NC Medicare Supplement & Long Term Care Insurance Licensing | Complete Study Guide Questions & Verified 2026 | 2027 (Latest Update Rated A+)

NC Medicare Supplement & Long Term Care Insurance Licensing | Complete Study Guide Questions & Verified 2026 | 2027 (Latest Update Rated A+) Quiz_________________? --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 t - ANSWER Medicaid Lookback on Asset Transfers Quiz_________________? -"Outline of Coverage" must be provided at time of application & a signed acknowledgement of receipt from applicant must be collected. -Must include renewal or continuation provision on first page -Riders added after issuance that affects policy coverage & premium must have a signed acceptance from insured -"Reasonable & Customary" must define the term & explained in outline of coverage. -ALL supplement policies MUST have a 30 Day Free Look Period -All applicant must be provided a NC Buyer's Guide from NAIC AND a Medicare Supplement Buyer's Guide from CMS at time of application. - ANSWER Med Supp Disclosure Provisions Quiz_________________? -acute inpatient hospital care -inpatient skilled nursing care -medically necessary home health care & hospice services - ANSWER Medicare Part A covers Quiz_________________? -adult day care services -hospice care -bed reservation - ANSWER Other possible benefits in LTC policy Quiz_________________? -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policies -Agents shall list any other health policies they've sold to applicant within the last 5 years that are no longer active.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. - ANSWER Med Supp Application & Replacement Quiz_________________? -Comparisons of policies will be fair & accurate -Avoid sale or issuance of excessive insurance. Do they have A&H? -On first page "Notice to buyer: This policy may not cover all your medical expenses" -High pressure tactics are prohibited. -Twisting is prohibited -Cold lead advertising is prohibited -All ads must be submitted to Commissioner for approval at least 90 days prior to use. -On or before March 1st, ea insurer must report policy #s & issue dates for each state resident that has duplicate med supp policies - ANSWER Marketing Standards for Med Supp Quiz_________________? -Deductible must be met for ea. benefit period -Benefit period ends 60 days after discharge -Deductible is $1364 plus need to pay/ replace first 3 pts of blood per calendar year. - ANSWER Medicare Deductible Quiz_________________? -Eating without assistance -Toileting without assistance -Bathing without assistance -Dressing without assistance -Transferring without assistance (from bed to chair) -Continence (maintaining control of bladder & bowel function) - ANSWER ADL's Monitored for impairment Quiz_________________? -Full time nursing services -Drugs & biologicals (covered under part D) -Homemaker & shopping services -Meal prep or delivery -Blood transfusions -Assistance with ADLs (Activities of Daily Living) - ANSWER Home Health Care will NOT cover Quiz_________________? -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 - ANSWER Medicare Part A Quiz_________________? -Hospital stays 150 days for first benefit period or no longer than 90 days after using up lifetime reserve -Private rooms unless medically necessary -Physician's or surgeon's fees (Medicare Part B) -Luxury or convenience items rented from hospital -Private duty nursing -Tests or exams conducted/ billed by 3rd party or similar hospital charges incurred on outpatient basis. -Inpatient psych care of 190 days during lifetime - ANSWER Medicare Part A does not cover Quiz_________________? -Hospitalization is prescribed by a physician to treat acute illness or accident -Level of care care only be received as an inpatient. -Facility must be certified by CMS & licensed by state -Utilization Review Committee must certify that treatment given in medically necessary before claim is submitted. - ANSWER Inpatient Medicare Benefits Quiz_________________? -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. - ANSWER Medicare as a secondary payer Quiz_________________? -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 - ANSWER Medicare Part D Enrollment