2022 AHIP REVIEW UNIT 1 MEDICARE BASICS Test Questions And A
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nswers 100%Correct/Verified Best Graded A+ t t t t t
2022 Ahip Review t t t
UNIT 1 Medicare Ba t t t
sics t
Question 1
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Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently reviewed h
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er Medicare Summary Notice (MSN) and disagrees with a determination that partially
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denied one of her claims forservices. What advice would you give her?
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a. Mrs. Duarte should file an appeal of this initial determination within 120 days of the
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date she receivedthe MSN in the mail.
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b.Mrs. Duarte has no right to appeal this determination since her claim has been partia
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lly paid.
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c. Mrs. Duarte should file an appeal of this initial determination within 90 days of the
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date she receivedthe MSN in the mail. If she still disagrees with Medicare Administra
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tive Contractor's (MAC's) further decision she should request a reconsideration by a
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qualified independent party within 10 days. t t t t t
Incorrect: Beneficiaries must file an appeal related to Part A or B services within 120
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days of the date they get the MSN in the mail. If a beneficiary disagrees with the Medi
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care Administrative Contractor’sdecision, he/she has 180 days after getting the deci
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sion notice to request a reconsideration by a Qualified Independent Contractor.
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d.Mrs. Duarte should request a reconsideration of the decision by a qualified indepe
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ndent party within60 days of the date she received the MSN in the mail.
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2022 AHIP REVIEW UNIT 1 MEDICARE BASICS Test Questions And A
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nswers 100%Correct/Verified Best Graded A+ t t t t t
,2022 AHIP REVIEW UNIT 1 MEDICARE BASICS Test Questions And A
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nswers 100%Correct/Verified Best Graded A+ t t t t t
Source: Module 1, Slide - t t t t
Appeals related to Part A and Part B Coverage and Payment Determinations.
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Question 2 t
Mr. Schmidt would like to plan for retirement and has asked you what is covered under
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Original Fee-for-Service (FFS) Medicare? What could you tell him?
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a.Part C, which always covers dental and vision services, is covered under Original Med
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icare.
b.Part A, which covers hospital, skilled nursing facility, hospice, and home health serv
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ices and Part B,which covers professional services such as those provided by a docto
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r are covered under Original Medicare.
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c.Part A, which covers long- t t t t
term custodial care services, is covered under Original Medicare.d.Part D, w
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hich covers prescription drug services, is covered under Original Medicare.
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Source: Module 1, Slide - Overview of Medicare Benefits and Coverage -
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Parts A, B, C, and Slide -Overview of Different Ways to Get Medicare
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Question 3 t
Juan Perez, who is turning age 65 next month, intends to work for several more year
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s at Smallcap, Incorporated. Smallcap has a workforce of 15 employees and offers em
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ployer-
sponsored healthcare coverage. Juan is a naturalized citizen and has contributed to t
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2022 AHIP REVIEW UNIT 1 MEDICARE BASICS Test Questions And A
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nswers 100%Correct/Verified Best Graded A+ t t t t t
,2022 AHIP REVIEW UNIT 1 MEDICARE BASICS Test Questions And A
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nswers 100%Correct/Verified Best Graded A+
t t t t t
he Medicare system for over 20 years.Juan asks you if he will be entitled to Medicare
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and if he enrolls how that will impact his employer-
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sponsored healthcare coverage. How would you respond?
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a.Juan is likely to be ineligible for Medicare since he was born outside the United States
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and has onlycontributed to the Medicare system for 20 years.
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2022 AHIP REVIEW UNIT 1 MEDICARE BASICS Test Questions And A
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nswers 100%Correct/Verified Best Graded A+
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, 2022 AHIP REVIEW UNIT 1 MEDICARE BASICS Test Questions And A
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nswers 100%Correct/Verified Best Graded A+ t t t t t
b. Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls Medi
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care would become the primary payor of his healthcare claims but Smallcap must co
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ntinue to offer him coverageunder its employer-
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sponsored group health plan and would become a secondary payor. t t t t t t t t t
c.Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls his em
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ployer-
sponsoredcoverage would continue to be the primary payor while Medicare would
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be considered a secondary payor of his healthcare claims.
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Incorrect: Medicare is the primary payor for individuals who have group health co
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verage due to theircontinued employment with a small employer. A small group h
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ealth plan is one offered by a companywith fewer than 20 employees.
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d. Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls Medi
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care would become the primary payor of his healthcare claims and Smallcap does no
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t have to continue to offer himcoverage comparable to those under age 65 under its
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employer-sponsored group health plan. t t t
Source: Module 1, Slide - Eligibility for Part A and Part B Benefits and Slide -
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Medicare for Individuals Who Are Still Working - Small GHPs and Slide -
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Medicare Coordination with Employer Group Health Plans
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Question 4 t
Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by t
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he Social SecurityAdministration and has been receiving disability payments. He
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is wondering whether he can obtaincoverage under Medicare. What should you
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2022 AHIP REVIEW UNIT 1 MEDICARE BASICS Test Questions And A
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nswers 100%Correct/Verified Best Graded A+ t t t t t
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nswers 100%Correct/Verified Best Graded A+ t t t t t
2022 Ahip Review t t t
UNIT 1 Medicare Ba t t t
sics t
Question 1
t t
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently reviewed h
t t t t t t t t t t t t t t t
er Medicare Summary Notice (MSN) and disagrees with a determination that partially
t t t t t t t t t t t t
denied one of her claims forservices. What advice would you give her?
t t t t t t t t t t t t
a. Mrs. Duarte should file an appeal of this initial determination within 120 days of the
t t t t t t t t t t t t t t t t
date she receivedthe MSN in the mail.
t t t t t t t
b.Mrs. Duarte has no right to appeal this determination since her claim has been partia
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lly paid.
t
c. Mrs. Duarte should file an appeal of this initial determination within 90 days of the
t t t t t t t t t t t t t t t t
date she receivedthe MSN in the mail. If she still disagrees with Medicare Administra
t t t t t t t t t t t t t t
tive Contractor's (MAC's) further decision she should request a reconsideration by a
t t t t t t t t t t t t
qualified independent party within 10 days. t t t t t
Incorrect: Beneficiaries must file an appeal related to Part A or B services within 120
t t t t t t t t t t t t t t t
days of the date they get the MSN in the mail. If a beneficiary disagrees with the Medi
t t t t t t t t t t t t t t t t t
care Administrative Contractor’sdecision, he/she has 180 days after getting the deci
t t t t t t t t t t t
sion notice to request a reconsideration by a Qualified Independent Contractor.
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d.Mrs. Duarte should request a reconsideration of the decision by a qualified indepe
t t t t t t t t t t t t
ndent party within60 days of the date she received the MSN in the mail.
t t t t t t t t t t t t t t
2022 AHIP REVIEW UNIT 1 MEDICARE BASICS Test Questions And A
t t t t t t t t t t
nswers 100%Correct/Verified Best Graded A+ t t t t t
,2022 AHIP REVIEW UNIT 1 MEDICARE BASICS Test Questions And A
t t t t t t t t t t
nswers 100%Correct/Verified Best Graded A+ t t t t t
Source: Module 1, Slide - t t t t
Appeals related to Part A and Part B Coverage and Payment Determinations.
t t t t t t t t t t t t
Question 2 t
Mr. Schmidt would like to plan for retirement and has asked you what is covered under
t t t t t t t t t t t t t t t t
Original Fee-for-Service (FFS) Medicare? What could you tell him?
t t t t t t t t t
a.Part C, which always covers dental and vision services, is covered under Original Med
t t t t t t t t t t t t t
icare.
b.Part A, which covers hospital, skilled nursing facility, hospice, and home health serv
t t t t t t t t t t t t
ices and Part B,which covers professional services such as those provided by a docto
t t t t t t t t t t t t t t
r are covered under Original Medicare.
t t t t t
c.Part A, which covers long- t t t t
term custodial care services, is covered under Original Medicare.d.Part D, w
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hich covers prescription drug services, is covered under Original Medicare.
t t t t t t t t t
Source: Module 1, Slide - Overview of Medicare Benefits and Coverage -
t t t t t t t t t t t
Parts A, B, C, and Slide -Overview of Different Ways to Get Medicare
t t t t t t t t t t t t t t
Question 3 t
Juan Perez, who is turning age 65 next month, intends to work for several more year
t t t t t t t t t t t t t t t
s at Smallcap, Incorporated. Smallcap has a workforce of 15 employees and offers em
t t t t t t t t t t t t t
ployer-
sponsored healthcare coverage. Juan is a naturalized citizen and has contributed to t
t t t t t t t t t t t t
2022 AHIP REVIEW UNIT 1 MEDICARE BASICS Test Questions And A
t t t t t t t t t t
nswers 100%Correct/Verified Best Graded A+ t t t t t
,2022 AHIP REVIEW UNIT 1 MEDICARE BASICS Test Questions And A
t t t t t t t t t t
nswers 100%Correct/Verified Best Graded A+
t t t t t
he Medicare system for over 20 years.Juan asks you if he will be entitled to Medicare
t t t t t t t t t t t t t t t t t
and if he enrolls how that will impact his employer-
t t t t t t t t t
sponsored healthcare coverage. How would you respond?
t t t t t t t
a.Juan is likely to be ineligible for Medicare since he was born outside the United States
t t t t t t t t t t t t t t t
and has onlycontributed to the Medicare system for 20 years.
t t t t t t t t t t t
2022 AHIP REVIEW UNIT 1 MEDICARE BASICS Test Questions And A
t t t t t t t t t t
nswers 100%Correct/Verified Best Graded A+
t t t t t
, 2022 AHIP REVIEW UNIT 1 MEDICARE BASICS Test Questions And A
t t t t t t t t t t
nswers 100%Correct/Verified Best Graded A+ t t t t t
b. Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls Medi
t t t t t t t t t t t t t t t t t t
care would become the primary payor of his healthcare claims but Smallcap must co
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ntinue to offer him coverageunder its employer-
t t t t t t t
sponsored group health plan and would become a secondary payor. t t t t t t t t t
c.Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls his em
t t t t t t t t t t t t t t t t t t
ployer-
sponsoredcoverage would continue to be the primary payor while Medicare would
t t t t t t t t t t t t
be considered a secondary payor of his healthcare claims.
t t t t t t t t
Incorrect: Medicare is the primary payor for individuals who have group health co
t t t t t t t t t t t t
verage due to theircontinued employment with a small employer. A small group h
t t t t t t t t t t t t t
ealth plan is one offered by a companywith fewer than 20 employees.
t t t t t t t t t t t t
d. Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls Medi
t t t t t t t t t t t t t t t t t t
care would become the primary payor of his healthcare claims and Smallcap does no
t t t t t t t t t t t t t
t have to continue to offer himcoverage comparable to those under age 65 under its
t t t t t t t t t t t t t t t t
employer-sponsored group health plan. t t t
Source: Module 1, Slide - Eligibility for Part A and Part B Benefits and Slide -
t t t t t t t t t t t t t t t
Medicare for Individuals Who Are Still Working - Small GHPs and Slide -
t t t t t t t t t t t t t
Medicare Coordination with Employer Group Health Plans
t t t t t t t
Question 4 t
Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by t
t t t t t t t t t t t t t t t
he Social SecurityAdministration and has been receiving disability payments. He
t t t t t t t t t t t
is wondering whether he can obtaincoverage under Medicare. What should you
t t t t t t t t t t t
2022 AHIP REVIEW UNIT 1 MEDICARE BASICS Test Questions And A
t t t t t t t t t t
nswers 100%Correct/Verified Best Graded A+ t t t t t
