NC Medicare Supplement & Long-Term Care Insurance Licensing Exam
Questions with Complete 100% Verified Solutions (2026/2027 update) |A+
Graded.
Medicaid Lookback on Asset Transfers - answer ---Medicaid has a look-back period of 60 months for
asset transfers when entering a nursing home (gifts to loved ones)
--The following transfers can be made without causing a period of Medicaid ineligibility:
---Transfer to a spouse ($119,200)
---Transfer to a child who is blind or disabled
---Transfer in trust for the benefit of a person under age 65 and disabled
---Transfer of a home to a child under the age of 21 or a child who has lived in the home for at least two
years before the applicant moved to a nursing home and provided care that enabled the applicant to stay
in the home during that time
---Transfer of a home to a sibling who has an equity interest in it and who lived in it at least a year before
the applicant moved to a nursing home
--If nursing home is $5,000/month and transferred $50,000 then $50,000/$5,000 = 10 months
ineligibility
-Recovery from the decedent's estate - assets that were exempt during the individual's lifetime, such as a
home or a car, are subject to the estate recovery
Spousal Impoverishment Protection - answer -The community spouse (noninstitutionalized) may retain a
sufficient amount of resources to stay above the federal poverty line.
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,Dual eligible - answer -an individual who is entitled to Medicare Part A and/or Part B, and also eligible for
some form of Medicaid benefit.
QMB-Qualified Medicare Beneficiary - answer -Will pay Medicare premiums, deductibles, copays and
coinsurance amountsfor beneficiaries who meet low-income, low-asset eligibility criteria.
-Does NOT cover excess charges from non participating doctor
SLMB - Specified Low Income Medicare Beneficiary - answer -Higher income lever than QMB
-Will pay Medicare part B premiums only.
2 Levels of Medicaid - answer -QMB
SLMB
Outline of Coverage for LTC Policy - answer -Must be provided upon delivery of policy
Must be in at least 10 point print
LTC Loss Ratios - answer -60% for individual
75% for group
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, Medicare - answer -Health insurance for those over age 65, people under 65 with certain disabilities &
those with ESRD (end stage renal disease - permanent kidney failure requiring dialysis or kidney
transplant)
CMS - answer -Centers for Medicare and Medicaid Services administers the Medicare program. Social
Security Administration handles most of the enrollment & plays a role in claims appeal process.
MAC - answer -Medicare Administrative Contractor - company contracted to administer Part A & Part B
claims.
Medicare Part A - answer --hospital coverage
-no premium requirements for those with 40 "work credits" of FICA or Self Employment tax credits.
-Those who don't qualify can voluntarily participate by paying a monthly premium
Medicare Part B - answer -The part of the Medicare program that pays for physician services, outpatient
hospital services, durable medical equipment, and other services and supplies.
-Has a monthly premium of $135.50 in 2019 which is deducted from SS check.
-Part B enrollment is optional. You can reject Part B by signing a rejection form.
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Questions with Complete 100% Verified Solutions (2026/2027 update) |A+
Graded.
Medicaid Lookback on Asset Transfers - answer ---Medicaid has a look-back period of 60 months for
asset transfers when entering a nursing home (gifts to loved ones)
--The following transfers can be made without causing a period of Medicaid ineligibility:
---Transfer to a spouse ($119,200)
---Transfer to a child who is blind or disabled
---Transfer in trust for the benefit of a person under age 65 and disabled
---Transfer of a home to a child under the age of 21 or a child who has lived in the home for at least two
years before the applicant moved to a nursing home and provided care that enabled the applicant to stay
in the home during that time
---Transfer of a home to a sibling who has an equity interest in it and who lived in it at least a year before
the applicant moved to a nursing home
--If nursing home is $5,000/month and transferred $50,000 then $50,000/$5,000 = 10 months
ineligibility
-Recovery from the decedent's estate - assets that were exempt during the individual's lifetime, such as a
home or a car, are subject to the estate recovery
Spousal Impoverishment Protection - answer -The community spouse (noninstitutionalized) may retain a
sufficient amount of resources to stay above the federal poverty line.
1|Page
,Dual eligible - answer -an individual who is entitled to Medicare Part A and/or Part B, and also eligible for
some form of Medicaid benefit.
QMB-Qualified Medicare Beneficiary - answer -Will pay Medicare premiums, deductibles, copays and
coinsurance amountsfor beneficiaries who meet low-income, low-asset eligibility criteria.
-Does NOT cover excess charges from non participating doctor
SLMB - Specified Low Income Medicare Beneficiary - answer -Higher income lever than QMB
-Will pay Medicare part B premiums only.
2 Levels of Medicaid - answer -QMB
SLMB
Outline of Coverage for LTC Policy - answer -Must be provided upon delivery of policy
Must be in at least 10 point print
LTC Loss Ratios - answer -60% for individual
75% for group
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, Medicare - answer -Health insurance for those over age 65, people under 65 with certain disabilities &
those with ESRD (end stage renal disease - permanent kidney failure requiring dialysis or kidney
transplant)
CMS - answer -Centers for Medicare and Medicaid Services administers the Medicare program. Social
Security Administration handles most of the enrollment & plays a role in claims appeal process.
MAC - answer -Medicare Administrative Contractor - company contracted to administer Part A & Part B
claims.
Medicare Part A - answer --hospital coverage
-no premium requirements for those with 40 "work credits" of FICA or Self Employment tax credits.
-Those who don't qualify can voluntarily participate by paying a monthly premium
Medicare Part B - answer -The part of the Medicare program that pays for physician services, outpatient
hospital services, durable medical equipment, and other services and supplies.
-Has a monthly premium of $135.50 in 2019 which is deducted from SS check.
-Part B enrollment is optional. You can reject Part B by signing a rejection form.
3|Page
