AHIP ACTUAL FINAL EXAM | COMPLETE QUESTIONS WITH EXPERT SOLUTIONS |
2026 LATEST UPDATED |GET A+
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?: Original Medicare covers ambulance services.
2. What impact, if any, have recent regulatory changes had on Medigap
plans?-
: The Part B deductible is no longer covered for individuals newly eligible for
Medicare starting January 1, 2020.
3. Joan and Loretta are both enrolled in Medicare. Joan pays a premium for
Part A coverage. Loretta does not. Which of the following statements best
explains
this difference?: Joan worked only a short time and did not accumulate
sufficient work credits. Loretta worked for well over 10 years accumulating
credit for more than 40 quarters of contributions to the Medicare program.
,4. 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?: Larry will be responsible for
three Part A deductibles.
5. Kevin Birch enrolled in Original Medicare (Parts A and B). Mr. Birch has
been receiving rehabilitation services in a skilled nursing facility. He calls
you to say that he has just received a notice that Medicare will no longer
cover his stay and he still cannot walk properly. He thinks they are ending
his services too soon. What do you tell him?: He should follow the directions
on the notice to file a fast appeal. Mr.
,Birch should file it by noon of the calendar day following receipt of the
provider's notice of termination of services.
6. Mr. Ray would like drug coverage but does not want to be enrolled in a
Medicare Advantage plan. What should you tell him?: Mr. Ray can enroll in a
stand-alone
prescription drug plan and continue to be covered for Part A and Part B
services through Original Fee-for-Service Medicare.
7. Mrs. Sanders will be 65 soon, has been a citizen for twelve years, has been
employed full-time, and paid taxes during that entire period. She is
concerned that she will not qualify for coverage under Part A because she
was not born in the United States. What should you tell her?: Most
individuals who are citizens and age 65 or over are covered under Part A by
virtue of having paid Medicare taxes while working, though some may be
covered as a result of paying monthly premiums.
8. Mrs. Carpenter is enrolled in Original Medicare Parts A and B. She has
recently reviewed her Medicare Summary Notice (MSN) and disagrees with
, a determination that partially denied one of her claims for services. What
advice
would you give her?: Mrs. Carpenter should file an appeal of this initial
determination within 120 days of the date she received the MSN in the mail.
9. Mr. Hoffman receives some help paying for his two generic prescription
drugs from his employer's retiree coverage, 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?: He generally would pay
a monthly premium, annual deductible, and per-prescription cost-sharing.
10. Mrs. Larson is enrolled in Original Medicare and has a Medigap policy as
well, but it provides no drug coverage. 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?: Mrs. Larson cannot purchase a
Medigap plan that covers drugs, but she could keep her Medigap policy and
enroll in a Part D prescription drug plan.
2026 LATEST UPDATED |GET A+
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?: Original Medicare covers ambulance services.
2. What impact, if any, have recent regulatory changes had on Medigap
plans?-
: The Part B deductible is no longer covered for individuals newly eligible for
Medicare starting January 1, 2020.
3. Joan and Loretta are both enrolled in Medicare. Joan pays a premium for
Part A coverage. Loretta does not. Which of the following statements best
explains
this difference?: Joan worked only a short time and did not accumulate
sufficient work credits. Loretta worked for well over 10 years accumulating
credit for more than 40 quarters of contributions to the Medicare program.
,4. 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?: Larry will be responsible for
three Part A deductibles.
5. Kevin Birch enrolled in Original Medicare (Parts A and B). Mr. Birch has
been receiving rehabilitation services in a skilled nursing facility. He calls
you to say that he has just received a notice that Medicare will no longer
cover his stay and he still cannot walk properly. He thinks they are ending
his services too soon. What do you tell him?: He should follow the directions
on the notice to file a fast appeal. Mr.
,Birch should file it by noon of the calendar day following receipt of the
provider's notice of termination of services.
6. Mr. Ray would like drug coverage but does not want to be enrolled in a
Medicare Advantage plan. What should you tell him?: Mr. Ray can enroll in a
stand-alone
prescription drug plan and continue to be covered for Part A and Part B
services through Original Fee-for-Service Medicare.
7. Mrs. Sanders will be 65 soon, has been a citizen for twelve years, has been
employed full-time, and paid taxes during that entire period. She is
concerned that she will not qualify for coverage under Part A because she
was not born in the United States. What should you tell her?: Most
individuals who are citizens and age 65 or over are covered under Part A by
virtue of having paid Medicare taxes while working, though some may be
covered as a result of paying monthly premiums.
8. Mrs. Carpenter is enrolled in Original Medicare Parts A and B. She has
recently reviewed her Medicare Summary Notice (MSN) and disagrees with
, a determination that partially denied one of her claims for services. What
advice
would you give her?: Mrs. Carpenter should file an appeal of this initial
determination within 120 days of the date she received the MSN in the mail.
9. Mr. Hoffman receives some help paying for his two generic prescription
drugs from his employer's retiree coverage, 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?: He generally would pay
a monthly premium, annual deductible, and per-prescription cost-sharing.
10. Mrs. Larson is enrolled in Original Medicare and has a Medigap policy as
well, but it provides no drug coverage. 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?: Mrs. Larson cannot purchase a
Medigap plan that covers drugs, but she could keep her Medigap policy and
enroll in a Part D prescription drug plan.
