MEDICARE AS A SECOND PAYER
(MSP) EXAM QUESTIONS AND
ANSWERS
What are the 3 ways someone is entitled to Medicare? - Correct Answers -Age (65),
disability, or End Stage Renal Disease
Department of Veterans Affairs - Correct Answers -If they have authorized and agreed
to pay for services, then they will be primary and Medicare will be secondary.
Workers Compensation - Correct Answers -If the procedure is due to an illness/injury
that is related to a work-related accident, then they will be the primary and Medicare will
be the secondary. If the patient returns for something unrelated to the work-related
illness/injury, then Medicare will be primary.
If the patient is age 65 or older and is covered by a Group Health Plan through current
employment or spouse's current employment (employer has less than 20 employees),
who is primary and secondary? - Correct Answers -Primary: Medicare. Secondary:
Group Health Plan.
If the patient is age 65 or older and covered by a Group Health Plan through current
employment or spouse's current employment (employment has >20 employees), who is
primary and secondary? - Correct Answers -Primary Group Health Plan. Secondary:
Medicare.
If the patient has an employer retirement plan and is 65 years or older and is entitled to
medicare, who is primary and secondary? - Correct Answers -Primary: Medicare.
Secondary: Retiree coverage.
Failure to comply with MSP provisions could result in - Correct Answers -Civil and
criminal penalties, except imprisonment.
How is Medicare Primary based on disability? - Correct Answers -If they are disabled
and covered by a GHP through his or her own current employment, or through a family
member's current employment. The employer must have less than 100 employees for
Medicare to be primary.
(MSP) EXAM QUESTIONS AND
ANSWERS
What are the 3 ways someone is entitled to Medicare? - Correct Answers -Age (65),
disability, or End Stage Renal Disease
Department of Veterans Affairs - Correct Answers -If they have authorized and agreed
to pay for services, then they will be primary and Medicare will be secondary.
Workers Compensation - Correct Answers -If the procedure is due to an illness/injury
that is related to a work-related accident, then they will be the primary and Medicare will
be the secondary. If the patient returns for something unrelated to the work-related
illness/injury, then Medicare will be primary.
If the patient is age 65 or older and is covered by a Group Health Plan through current
employment or spouse's current employment (employer has less than 20 employees),
who is primary and secondary? - Correct Answers -Primary: Medicare. Secondary:
Group Health Plan.
If the patient is age 65 or older and covered by a Group Health Plan through current
employment or spouse's current employment (employment has >20 employees), who is
primary and secondary? - Correct Answers -Primary Group Health Plan. Secondary:
Medicare.
If the patient has an employer retirement plan and is 65 years or older and is entitled to
medicare, who is primary and secondary? - Correct Answers -Primary: Medicare.
Secondary: Retiree coverage.
Failure to comply with MSP provisions could result in - Correct Answers -Civil and
criminal penalties, except imprisonment.
How is Medicare Primary based on disability? - Correct Answers -If they are disabled
and covered by a GHP through his or her own current employment, or through a family
member's current employment. The employer must have less than 100 employees for
Medicare to be primary.
