NC Medicare Supplement
& Long Term Care
Insurance Licensing 2026 |
Exam Prep & Study
|Graded A+ | Guaranteed
success|
Updated 2026 Questions and Answers
100% Verified Exam Prep and Comprehensive
Rationales
Included
, Medicare Eligibility -Over age 65 who have earned 40 "work credits" in order to receive premium free
part A benefits
-Permanently disabled prior to age 65 for at least 24 months
-ESRD or kidney disease requiring dialysis or kidney transplant
Medicare enrollment requirements Part A & B are automatically conducted by SSA when individual age 65+ enrolls for
their Social Security retirement benefits
Initial Enrollment Period 7 month period straddling 3 months before and ends 3 months after the individual
turns 65, including the birthday month.
-If enrollment is during the 3 mos prior to 65th birthday, coverage begins on 1st
day of 65th birthday month
-If enrollment is during or after 65th birthday month, coverage begins on 1st day
of month after enrollment
General Enrollment Period Medicare enrollment period - January 1st through March 31st annually.
-Coverage begins July 1st of that year
-Monthly premium for part B may go up 10% for each full 12 month period that
you're eligible but didn't sign up.
Special Enrollment Period Individual can enroll at 8 months beginning with the month employment ends or
when group coverage ends whichever is earlier without subject to late enrollment
surcharge
Medicare as a secondary or primary payer -Medicare is the secondary payer for the 'working aged' who has a group health
plan if the group has 20+ enrollees
-For single employer with <20 employees with a group health plan, Medicare is
the primary payer.
-If individual retains coverage thru the group plan, the group contract is the
primary unless person is retired & still covered under the group plan. In that case,
Medicare is the primary.
-If individual rejects the employer plan, Medicare is the primary payer
Medicare as a secondary payer -In cases of Workers' Comp when it applies to an injury or illness
- In cases where no-fault insurance or liability insurance is available as primary
payer.
Medicare & the VA Can choose to get treatment under either plan. Medicare usually will not pay
benefits if services are rendered in a VA facility but will pay if outside of VA. There
is NO coordination between Federal agencies.
Expenses NOT paid by Medicare -Purely custodial care/ chronic care
-Services that are not reasonable or medically necessary under Medicare
standards
-Services performed by relatives/ member of beneficiary's household
-Services paid for by another gov't agency
Medicare Part A covers -acute inpatient hospital care
-inpatient skilled nursing care
-medically necessary home health care & hospice services
& Long Term Care
Insurance Licensing 2026 |
Exam Prep & Study
|Graded A+ | Guaranteed
success|
Updated 2026 Questions and Answers
100% Verified Exam Prep and Comprehensive
Rationales
Included
, Medicare Eligibility -Over age 65 who have earned 40 "work credits" in order to receive premium free
part A benefits
-Permanently disabled prior to age 65 for at least 24 months
-ESRD or kidney disease requiring dialysis or kidney transplant
Medicare enrollment requirements Part A & B are automatically conducted by SSA when individual age 65+ enrolls for
their Social Security retirement benefits
Initial Enrollment Period 7 month period straddling 3 months before and ends 3 months after the individual
turns 65, including the birthday month.
-If enrollment is during the 3 mos prior to 65th birthday, coverage begins on 1st
day of 65th birthday month
-If enrollment is during or after 65th birthday month, coverage begins on 1st day
of month after enrollment
General Enrollment Period Medicare enrollment period - January 1st through March 31st annually.
-Coverage begins July 1st of that year
-Monthly premium for part B may go up 10% for each full 12 month period that
you're eligible but didn't sign up.
Special Enrollment Period Individual can enroll at 8 months beginning with the month employment ends or
when group coverage ends whichever is earlier without subject to late enrollment
surcharge
Medicare as a secondary or primary payer -Medicare is the secondary payer for the 'working aged' who has a group health
plan if the group has 20+ enrollees
-For single employer with <20 employees with a group health plan, Medicare is
the primary payer.
-If individual retains coverage thru the group plan, the group contract is the
primary unless person is retired & still covered under the group plan. In that case,
Medicare is the primary.
-If individual rejects the employer plan, Medicare is the primary payer
Medicare as a secondary payer -In cases of Workers' Comp when it applies to an injury or illness
- In cases where no-fault insurance or liability insurance is available as primary
payer.
Medicare & the VA Can choose to get treatment under either plan. Medicare usually will not pay
benefits if services are rendered in a VA facility but will pay if outside of VA. There
is NO coordination between Federal agencies.
Expenses NOT paid by Medicare -Purely custodial care/ chronic care
-Services that are not reasonable or medically necessary under Medicare
standards
-Services performed by relatives/ member of beneficiary's household
-Services paid for by another gov't agency
Medicare Part A covers -acute inpatient hospital care
-inpatient skilled nursing care
-medically necessary home health care & hospice services
