Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 2/5
If Medicare denies payment for a covered service, the beneficiary:
Select an option to reveal the answer and the full 3-part explanation — free, no signup.
Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
Medicare beneficiaries have a right of appeal when Medicare denies payment or does not pay for a service they believe should be covered. The appeals process has multiple levels: redetermination by the claims contractor, reconsideration by a qualified independent contractor, an administrative law judge hearing, review by the Medicare Appeals Council, and finally judicial review in federal court. Beneficiaries must generally file the first-level appeal within a specified time after receiving the denial notice.
Why the other options are wrong
- A) Beneficiaries are not required to accept a denial; the appeals process exists precisely to challenge it.
- B) Medigap policies do not administer Medicare appeals; the appeal runs through the Medicare administrative process.
- D) Filing an appeal does not result in disenrollment; Medicare coverage continues throughout the process.
Memory hook
Denied? Appeal. Medicare's ladder has five rungs, from redetermination all the way up to federal court.