Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 2/5
When Medicare denies payment for a service the beneficiary believes should be covered, the beneficiary:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Medicare beneficiaries have a right to appeal coverage and payment decisions. The appeal process in Original Medicare has five levels: redetermination by the claims contractor, reconsideration by a qualified independent contractor, an administrative law judge hearing, the Medicare Appeals Council, and finally federal court review. Filing a redetermination within 120 days of the MSN begins the process. A denial of a service Medicare should have covered can therefore be challenged, and the right to appeal is protected at every stage.
Why the other options are wrong
- B) Medicare decisions are not final; the beneficiary has an explicit multi-level appeal right for denied claims.
- C) Refiling with a private insurer is not the remedy; the appeal runs within the Medicare system itself.
- D) An attorney is not required, and there is no 10-day appeal deadline; the first appeal is filed within 120 days.
Memory hook
Medicare denials are appealable, five levels deep. Never take a denial as the last word.