2023 AHIP REVIEW UNIT 1 MEDICARE BASICS Test Questions And Answers 100%Correct/Verified Best Graded A+

2022 Ahip Review UNIT 1 Medicare Basics Question 1 Mrs. Duarte 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? a. Mrs. Duarte should file an appeal of this initial determination within 120 days of the date she received the MSN in the mail. b.Mrs. Duarte has no right to appeal this determination since her claim has been partially paid. c. Mrs. Duarte should file an appeal of this initial determination within 90 days of the date she received the MSN in the mail. If she still disagrees with Medicare Administrative Contractor's (MAC's) further decision she should request a reconsideration by a qualified independent party within 10 days. Incorrect: Beneficiaries must file an appeal related to Part A or B services within 120 days of the date they get the MSN in the mail. If a beneficiary disagrees with the Medicare Administrative Contractor’s decision, he/she has 180 days after getting the decision notice to request a reconsideration by a Qualified Independent Contractor. d.Mrs. Duarte should request a reconsideration of the decision by a qualified independent party within 60 days of the date she received the MSN in the mail. Source: Module 1, Slide - Appeals related to Part A and Part B Coverage and Payment Determinations. Question 2 Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original Fee-for- Service (FFS) Medicare? What could you tell him? a.Part C, which always covers dental and vision services, is covered under Original Medicare. b.Part A, which covers hospital, skilled nursing facility, hospice, and home health services and Part B, which covers professional services such as those provided by a doctor are covered under Original Medicare. c.Part A, which covers long-term custodial care services, is covered under Original Medicare. d.Part D, which covers prescription drug services, is covered under Original Medicare. Source: Module 1, Slide - Overview of Medicare Benefits and Coverage - Parts A, B, C, and Slide - Overview of Different Ways to Get Medicare Question 3 Juan Perez, who is turning age 65 next month, intends to work for several more years at Smallcap, Incorporated. Smallcap has a workforce of 15 employees and offers employer-sponsored healthcare coverage. Juan is a naturalized citizen and has contributed to the Medicare system for over 20 years. Juan asks you if he will be entitled to Medicare and if he enrolls how that will impact his employer- sponsored healthcare coverage. How would you respond? a.Juan is likely to be ineligible for Medicare since he was born outside the United States and has only contributed to the Medicare system for 20 years.