NC MEDICARE COMPREHENSIVE EXAM 2026
QUESTIONS WITH SOLUTIONS GRADED A+
◉ Programs that are provided to people who are too poor to qualify for
Medicaid. Answer: State-only Medicaid programs
◉ LTC provision that provides a guarantee that certain policy benefits
will remain available even if the insured stops paying premiums. (Offers
option of a paid-up policy providing the same benefits for a shorter
period, etc.) Answer: Nonforfeiture
◉ When must the outline of coverage for a Medigap policy be provided
to the insured? Answer: At the time of application.
◉ Home health equipment such as dialysis equipment and supplies are
covered under which part of Medicare? Answer: Medicare Part B
(Considered an outpatient service)
◉ What is the Medicare Part B enrollment period for an individual who
is turning 65? Answer: 3 months before the month in which the
individual turns 65, as well as the 3 months following that month (7
months).
, ◉ What is the copayment of the Medicare approved amount? Answer:
20% paid by the insured individual.
◉ Prospective review (Precertification provision) Answer: Physician
submits claim information prior to providing treatment to know in
advance if the procedure is covered and what the rate will be.
◉ What options does an insured person have for prescription drug
coverage if they are enrolled in a Medicare Advantage Plan? Answer: 1)
Receive prescription drug coverage through the Medicare Advantage
Plan.
2) Sign up for separate prescription drug plan through Medicare Part D.
◉ Who facilitates processing Medicare applications, collects Medicare
premiums, and provides general information about Medicare? Answer:
The Social Security Administration
◉ Who administers Medicare? Answer: Centers for Medicare and
Medicaid Services (CMS)
◉ How are LTC benefits triggered? Answer: Insured must be unable to
perform at least 2 ADLs without substantial assistance.
(Cannot be triggered solely due to medical necessity)
QUESTIONS WITH SOLUTIONS GRADED A+
◉ Programs that are provided to people who are too poor to qualify for
Medicaid. Answer: State-only Medicaid programs
◉ LTC provision that provides a guarantee that certain policy benefits
will remain available even if the insured stops paying premiums. (Offers
option of a paid-up policy providing the same benefits for a shorter
period, etc.) Answer: Nonforfeiture
◉ When must the outline of coverage for a Medigap policy be provided
to the insured? Answer: At the time of application.
◉ Home health equipment such as dialysis equipment and supplies are
covered under which part of Medicare? Answer: Medicare Part B
(Considered an outpatient service)
◉ What is the Medicare Part B enrollment period for an individual who
is turning 65? Answer: 3 months before the month in which the
individual turns 65, as well as the 3 months following that month (7
months).
, ◉ What is the copayment of the Medicare approved amount? Answer:
20% paid by the insured individual.
◉ Prospective review (Precertification provision) Answer: Physician
submits claim information prior to providing treatment to know in
advance if the procedure is covered and what the rate will be.
◉ What options does an insured person have for prescription drug
coverage if they are enrolled in a Medicare Advantage Plan? Answer: 1)
Receive prescription drug coverage through the Medicare Advantage
Plan.
2) Sign up for separate prescription drug plan through Medicare Part D.
◉ Who facilitates processing Medicare applications, collects Medicare
premiums, and provides general information about Medicare? Answer:
The Social Security Administration
◉ Who administers Medicare? Answer: Centers for Medicare and
Medicaid Services (CMS)
◉ How are LTC benefits triggered? Answer: Insured must be unable to
perform at least 2 ADLs without substantial assistance.
(Cannot be triggered solely due to medical necessity)
