NORTH CAROLINA MEDICARE SUPPLEMENT AND LONGTERM CARE
TEST PAPER 2025 QUESTIONS WITH SOLUTIONS RATED A+
✔✔Policy Termination - ✔✔Ongoing claims remain unaffected by policy termination.
✔✔Disclosure Requirement - ✔✔Insurers must inform clients about non-Medigap
policies.
✔✔Twisting - ✔✔Misleading practices to switch insurance policies.
✔✔High-pressure Tactics - ✔✔Forceful methods to sell insurance policies.
✔✔Cold Lead Advertising - ✔✔Marketing without disclosing insurance solicitation
purpose.
✔✔Misrepresentation - ✔✔False statements about insurance policy facts.
✔✔Insurance Producers - ✔✔Agents who sell insurance policies to consumers.
✔✔Notice Regarding Replacement - ✔✔Document provided when replacing an existing
policy.
✔✔Beneficiary Limitations - ✔✔Individuals can only hold one Medigap policy.
✔✔Marketing Standards - ✔✔Guidelines for ethical insurance marketing practices.
✔✔Claims Payment - ✔✔Ongoing claims paid regardless of policy status.
✔✔Qualified Applicants - ✔✔Individuals eligible for Medicare Supplement coverage.
✔✔Continuous Creditable Coverage - ✔✔Coverage maintained for six months before
application.
✔✔Genetic Information Discrimination - ✔✔Insurers cannot deny coverage based on
genetic data.
✔✔Family Genetic Condition - ✔✔One family member's condition isn't genetic info for
others.
✔✔Medicare Supplement Insurer Restrictions - ✔✔Cannot require genetic testing for
individuals or families.
✔✔Long-Term Care Services - ✔✔Includes diagnostic, preventive, and rehabilitative
services.
, ✔✔Maintenance Care Services - ✔✔Personal care services included in long-term care.
✔✔Commissioner Policy Modification - ✔✔Can modify LTC policy for insured's best
interest.
✔✔Innovative LTC Approaches - ✔✔Modification needed for reasonable insurance
approaches.
✔✔Continuing Care Facility Policies - ✔✔Special provisions for residents of care
facilities.
✔✔LTC Insurance Definition - ✔✔Insurance for restoring health and maintaining
independence.
✔✔Covered LTC Services - ✔✔Includes daily living assistance and home health care.
✔✔Minimum Coverage Duration - ✔✔Policies must provide at least 12 months
coverage.
✔✔LTCI Product Inclusion - ✔✔Includes life insurance with long-term care riders.
✔✔Excluded LTC Policies - ✔✔Medical expense and disability insurance are excluded.
✔✔Institutionalization Benefit Condition - ✔✔No policy can condition benefits on prior
institutionalization.
✔✔Home Health Care Requirement - ✔✔Facility-only policies must also cover home
care.
✔✔Levels of Nursing Care - ✔✔Covers skilled, intermediate, and custodial nursing
care.
✔✔Activities of Daily Living - ✔✔Includes bathing, dressing, toileting, transferring,
continence, eating.
✔✔Bathing Definition - ✔✔Washing oneself using sponge bath, bath, or shower.
✔✔Dressing Definition - ✔✔Putting on and taking off clothes and braces.
✔✔Toileting Definition - ✔✔Getting to/from toilet and performing hygiene tasks.
✔✔Transferring Definition - ✔✔Moving into/out of bed, chair, or wheelchair.
TEST PAPER 2025 QUESTIONS WITH SOLUTIONS RATED A+
✔✔Policy Termination - ✔✔Ongoing claims remain unaffected by policy termination.
✔✔Disclosure Requirement - ✔✔Insurers must inform clients about non-Medigap
policies.
✔✔Twisting - ✔✔Misleading practices to switch insurance policies.
✔✔High-pressure Tactics - ✔✔Forceful methods to sell insurance policies.
✔✔Cold Lead Advertising - ✔✔Marketing without disclosing insurance solicitation
purpose.
✔✔Misrepresentation - ✔✔False statements about insurance policy facts.
✔✔Insurance Producers - ✔✔Agents who sell insurance policies to consumers.
✔✔Notice Regarding Replacement - ✔✔Document provided when replacing an existing
policy.
✔✔Beneficiary Limitations - ✔✔Individuals can only hold one Medigap policy.
✔✔Marketing Standards - ✔✔Guidelines for ethical insurance marketing practices.
✔✔Claims Payment - ✔✔Ongoing claims paid regardless of policy status.
✔✔Qualified Applicants - ✔✔Individuals eligible for Medicare Supplement coverage.
✔✔Continuous Creditable Coverage - ✔✔Coverage maintained for six months before
application.
✔✔Genetic Information Discrimination - ✔✔Insurers cannot deny coverage based on
genetic data.
✔✔Family Genetic Condition - ✔✔One family member's condition isn't genetic info for
others.
✔✔Medicare Supplement Insurer Restrictions - ✔✔Cannot require genetic testing for
individuals or families.
✔✔Long-Term Care Services - ✔✔Includes diagnostic, preventive, and rehabilitative
services.
, ✔✔Maintenance Care Services - ✔✔Personal care services included in long-term care.
✔✔Commissioner Policy Modification - ✔✔Can modify LTC policy for insured's best
interest.
✔✔Innovative LTC Approaches - ✔✔Modification needed for reasonable insurance
approaches.
✔✔Continuing Care Facility Policies - ✔✔Special provisions for residents of care
facilities.
✔✔LTC Insurance Definition - ✔✔Insurance for restoring health and maintaining
independence.
✔✔Covered LTC Services - ✔✔Includes daily living assistance and home health care.
✔✔Minimum Coverage Duration - ✔✔Policies must provide at least 12 months
coverage.
✔✔LTCI Product Inclusion - ✔✔Includes life insurance with long-term care riders.
✔✔Excluded LTC Policies - ✔✔Medical expense and disability insurance are excluded.
✔✔Institutionalization Benefit Condition - ✔✔No policy can condition benefits on prior
institutionalization.
✔✔Home Health Care Requirement - ✔✔Facility-only policies must also cover home
care.
✔✔Levels of Nursing Care - ✔✔Covers skilled, intermediate, and custodial nursing
care.
✔✔Activities of Daily Living - ✔✔Includes bathing, dressing, toileting, transferring,
continence, eating.
✔✔Bathing Definition - ✔✔Washing oneself using sponge bath, bath, or shower.
✔✔Dressing Definition - ✔✔Putting on and taking off clothes and braces.
✔✔Toileting Definition - ✔✔Getting to/from toilet and performing hygiene tasks.
✔✔Transferring Definition - ✔✔Moving into/out of bed, chair, or wheelchair.
