NORTH CAROLINA MEDICARE
SUPPLEMENT AND LONG-TERM CARE
EXAM 2025 QUESTIONS AND ANSWERS
An individual who is not eligible for premium-free Medicare Part A coverage may apply for
coverage during which of the following enrollment periods?
A. All of the above
B. Initial enrollment period
C. General enrollment period
D. Special enrollment period - ANS A. All of the above
Medicare makes what payment for services in which another payer may be responsible:
A. Conditional payment
B. Interim payment
C. Transitional payment
D. Temporary payment - ANS A. Conditional payment
Insurers must offer inflation protection in which of the following policies?
A. Medicare Part C
B. Medigap
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,C. Long-Term Care
D. Medicaid - ANS C. Long-Term Care
What program safeguards against unnecessary and inappropriate medical care rendered to
Medicaid recipients?
A. Medicaid review program
B. Utilization renew program
C. Quality improvement organization
D. Utilization review program - ANS D. Utilization review program
Which of the following is not a requirement for long-term care plans?
A. The individual must be unable to perform at least two ADLs
B. Inflation protection must be provided
C. Policies must accrue cash value
D. Coveraged cannot reimburse insureds for medical expenses or services covered by Medicare.
- ANS C. Policies must accrue cash value.
Which entity handles claims from hospitals, skilled nursing facilities, home health agencies and
hospices?
A. Carrier
B. Intermediary
C. Quality Improvement Organization
D. Utilization Review Committee - ANS B. Intermediary
What is the term for private organizations that administer Medicare Part B benefits?
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, A. Carriers
B. Medical Providers
C. Intermediaries
D. Peer review organizations - ANS A. Carriers
All of the following are requirements for long-term care and medigap policy except:
A. The agent must provide the applicant with a notice regarding replacement
B. The notice regarding replacement must contain the free look period
C. The notice regarding replacement explains the replacing coverage in comparison to the
existing coverage
D. A 60-day free look period must be provided - ANS D. A 60-day free look period must be
provided.
Which of the following is not an optional benefit provided by long-term care policies?
A. Inflation protection
B. Guaranteed insurability
C. Nonforfeiture options
D. Guaranteed renewable or noncancelable - ANS D. Guaranteed renewable or
noncancelable
All of the following are required to qualify for Medicare's nursing facility benefit except:
A. The patient must spend at least three days in a hospital within 30 past days
B. The patient must meet stated income limits
C. The patient's physician must certify that skilled care is required
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SUPPLEMENT AND LONG-TERM CARE
EXAM 2025 QUESTIONS AND ANSWERS
An individual who is not eligible for premium-free Medicare Part A coverage may apply for
coverage during which of the following enrollment periods?
A. All of the above
B. Initial enrollment period
C. General enrollment period
D. Special enrollment period - ANS A. All of the above
Medicare makes what payment for services in which another payer may be responsible:
A. Conditional payment
B. Interim payment
C. Transitional payment
D. Temporary payment - ANS A. Conditional payment
Insurers must offer inflation protection in which of the following policies?
A. Medicare Part C
B. Medigap
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,C. Long-Term Care
D. Medicaid - ANS C. Long-Term Care
What program safeguards against unnecessary and inappropriate medical care rendered to
Medicaid recipients?
A. Medicaid review program
B. Utilization renew program
C. Quality improvement organization
D. Utilization review program - ANS D. Utilization review program
Which of the following is not a requirement for long-term care plans?
A. The individual must be unable to perform at least two ADLs
B. Inflation protection must be provided
C. Policies must accrue cash value
D. Coveraged cannot reimburse insureds for medical expenses or services covered by Medicare.
- ANS C. Policies must accrue cash value.
Which entity handles claims from hospitals, skilled nursing facilities, home health agencies and
hospices?
A. Carrier
B. Intermediary
C. Quality Improvement Organization
D. Utilization Review Committee - ANS B. Intermediary
What is the term for private organizations that administer Medicare Part B benefits?
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, A. Carriers
B. Medical Providers
C. Intermediaries
D. Peer review organizations - ANS A. Carriers
All of the following are requirements for long-term care and medigap policy except:
A. The agent must provide the applicant with a notice regarding replacement
B. The notice regarding replacement must contain the free look period
C. The notice regarding replacement explains the replacing coverage in comparison to the
existing coverage
D. A 60-day free look period must be provided - ANS D. A 60-day free look period must be
provided.
Which of the following is not an optional benefit provided by long-term care policies?
A. Inflation protection
B. Guaranteed insurability
C. Nonforfeiture options
D. Guaranteed renewable or noncancelable - ANS D. Guaranteed renewable or
noncancelable
All of the following are required to qualify for Medicare's nursing facility benefit except:
A. The patient must spend at least three days in a hospital within 30 past days
B. The patient must meet stated income limits
C. The patient's physician must certify that skilled care is required
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