2026 GRADED A+ FREE DOWNLOAD
NC Medicare Supplement & LTC Practice Questions
1. What is the minimum "Free Look" period for a Medicare Supplement policy in
North Carolina?
• Answer: 30 days.
• Rationale: North Carolina statutes mandate a 30-day "right to return" for both
Medicare Supplement and Long-Term Care policies, allowing the consumer to
return the policy for a full premium refund for any reason.
2. In North Carolina, what are the minimum loss ratio standards for Medicare
Supplement policies?
• Answer: 65% for individual policies and 75% for group policies.
• Rationale: The loss ratio ensures that a significant portion of premiums are
returned to policyholders as benefits. Commercial for-profit insurers in NC must
meet these specific 65/75 thresholds.
3. Under North Carolina's "Guarantee Issue" for those under age 65, which
Medigap plans must be made available to individuals eligible for Medicare due to
disability?
• Answer: Plans A, D, and G.
• Rationale: North Carolina G.S. 58-54-45 mandates that disabled individuals
under 65 can purchase these specific plans without medical underwriting during
their initial enrollment.
4. What is the maximum "Look-Back" period an insurer can use for pre-existing
conditions on a new Medicare Supplement policy in NC?
• Answer: 6 months.
• Rationale: Insurers may exclude coverage for conditions diagnosed or treated
within the 6 months prior to the policy's effective date, but only for a maximum
waiting period of 6 months.
5. To be considered "Partnership Qualified" in North Carolina, a Long-Term Care
policy must include which of the following?
• Answer: Inflation Protection.
,2026 GRADED A+ FREE DOWNLOAD
• Rationale: For younger applicants, NC requires specific inflation protection (e.g.,
5% compound for those under 61) for the policy to qualify for the Medicaid asset-
disregard program.
6. Which of the following is NOT an Activity of Daily Living (ADL) used as a
benefit trigger for LTC insurance?
• Answer: Driving.
• Rationale: The six standardized ADLs are Bathing, Dressing, Toileting,
Transferring, Continence, and Eating. Driving is an Instrumental Activity of Daily
Living (IADL) and is not a primary trigger.
7. When must an agent provide the "Outline of Coverage" to a Medicare
Supplement applicant?
• Answer: At the time of application.
• Rationale: North Carolina regulations require that the applicant receives a
summary of the policy's benefits, exclusions, and premiums before or at the
moment the application is signed.
8. What is the primary benefit of the North Carolina Long-Term Care Partnership
Program?
• Answer: Dollar-for-dollar asset protection.
• Rationale: For every dollar the Partnership policy pays in benefits, a dollar of the
insured’s assets is disregarded if they later apply for Medicaid assistance.
)
9. How many days of inpatient hospital care does Medicare Part A pay for in full
before a daily co-payment is required in 2026?
• Answer: 60 days.
• Rationale: After the Part A deductible ($1,736 in 2026), Medicare pays 100% of
hospital costs for days 1–60 of each benefit period.
Medicare (.gov) +1
10. What is the standard Part B monthly premium for most enrollees in 2026?
• Answer: $202.90.
, 2026 GRADED A+ FREE DOWNLOAD
• Rationale: The standard premium for Part B in 2026 is $202.90, though high-
income earners may pay more due to IRMAA adjustments.
Medicare (.gov)
11. An insured must be out of the hospital for how many consecutive days before
a new "Benefit Period" begins under Medicare Part A?
• Answer: 60 days.
• Rationale: A benefit period ends when the patient has not received any inpatient
hospital or skilled nursing care for 60 days in a row.
12. In 2026, what is the annual out-of-pocket cap for covered Part D prescription
drugs?
• Answer: $2,100.
• Rationale: Under the CMS Final Rule for 2026, out-of-pocket costs for Part D
drugs are capped at $2,100 annually.
13. Which of the following renewal provisions is required for all Medicare
Supplement policies?
• Answer: Guaranteed Renewable.
• Rationale: Insurers cannot cancel a Medicare Supplement policy based on the
health of the insured; they can only cancel for non-payment of premium.
14. What is the "Elimination Period" in a Long-Term Care policy?
• Answer: A "time deductible" before benefits begin.
• Rationale: It is the number of days the insured must receive care (often 30, 60, or
90 days) out-of-pocket before the insurer starts paying benefits.
15. Under North Carolina law, a "Pre-existing Condition" is defined as a condition
for which medical advice or treatment was recommended or received within how
many months before the effective date?
• Answer: 6 months.
• Rationale: NC uses the "6 and 6" rule: a 6-month look-back and a maximum 6-
month waiting period.
Humana +1
NC Medicare Supplement & LTC Practice Questions
1. What is the minimum "Free Look" period for a Medicare Supplement policy in
North Carolina?
• Answer: 30 days.
• Rationale: North Carolina statutes mandate a 30-day "right to return" for both
Medicare Supplement and Long-Term Care policies, allowing the consumer to
return the policy for a full premium refund for any reason.
2. In North Carolina, what are the minimum loss ratio standards for Medicare
Supplement policies?
• Answer: 65% for individual policies and 75% for group policies.
• Rationale: The loss ratio ensures that a significant portion of premiums are
returned to policyholders as benefits. Commercial for-profit insurers in NC must
meet these specific 65/75 thresholds.
3. Under North Carolina's "Guarantee Issue" for those under age 65, which
Medigap plans must be made available to individuals eligible for Medicare due to
disability?
• Answer: Plans A, D, and G.
• Rationale: North Carolina G.S. 58-54-45 mandates that disabled individuals
under 65 can purchase these specific plans without medical underwriting during
their initial enrollment.
4. What is the maximum "Look-Back" period an insurer can use for pre-existing
conditions on a new Medicare Supplement policy in NC?
• Answer: 6 months.
• Rationale: Insurers may exclude coverage for conditions diagnosed or treated
within the 6 months prior to the policy's effective date, but only for a maximum
waiting period of 6 months.
5. To be considered "Partnership Qualified" in North Carolina, a Long-Term Care
policy must include which of the following?
• Answer: Inflation Protection.
,2026 GRADED A+ FREE DOWNLOAD
• Rationale: For younger applicants, NC requires specific inflation protection (e.g.,
5% compound for those under 61) for the policy to qualify for the Medicaid asset-
disregard program.
6. Which of the following is NOT an Activity of Daily Living (ADL) used as a
benefit trigger for LTC insurance?
• Answer: Driving.
• Rationale: The six standardized ADLs are Bathing, Dressing, Toileting,
Transferring, Continence, and Eating. Driving is an Instrumental Activity of Daily
Living (IADL) and is not a primary trigger.
7. When must an agent provide the "Outline of Coverage" to a Medicare
Supplement applicant?
• Answer: At the time of application.
• Rationale: North Carolina regulations require that the applicant receives a
summary of the policy's benefits, exclusions, and premiums before or at the
moment the application is signed.
8. What is the primary benefit of the North Carolina Long-Term Care Partnership
Program?
• Answer: Dollar-for-dollar asset protection.
• Rationale: For every dollar the Partnership policy pays in benefits, a dollar of the
insured’s assets is disregarded if they later apply for Medicaid assistance.
)
9. How many days of inpatient hospital care does Medicare Part A pay for in full
before a daily co-payment is required in 2026?
• Answer: 60 days.
• Rationale: After the Part A deductible ($1,736 in 2026), Medicare pays 100% of
hospital costs for days 1–60 of each benefit period.
Medicare (.gov) +1
10. What is the standard Part B monthly premium for most enrollees in 2026?
• Answer: $202.90.
, 2026 GRADED A+ FREE DOWNLOAD
• Rationale: The standard premium for Part B in 2026 is $202.90, though high-
income earners may pay more due to IRMAA adjustments.
Medicare (.gov)
11. An insured must be out of the hospital for how many consecutive days before
a new "Benefit Period" begins under Medicare Part A?
• Answer: 60 days.
• Rationale: A benefit period ends when the patient has not received any inpatient
hospital or skilled nursing care for 60 days in a row.
12. In 2026, what is the annual out-of-pocket cap for covered Part D prescription
drugs?
• Answer: $2,100.
• Rationale: Under the CMS Final Rule for 2026, out-of-pocket costs for Part D
drugs are capped at $2,100 annually.
13. Which of the following renewal provisions is required for all Medicare
Supplement policies?
• Answer: Guaranteed Renewable.
• Rationale: Insurers cannot cancel a Medicare Supplement policy based on the
health of the insured; they can only cancel for non-payment of premium.
14. What is the "Elimination Period" in a Long-Term Care policy?
• Answer: A "time deductible" before benefits begin.
• Rationale: It is the number of days the insured must receive care (often 30, 60, or
90 days) out-of-pocket before the insurer starts paying benefits.
15. Under North Carolina law, a "Pre-existing Condition" is defined as a condition
for which medical advice or treatment was recommended or received within how
many months before the effective date?
• Answer: 6 months.
• Rationale: NC uses the "6 and 6" rule: a 6-month look-back and a maximum 6-
month waiting period.
Humana +1
