1
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NC Medicare Supplement & Long Term
Care Insurance Licensing Questions and
Answers (100% Correct Answers) Already
Graded A+
Medicare [ANS:] 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
© 2025 Assignment Expert
transplant)
CMS [ANS:] Centers for Medicare and Medicaid Services
administers the Medicare program. Social Security Administration
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handles most of the enrollment & plays a role in claims appeal
process.
MAC [ANS:] Medicare Administrative Contractor - company
contracted to administer Part A & Part B claims.
Medicare Part A [ANS:] -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 [ANS:] 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.
, 2
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-Part B enrollment is optional. You can reject Part B by signing a
rejection form.
Medicare Part C [ANS:] Medicare Advantage Plans that are
offered through private insurance companies that provide both
hospital and physician coverage and possible prescriptions -
financed by Social Security and monthly premiums
Medicare Eligibility [ANS:] -Over age 65 who have earned 40 "work
credits" in order to receive premium free part A benefits
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-Permanently disabled prior to age 65 for at least 24 months
-ESRD or kidney disease requiring dialysis or kidney transplant
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Medicare enrollment requirements [ANS:] Part A & B are
automatically conducted by SSA when individual age 65+ enrolls
for their Social Security retirement benefits
Initial Enrollment Period [ANS:] 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 [ANS:] Medicare enrollment period -
January 1st through March 31st annually.
-Coverage begins July 1st of that year
, 3
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-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 [ANS:] 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 [ANS:] -Medicare is the
secondary payer for the 'working aged' who has a group health
plan if the group has 20+ enrollees
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-For single employer with <20 employees with a group health plan,
Medicare is the primary payer.
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-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 [ANS:] -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 [ANS:] 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 [ANS:] -Purely custodial care/
chronic care
For Expert help and assignment solutions, +254707240657
NC Medicare Supplement & Long Term
Care Insurance Licensing Questions and
Answers (100% Correct Answers) Already
Graded A+
Medicare [ANS:] 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
© 2025 Assignment Expert
transplant)
CMS [ANS:] Centers for Medicare and Medicaid Services
administers the Medicare program. Social Security Administration
Guru01 - Stuvia
handles most of the enrollment & plays a role in claims appeal
process.
MAC [ANS:] Medicare Administrative Contractor - company
contracted to administer Part A & Part B claims.
Medicare Part A [ANS:] -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 [ANS:] 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.
, 2
For Expert help and assignment solutions, +254707240657
-Part B enrollment is optional. You can reject Part B by signing a
rejection form.
Medicare Part C [ANS:] Medicare Advantage Plans that are
offered through private insurance companies that provide both
hospital and physician coverage and possible prescriptions -
financed by Social Security and monthly premiums
Medicare Eligibility [ANS:] -Over age 65 who have earned 40 "work
credits" in order to receive premium free part A benefits
© 2025 Assignment Expert
-Permanently disabled prior to age 65 for at least 24 months
-ESRD or kidney disease requiring dialysis or kidney transplant
Guru01 - Stuvia
Medicare enrollment requirements [ANS:] Part A & B are
automatically conducted by SSA when individual age 65+ enrolls
for their Social Security retirement benefits
Initial Enrollment Period [ANS:] 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 [ANS:] Medicare enrollment period -
January 1st through March 31st annually.
-Coverage begins July 1st of that year
, 3
For Expert help and assignment solutions, +254707240657
-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 [ANS:] 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 [ANS:] -Medicare is the
secondary payer for the 'working aged' who has a group health
plan if the group has 20+ enrollees
© 2025 Assignment Expert
-For single employer with <20 employees with a group health plan,
Medicare is the primary payer.
Guru01 - Stuvia
-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 [ANS:] -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 [ANS:] 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 [ANS:] -Purely custodial care/
chronic care
