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NC MEDICARE SUPPLEMENT & LONG TERM CARE INSURANCE LICENSING QUESTIONS WITH COMPLETE ANSWERS

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NC MEDICARE SUPPLEMENT & LONG TERM CARE INSURANCE LICENSING QUESTIONS WITH COMPLETE ANSWERS

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MAC


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Medicare Administrative Contractor - company contracted to administer
Part A & Part B claims.




Medicare Part D Enrollment

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-Initial Enrollment Period- can enroll without penalty
-Open Enrollment/ Annual Election Period- Oct 15th to Dec 7th- coverage
begins Jan 1 of following year
-Late Enrollment- Any time after initial enrollment or a period of 63+ days
where doesn't have Part D coverage. There's a penalty of +1% Part D
premium for ea month of delay in enrollment




QMB-Qualified Medicare Beneficiary


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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




Med Supp Application & Replacement


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, -Both applicant & agent must sign application containing terms designed to
disclose duplicate or replacement policies
-Agents shall list any other health policies they've sold to applicant within
the last 5 years that are no longer active.
-If replacement, "Notice Regarding Replacement of Medicare Supplement
Insurance" must be signed by both agent & applicant with each retaining a
copy.
-Insurer must waive time periods if already fulfilled under original policy.
e.g. probationary periods, etc...
-Individual cannot have more than 1 such policy. Illegal for agent to sell a
Medigap to someone who has Medicare Advantage unless switching to
original Medicare.




Other possible benefits in LTC policy


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-adult day care services
-hospice care
-bed reservation




Medicare Supplement - minimum standards


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