North Carolina Medicare
Supplement and Long-
Term Care Exam
1. What is the purpose of a Medicare Supplement (Medigap) policy?
Answer: To cover gaps in Original Medicare (Parts A and B), such as deductibles,
coinsurance, and copayments.
Explanation: Medigap does not replace Medicare; it supplements it.
2. Who is eligible to purchase a Medigap policy in North Carolina?
Answer: Individuals enrolled in Medicare Part A and Part B.
Explanation: Enrollment in both parts is required.
3. When is the Medigap Open Enrollment Period?
Answer: The six-month period starting the month an individual is 65 or older and
enrolled in Part B.
Explanation: During this period, policies are guaranteed issue.
4. Can a Medigap policy be canceled due to health conditions?
Answer: No, as long as premiums are paid on time.
Explanation: Medigap policies are guaranteed renewable.
5. Are Medigap policies standardized in North Carolina?
Answer: Yes.
Explanation: Plans are standardized by the federal government (Plans A–N).
,6. Do Medigap policies cover prescription drugs?
Answer: No.
Explanation: Prescription drug coverage is provided by Medicare Part D.
7. Which Medigap plan offers the most comprehensive coverage?
Answer: Plan G.
Explanation: Plan G covers all gaps except the Part B deductible.
8. Can an insurer require medical underwriting during open enrollment?
Answer: No.
Explanation: Health questions are prohibited during open enrollment.
9. Are Medigap premiums regulated by the state of North Carolina?
Answer: Yes.
Explanation: Rates must be approved by the North Carolina Department of
Insurance.
10. Can an individual have both Medicare Advantage and Medigap at the same time?
Answer: No.
Explanation: Medigap works only with Original Medicare.
North Carolina Long-Term Care (LTC) Insurance – Q&A
11. What does Long-Term Care insurance primarily cover?
Answer: Assistance with activities of daily living (ADLs) and cognitive impairment.
Explanation: Medical care alone does not qualify for benefits.
12. How many ADLs are typically used to determine benefit eligibility?
Answer: Six.
Explanation: Bathing, dressing, toileting, transferring, continence, and eating.
13. What is the elimination period in an LTC policy?
, Answer: The waiting period before benefits begin.
Explanation: Similar to a deductible measured in time.
14. Does Medicare pay for long-term custodial care?
Answer: No.
Explanation: Medicare covers only limited skilled care.
15. What is the purpose of inflation protection in LTC policies?
Answer: To increase benefits over time to keep pace with rising costs.
Explanation: Often required or strongly encouraged for younger applicants.
16. Can LTC benefits be paid for home care in North Carolina?
Answer: Yes.
Explanation: Modern LTC policies cover home, assisted living, and nursing care.
17. What triggers LTC policy benefits?
Answer: Inability to perform at least two ADLs or severe cognitive impairment.
Explanation: Must be certified by a licensed health professional.
18. Are LTC policy premiums guaranteed to remain level?
Answer: No.
Explanation: Premiums may increase with state approval.
19. What is a nonforfeiture benefit?
Answer: A benefit that provides reduced coverage if the policy lapses.
Explanation: Protects value after years of premium payments.
20. What role does the North Carolina Department of Insurance play in LTC policies?
Answer: Regulates policy forms, rates, and consumer protections.
Explanation: Ensures compliance with state and federal laws.
Combined Medicare Supplement & LTC Concepts
Supplement and Long-
Term Care Exam
1. What is the purpose of a Medicare Supplement (Medigap) policy?
Answer: To cover gaps in Original Medicare (Parts A and B), such as deductibles,
coinsurance, and copayments.
Explanation: Medigap does not replace Medicare; it supplements it.
2. Who is eligible to purchase a Medigap policy in North Carolina?
Answer: Individuals enrolled in Medicare Part A and Part B.
Explanation: Enrollment in both parts is required.
3. When is the Medigap Open Enrollment Period?
Answer: The six-month period starting the month an individual is 65 or older and
enrolled in Part B.
Explanation: During this period, policies are guaranteed issue.
4. Can a Medigap policy be canceled due to health conditions?
Answer: No, as long as premiums are paid on time.
Explanation: Medigap policies are guaranteed renewable.
5. Are Medigap policies standardized in North Carolina?
Answer: Yes.
Explanation: Plans are standardized by the federal government (Plans A–N).
,6. Do Medigap policies cover prescription drugs?
Answer: No.
Explanation: Prescription drug coverage is provided by Medicare Part D.
7. Which Medigap plan offers the most comprehensive coverage?
Answer: Plan G.
Explanation: Plan G covers all gaps except the Part B deductible.
8. Can an insurer require medical underwriting during open enrollment?
Answer: No.
Explanation: Health questions are prohibited during open enrollment.
9. Are Medigap premiums regulated by the state of North Carolina?
Answer: Yes.
Explanation: Rates must be approved by the North Carolina Department of
Insurance.
10. Can an individual have both Medicare Advantage and Medigap at the same time?
Answer: No.
Explanation: Medigap works only with Original Medicare.
North Carolina Long-Term Care (LTC) Insurance – Q&A
11. What does Long-Term Care insurance primarily cover?
Answer: Assistance with activities of daily living (ADLs) and cognitive impairment.
Explanation: Medical care alone does not qualify for benefits.
12. How many ADLs are typically used to determine benefit eligibility?
Answer: Six.
Explanation: Bathing, dressing, toileting, transferring, continence, and eating.
13. What is the elimination period in an LTC policy?
, Answer: The waiting period before benefits begin.
Explanation: Similar to a deductible measured in time.
14. Does Medicare pay for long-term custodial care?
Answer: No.
Explanation: Medicare covers only limited skilled care.
15. What is the purpose of inflation protection in LTC policies?
Answer: To increase benefits over time to keep pace with rising costs.
Explanation: Often required or strongly encouraged for younger applicants.
16. Can LTC benefits be paid for home care in North Carolina?
Answer: Yes.
Explanation: Modern LTC policies cover home, assisted living, and nursing care.
17. What triggers LTC policy benefits?
Answer: Inability to perform at least two ADLs or severe cognitive impairment.
Explanation: Must be certified by a licensed health professional.
18. Are LTC policy premiums guaranteed to remain level?
Answer: No.
Explanation: Premiums may increase with state approval.
19. What is a nonforfeiture benefit?
Answer: A benefit that provides reduced coverage if the policy lapses.
Explanation: Protects value after years of premium payments.
20. What role does the North Carolina Department of Insurance play in LTC policies?
Answer: Regulates policy forms, rates, and consumer protections.
Explanation: Ensures compliance with state and federal laws.
Combined Medicare Supplement & LTC Concepts
