial determination within 120 days of the
She has recently reviewed her Medicare Summary Notice date she received the MSN in the mail.
(MSN) and disagrees with a determination that partially
denied one of her claims for services. What advice would
you give her?
Mrs. Geisler's neighbor told her she should look at her Part Part D covers prescription drugs and she should look at her premiums, formulary,
D options during the annual Medicare enrollment period and cost-sharing among other factors to see if they have changed.
because the features of Part D might have changed. Mrs.
Geisler can't remember what Part D is so she called you to
ask what her neighbor was talking about. What could you
tell her?
Mr. Rainey is experiencing paranoid delusions and his Medicare will cover a total of 190 days of inpatient psychiatric care during Mr.
physician feels that he should be hospitalized. What Rainey's entire lifetime.
should you tell Mr. Rainey (or his representative) about the
length of an inpatient psychiatric hospital stay that
Medicare will cover?
Mr. Xi will soon turn age 65 and has come to you for Beneficiaries under Original Medicare have no cost-sharing for most preventive
advice as to what services are provided under Original services.
Medicare. What should you tell Mr. Xi that best describes
the health coverage provided to Medicare beneficiaries?
Mr. Singh would like drug coverage but does not want to Mr. Singh can enroll in a stand-alone prescription drug plan and continue to be
be enrolled in a Medicare Advantage plan. What should covered for Part A and Part B services through Original Fee-for-Service Medicare.
you tell him?
Stuvia 2026-2027
,EXAM, PRACTICE EXAM AND STUDY GUIDE LATEST ACTUAL EXAM 135 QUESTIONS WITH CORRECT ANSWERS 100_ VERIFIED
Mrs. Chen will be 65 soon, has been a citizen for twelve Most individuals who are citizens and age 65 or over are covered under Part A by
years, has been employed full time, and paid taxes during virtue of having paid Medicare taxes while working, though some may be covered
that entire period. She is concerned that she will not as a result of paying monthly premiums.
qualify for coverage under part A because she was not
born in the United States. What should you tell her?
Mrs. Quinn recently turned 66 and decided after many Part B primarily covers physician services. She will be paying a monthly premium
years of work to retire and begin receiving Social Security and, except for many preventive and screening tests, generally will have 20% co-
benefits. Shortly thereafter Mrs. Quinn received a letter payments for these services, in addition to an annual deductible.
informing her that she had been automatically enrolled in
Medicare Part B. She wants to understand what this
means. What should you tell Mrs. Quinn?
Mr. Patel is in good health and is preparing a budget in Under Original Medicare, there is a single deductible amount due for the first 60
anticipation of his retirement when he turns 66. He wants days of any inpatient hospital stay, after which it converts into a per-day
to understand the health care costs he might be exposed coinsurance amount through day 90. After day 90, he would pay a daily amount up
to under Medicare if he were to require hospitalization to 60 days over his lifetime, after which he would be responsible for all costs.
because of an illness. In general terms, what could you tell
him about his costs for inpatient hospital services under
Original Medicare?
What impact, if any, have recent regulatory changes had The Part B deductible is no longer covered for individuals newly eligible for
on Medigap plans? Medicare starting January 1, 2020.
Mrs. Paterson is concerned about the deductibles and co- Medigap plans do not cover Original Medicare benefits, but they coordinate with
payments associated with Original Medicare. What can Original Medicare coverage.
you tell her about Medigap as an option to address this
concern?
Mrs. Turner is comparing her employer's retiree insurance Original Medicare covers ambulance services.
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?
Ms. Brooks has aggressive cancer and would like to know Medicare covers hospice services, and they will be available for her.
if Medicare will cover hospice services in case she needs
them. What should you tell her?
Mr. Diaz continued working with his company and was Mr. Diaz will not pay any penalty because he had continuous coverage under his
insured under his employer's group plan until he reached employer's plan.
age 68. He has heard that there is a premium penalty for
those who did not sign up for Part B when first eligible and
wants to know how much he will have to pay. What should
you tell him?
Anita Magri will turn age 65 in August 2023. Anita intends You are sorry to disappoint Anita, but a Medigap F plan is no longer available to
to enroll in Original Medicare Part A and Part B. She would those who turn age 65 after January 1, 2020. Anita might instead consider other
also like to enroll in a Medicare Supplement (Medigap) Medigap plans that offer foreign travel benefits but do not cover the Part B
plan. Anita's older neighbor Mel has told her about the deductible.
Medigap Plan F in which he is enrolled. It not only provides
foreign travel emergency benefits but also covers his
Medicare Part B deductible. Anita comes to you for advice.
What should you tell her?
Hank's Fish Store, Inc. is a small company with just 15 Hank's can continue to offer William the same employee health benefit plan, or, if
employees located in Florida. Hank, the store owner, has William enrolls in Medicare Part B, it can enroll him in a Medicare Advantage plan
provided excellent health benefits to the store's workforce. that is offered to the public.
William, one of the store's long-time employees, will soon
be reaching age 65 and eligible for Medicare. William is in
good health. He intends to remain an active full-time
employee, working several years after becoming eligible
for Medicare. What type(s) of retiree health benefit will
Hank's Fish Store be able to offer William?
Stuvia 2026-2027
Mrs. Shields is covered by Original Medicare. She Medicare will cover Mrs. Shield's skilled nursing services provided during the first 20
sustained a hip fracture and is being successfully treated days of her stay, after which she would have a copay until she has been in the
for that condition. However, she and her physicians feel facility for 100 days.
that after her lengthy hospital stay, she will need a month
or two of nursing and rehabilitative care. What should you
tell them about Original Medicare's coverage of care in a
skilled nursing facility?
Mrs. West wears glasses and dentures and has enjoyed Medicare does not cover massage therapy, or, in general, glasses or dentures.
considerable pain relief from arthritis through massage
therapy. She is concerned about whether or not Medicare
will cover these items and services. What should you tell
her?
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed She should contact her state Medicaid agency to see if she qualifies for one of
income. What could you tell Mrs. Park that might be of several programs that can help with Medicare costs for which she is responsible.
assistance?
Mr. Alonso receives some help paying for his two generic He generally would pay a monthly premium, annual deductible, and per-prescription
prescription drugs from his employer's retiree coverage, cost-sharing.
but he wants to compare it to a Part D prescription drug
plan. He asks you what costs he would generally expect to
encounter when enrolling into a standard Medicare Part D
prescription drug plan. What should you tell him?
Mrs. Gonzalez is enrolled in Original Medicare and has a Mrs. Gonzalez cannot purchase a Medigap plan that covers drugs, but she could
Medigap policy as well, but it provides no drug coverage. keep her Medigap policy and enroll in a Part D prescription drug plan.
She would like to keep the coverage she has but replace
her existing Medigap plan with one that provides drug
coverage. What should you tell her?
Mr. Davis is 52 years old and has recently been diagnosed He may sign-up for Medicare at any time however coverage usually begins on the
with end-stage renal disease (ESRD) and will soon begin fourth month after dialysis treatments start.
dialysis. He is wondering if he can obtain coverage under
Medicare. What should you tell him?
Mrs. Duarte is enrolled in Original Medicare Parts A and B. Mrs. Duarte should file an appeal of this initial determination within 120 days of the
She has recently reviewed her Medicare Summary Notice date she received the MSN in the mail.
(MSN) and disagrees with a determination that partially
denied one of her claims for services. What advice would
you give her?
Mrs. Geisler's neighbor told her she should look at her Part Part D covers prescription drugs and she should look at her premiums, formulary,
D options during the annual Medicare enrollment period and cost-sharing among other factors to see if they have changed.
because the features of Part D might have changed. Mrs.
Geisler can't remember what Part D is so she called you to
ask what her neighbor was talking about. What could you
tell her?
Mr. Rainey is experiencing paranoid delusions and his Medicare will cover a total of 190 days of inpatient psychiatric care during Mr.
physician feels that he should be hospitalized. What Rainey's entire lifetime.
should you tell Mr. Rainey (or his representative) about the
length of an inpatient psychiatric hospital stay that
Medicare will cover?
Mr. Xi will soon turn age 65 and has come to you for Beneficiaries under Original Medicare have no cost-sharing for most preventive
advice as to what services are provided under Original services.
Medicare. What should you tell Mr. Xi that best describes
the health coverage provided to Medicare beneficiaries?
Mr. Singh would like drug coverage but does not want to Mr. Singh can enroll in a stand-alone prescription drug plan and continue to be
be enrolled in a Medicare Advantage plan. What should covered for Part A and Part B services through Original Fee-for-Service Medicare.
you tell him?
Stuvia 2026-2027
,EXAM, PRACTICE EXAM AND STUDY GUIDE LATEST ACTUAL EXAM 135 QUESTIONS WITH CORRECT ANSWERS 100_ VERIFIED
Mrs. Chen will be 65 soon, has been a citizen for twelve Most individuals who are citizens and age 65 or over are covered under Part A by
years, has been employed full time, and paid taxes during virtue of having paid Medicare taxes while working, though some may be covered
that entire period. She is concerned that she will not as a result of paying monthly premiums.
qualify for coverage under part A because she was not
born in the United States. What should you tell her?
Mrs. Quinn recently turned 66 and decided after many Part B primarily covers physician services. She will be paying a monthly premium
years of work to retire and begin receiving Social Security and, except for many preventive and screening tests, generally will have 20% co-
benefits. Shortly thereafter Mrs. Quinn received a letter payments for these services, in addition to an annual deductible.
informing her that she had been automatically enrolled in
Medicare Part B. She wants to understand what this
means. What should you tell Mrs. Quinn?
Mr. Patel is in good health and is preparing a budget in Under Original Medicare, there is a single deductible amount due for the first 60
anticipation of his retirement when he turns 66. He wants days of any inpatient hospital stay, after which it converts into a per-day
to understand the health care costs he might be exposed coinsurance amount through day 90. After day 90, he would pay a daily amount up
to under Medicare if he were to require hospitalization to 60 days over his lifetime, after which he would be responsible for all costs.
because of an illness. In general terms, what could you tell
him about his costs for inpatient hospital services under
Original Medicare?
What impact, if any, have recent regulatory changes had The Part B deductible is no longer covered for individuals newly eligible for
on Medigap plans? Medicare starting January 1, 2020.
Mrs. Paterson is concerned about the deductibles and co- Medigap plans do not cover Original Medicare benefits, but they coordinate with
payments associated with Original Medicare. What can Original Medicare coverage.
you tell her about Medigap as an option to address this
concern?
Mrs. Turner is comparing her employer's retiree insurance Original Medicare covers ambulance services.
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?
Ms. Brooks has aggressive cancer and would like to know Medicare covers hospice services, and they will be available for her.
if Medicare will cover hospice services in case she needs
them. What should you tell her?
Mr. Diaz continued working with his company and was Mr. Diaz will not pay any penalty because he had continuous coverage under his
insured under his employer's group plan until he reached employer's plan.
age 68. He has heard that there is a premium penalty for
those who did not sign up for Part B when first eligible and
wants to know how much he will have to pay. What should
you tell him?
Anita Magri will turn age 65 in August 2023. Anita intends You are sorry to disappoint Anita, but a Medigap F plan is no longer available to
to enroll in Original Medicare Part A and Part B. She would those who turn age 65 after January 1, 2020. Anita might instead consider other
also like to enroll in a Medicare Supplement (Medigap) Medigap plans that offer foreign travel benefits but do not cover the Part B
plan. Anita's older neighbor Mel has told her about the deductible.
Medigap Plan F in which he is enrolled. It not only provides
foreign travel emergency benefits but also covers his
Medicare Part B deductible. Anita comes to you for advice.
What should you tell her?
Hank's Fish Store, Inc. is a small company with just 15 Hank's can continue to offer William the same employee health benefit plan, or, if
employees located in Florida. Hank, the store owner, has William enrolls in Medicare Part B, it can enroll him in a Medicare Advantage plan
provided excellent health benefits to the store's workforce. that is offered to the public.
William, one of the store's long-time employees, will soon
be reaching age 65 and eligible for Medicare. William is in
good health. He intends to remain an active full-time
employee, working several years after becoming eligible
for Medicare. What type(s) of retiree health benefit will
Hank's Fish Store be able to offer William?
Stuvia 2026-2027
