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NORTH CAROLINA MEDICARE
SUPPLEMENT AND LONG TERM CARE
EXAMS WITH ACTUAL CORRECT
QUESTIONS AND VERIFIED DETAILED
RATIONALES ANSWERS 2024 (NEWEST)
ALREADY GRADED A+
What is a system of classifying hospital patients on the basis of diagnosis consisting of distinct
groupings?
A. Patient diagnostic system
B. Distinct grouping assignment
C. Patient classification basis
D. Diagnosis-related group
D. Diagnosis-related group
What two types of long-term care insurance policies resulted from the Health Insurance Portability and
Accountability Act?
Tax qualified and non-tax qualified
Medicare Part B covers which of the following expenses?
A. Hospital care
B. Physicians' services
C. Hospice care
D. Skilled nursing home care
B. Physicians' services
Medicare pays the remaining 80% of covered Medicare Part B charges after:
A. Premiums are paid
B. The annual deductible is met
C. The $1,000 deductible is met
D. The blood deductible is met
B. The annual deductible is met
Medicare Part A covers which of the following services?
A. Medications
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B. Hospital room and board
C. Physicians services
D. Surgical services
B. Hospital room and board
Which of the following services in NOT excluded under Medicare Part B?
A. Custodial care
B. Skilled nursing care
C. Diagnostic tests
D. Routine physical exams
C. Diagnostic tests
Premiums for Medicare Part B are based on:
.
An individual's annual earnings
Managed care companies have entered the medicare services market through the expansion of which of
the following:
A. Part A
B. Part B
C. Part C
D. Medicare supplement policies
C. Part C
A Medicare Medical Savings Account is comprised of what?
A high-deductible medicare plan and a savings account
All approved charges under Medicare Part A will be covered for ________ after the deductible has been
met?
A. For days 1 through 60
B For days 91 through 150
C. After 150 days
D. For days 61 through 90
A. For days 1 through 60
An insurance provider suggests to Jim that he purchase a second Medicare supplement policy in order to
provide coverage for all his medical costs. What describes this offer?
Illegal. The sale of a supplement that provides the client with more than one medicare supplement is
prohibited by law.
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A tax-qualified long-term care insurance policy enables policy owners deduct premiums as a medical
expense and to also do which of the following:
A. Receive unlimited benefits tax free
B. Receive limited benefits tax free
C. Receive a partial return of premium if no claim is filed within ten years
D. Receive a partial return of premium if no claim is filed within three years
B. Receive limited benefits tax free
J received the following home health services: housekeeping, shopping, custodial care and physical
therapy. Which of these services will be covered by Medicare Part A?
A. Housekeeping
B. Shopping
C. Custodial Care
D. Physical therapy
D. Physical therapy
When can individuals change from Original Medicare to Part C Medicare coverage?
During open enrollment.
The open enrollment period is Oct. 15th to Dec. 7th, with coverage beginning on Jan. 1st.
Which of the following is covered by Medicare Part C:
A. Skilled nursing facility care
B. Doctors' services
C. Occupational therapy
D. Managed care plans
D. Managed care plans
An agent's commission for the sale of a medicare supplement policy in the first year following its
effective date cannot exceed what percentage of the commission paid for servicing the policy in the
second year?
200
After being released from a week's stay in the hospital, Jim's doctor orders him into a into a skilled
nursing facility for wound care. How long will Medicare Part A cover 100% of the approved charges in
the facility?
20 days
Longer elimination periods reduce the __________
Premium amount
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S is enrolled in a group health plan that is scheduled to terminate on March 1st. When can he enroll in
Medicare Part B without having to pay the 10 percent premium surcharge?
During the eight month period following the month his group coverage ends.
G is applying for Medicare supplement Plan C. At what point must the insurer give her an outline of
coverage?
At the time of application
Long-term coverage differs from Medigap in what way?
Long-term care coverage provides custodial care
How much is the penalty for delaying in Medicare Part A or Part B beyond the initial enrollment period?
10%
Who regionally manages policy and payment related to reimbursement and payment for medicare?
Medicare Administrative Contractors
Medicare Part B supplement insurance is:
Voluntary
Individual long-term care policies are generally available to individuals between the ages of
40 and 85
Medicare Parts A and B have gaps in their coverage where subscribers must pay for their coverage.
What do these gaps include?
The Part A deductible and daily co-payments for hospitalization and nursing home care and the part B
deductible, which requires 20% coinsurance or copayments
Prescription drug coverage is covered by:
Medicare Part D
What serves as the primary point of contact for provider enrollment and Medicare coverage:
A. LCDs
B. AQOs
C. QIOs
D. MAC's
D. MAC's (Medicare Administrative Contractors)
For what type of North Carolina residents will Medicare-Aid pay for their Medicare Part B Premiums
only?
A specified low income beneficiary
NORTH CAROLINA MEDICARE
SUPPLEMENT AND LONG TERM CARE
EXAMS WITH ACTUAL CORRECT
QUESTIONS AND VERIFIED DETAILED
RATIONALES ANSWERS 2024 (NEWEST)
ALREADY GRADED A+
What is a system of classifying hospital patients on the basis of diagnosis consisting of distinct
groupings?
A. Patient diagnostic system
B. Distinct grouping assignment
C. Patient classification basis
D. Diagnosis-related group
D. Diagnosis-related group
What two types of long-term care insurance policies resulted from the Health Insurance Portability and
Accountability Act?
Tax qualified and non-tax qualified
Medicare Part B covers which of the following expenses?
A. Hospital care
B. Physicians' services
C. Hospice care
D. Skilled nursing home care
B. Physicians' services
Medicare pays the remaining 80% of covered Medicare Part B charges after:
A. Premiums are paid
B. The annual deductible is met
C. The $1,000 deductible is met
D. The blood deductible is met
B. The annual deductible is met
Medicare Part A covers which of the following services?
A. Medications
,2|Page
B. Hospital room and board
C. Physicians services
D. Surgical services
B. Hospital room and board
Which of the following services in NOT excluded under Medicare Part B?
A. Custodial care
B. Skilled nursing care
C. Diagnostic tests
D. Routine physical exams
C. Diagnostic tests
Premiums for Medicare Part B are based on:
.
An individual's annual earnings
Managed care companies have entered the medicare services market through the expansion of which of
the following:
A. Part A
B. Part B
C. Part C
D. Medicare supplement policies
C. Part C
A Medicare Medical Savings Account is comprised of what?
A high-deductible medicare plan and a savings account
All approved charges under Medicare Part A will be covered for ________ after the deductible has been
met?
A. For days 1 through 60
B For days 91 through 150
C. After 150 days
D. For days 61 through 90
A. For days 1 through 60
An insurance provider suggests to Jim that he purchase a second Medicare supplement policy in order to
provide coverage for all his medical costs. What describes this offer?
Illegal. The sale of a supplement that provides the client with more than one medicare supplement is
prohibited by law.
,3|Page
A tax-qualified long-term care insurance policy enables policy owners deduct premiums as a medical
expense and to also do which of the following:
A. Receive unlimited benefits tax free
B. Receive limited benefits tax free
C. Receive a partial return of premium if no claim is filed within ten years
D. Receive a partial return of premium if no claim is filed within three years
B. Receive limited benefits tax free
J received the following home health services: housekeeping, shopping, custodial care and physical
therapy. Which of these services will be covered by Medicare Part A?
A. Housekeeping
B. Shopping
C. Custodial Care
D. Physical therapy
D. Physical therapy
When can individuals change from Original Medicare to Part C Medicare coverage?
During open enrollment.
The open enrollment period is Oct. 15th to Dec. 7th, with coverage beginning on Jan. 1st.
Which of the following is covered by Medicare Part C:
A. Skilled nursing facility care
B. Doctors' services
C. Occupational therapy
D. Managed care plans
D. Managed care plans
An agent's commission for the sale of a medicare supplement policy in the first year following its
effective date cannot exceed what percentage of the commission paid for servicing the policy in the
second year?
200
After being released from a week's stay in the hospital, Jim's doctor orders him into a into a skilled
nursing facility for wound care. How long will Medicare Part A cover 100% of the approved charges in
the facility?
20 days
Longer elimination periods reduce the __________
Premium amount
, 4|Page
S is enrolled in a group health plan that is scheduled to terminate on March 1st. When can he enroll in
Medicare Part B without having to pay the 10 percent premium surcharge?
During the eight month period following the month his group coverage ends.
G is applying for Medicare supplement Plan C. At what point must the insurer give her an outline of
coverage?
At the time of application
Long-term coverage differs from Medigap in what way?
Long-term care coverage provides custodial care
How much is the penalty for delaying in Medicare Part A or Part B beyond the initial enrollment period?
10%
Who regionally manages policy and payment related to reimbursement and payment for medicare?
Medicare Administrative Contractors
Medicare Part B supplement insurance is:
Voluntary
Individual long-term care policies are generally available to individuals between the ages of
40 and 85
Medicare Parts A and B have gaps in their coverage where subscribers must pay for their coverage.
What do these gaps include?
The Part A deductible and daily co-payments for hospitalization and nursing home care and the part B
deductible, which requires 20% coinsurance or copayments
Prescription drug coverage is covered by:
Medicare Part D
What serves as the primary point of contact for provider enrollment and Medicare coverage:
A. LCDs
B. AQOs
C. QIOs
D. MAC's
D. MAC's (Medicare Administrative Contractors)
For what type of North Carolina residents will Medicare-Aid pay for their Medicare Part B Premiums
only?
A specified low income beneficiary
