North Carolina Medicare Supplement and Long-Term Care Complete Exam Study Questions with Accurate Answers

North Carolina Medicare Supplement and Long-Term Care Complete Exam Study Questions with Accurate Answers 1. What is Medicare? - ANSWER Government health insurance program for people over 65 or younger people who may qualify. 2. Who under 65 may qualify for Medicare? - ANSWER Individuals who have disabilities such as permanent kidney failure or ALS 3. What is the term for private organizations that administer Medicare Part B benefits? A. Carriers B. Medical Providers C. Intermediaries D. Peer review organizations - ANSWER A. Carriers 4. All of the following are requirements for long-term care and medigap policy except: A. The agent must provide the applicant with a notice regarding replacement B. The notice regarding replacement must contain the free look period C. The notice regarding replacement explains the replacing coverage in comparison to the existing coverage D. A 60-day free look period must be provided - ANSWER D. A 60-day free look period must be provided. 5. Which of the following is not an optional benefit provided by long-term care policies? A. Inflation protection B. Guaranteed insurability C. Non forfeiture options D. Guaranteed renewable or non cancelable - ANSWER D. Guaranteed renewable or non cancelable 6. All of the following are required to qualify for Medicare's nursing facility benefit except: A. The patient must spend at least three days in a hospital within 30 past days B. The patient must meet stated income limits C. The patient's physician must certify that skilled care is required D. The patient must enter a Medicare-certified skilled nursing facility - ANSWER B. The patient must meet stated income limits 7. Medical coverage is provided by: A. Medicare Part A B. Medicare Part B C. Medicare Part C D. Medicare Part D - ANSWER B. Medicare Part B 8. If an individual enrolls in Medicare before their birthday month and their birthday is NOT the first day of the month, when does coverage begin? - ANSWER The first day of their birthday month 9. B's long-term care insurance policy has a 30-calendar day elimination period. He became eligible for long-term care benefits and started receiving care on May 1. At what point will his policy begin paying benefits? A. After Bill has received 30 days of weekday care B. After Bill has received 30 days of care C. 30 days after the policy is issued D. 30 days after the triggering event - ANSWER D. 30 days after the triggering event 10. An individual who is not eligible for premium-free Medicare Part A coverage may apply for coverage during which of the following enrollment periods? A. All of the above B. Initial enrollment period C. General enrollment period D. Special enrollment period - ANSWER A. All of the above 11. Medicare makes what payment for services in which another payer may be responsible: A. Conditional payment B. Interim payment C. Transitional payment D. Temporary payment - ANSWER A. Conditional payment 12. Insurers must offer inflation protection in which of the following policies? A. Medicare Part C B. Medigap C. Long-Term Care D. Medicaid - ANSWER C. Long-Term Care 13. What program safeguards against unnecessary and inappropriate medical care rendered to Medicaid recipients? A. Medicaid review program B. Utilization renew program C. Quality improvement organization D. Utilization review program - ANSWER D. Utilization review program 14. Which of the following is not a requirement for long-term care plans? A. The individual must be unable to perform at least two ADLs B. Inflation protection must be provided C. Policies must accrue cash value D. Coveraged cannot reimburse insureds for medical expenses or services covered by Medicare. - ANSWER C. Policies must accrue cash value. 15. Which entity handles claims from hospitals, skilled nursing facilities, home health agencies and hospices? A. Carrier B. Intermediary C. Quality Improvement Organization D. Utilization Review Committee - ANSWER B. Intermediary