NC MEDICARE SUPPLEMENT AND LONG-TERM CARE
CERTIFICATION 2025/2026 EXAM QUESTIONS - 90
Questions and Answers Already Graded A+ Premium Exam
Tested And Verified
Subject Area Medicare Supplement and Long-Term Care Insurance
Description This rigorous examination assesses mastery of Medicare Supplement (Medigap)
and Long-Term Care (LTC) insurance principles, including federal and North
Carolina regulations, policy provisions, underwriting, claims, and ethical
standards. It requires integration of actuarial concepts, legal frameworks, and
consumer protections.
Expected Grade A+
Total Questions 90
Duration 3 hours
Learning Outcomes 1. Analyze Medigap plan types and their standardized benefits.
2. Evaluate LTC insurance policy features and inflation protection.
3. Interpret North Carolina-specific regulations and consumer protections.
4. Apply ethical and suitability standards in sales and claims.
5. Differentiate Medicare Advantage, Medigap, and LTC coordination.
Accreditation Meets North Carolina Department of Insurance certification standards for
Medicare Supplement and Long-Term Care insurance producers.
Page 1
,1. A beneficiary is enrolled in Original Medicare Part A and Part B and wishes to
purchase a Medicare Supplement (Medigap) policy. The insurer issues the policy
with a pre-existing condition waiting period. Under federal law, which of the
following conditions must be met to reduce or eliminate the waiting period?
A. The beneficiary must have had at least 6 months of continuous prior creditable coverage,
and the waiting period is reduced by the length of that coverage.
B. The waiting period is automatically waived if the beneficiary applies within 6 months of
first enrolling in Part B.
C. The waiting period cannot exceed 3 months for any condition, regardless of prior
coverage.
D. The waiting period applies only to conditions not disclosed on the application; disclosed
conditions are covered immediately.
Answer: A. The beneficiary must have had at least 6 months of continuous prior
creditable coverage, and the waiting period is reduced by the length of that
coverage.
Under the Health Insurance Portability and Accountability Act (HIPAA), creditable
coverage reduces the pre-existing condition waiting period. Option A correctly states
that the waiting period is reduced by the length of prior creditable coverage. Option B
is incorrect because the open enrollment period guarantees issue but does not waive the
waiting period. Option C is false; the maximum waiting period is 6 months. Option D is
false; the waiting period applies to all pre-existing conditions regardless of disclosure.
2. An insurer is designing a Long-Term Care insurance policy for the North Carolina
market. To comply with the state's partnership program requirements, the policy
must include which of the following features?
A. A 5% compound annual inflation benefit rider for all policyholders.
B. A provision that the policy's benefits are automatically adjusted for inflation at a rate
equal to the Consumer Price Index (CPI).
C. A guarantee that the policyholder's assets are disregarded for Medicaid eligibility up to
the amount of benefits paid.
D. A requirement that the policy covers at least 5 years of skilled nursing facility care.
Answer: C. A guarantee that the policyholder's assets are disregarded for
Medicaid eligibility up to the amount of benefits paid.
North Carolina's Long-Term Care Partnership Program requires that policies include
asset disregard equal to the amount of benefits paid. This allows policyholders to
protect assets for Medicaid eligibility. Option A is incorrect because compound
inflation riders are not mandatory for all policies. Option B is incorrect; inflation
adjustment options vary. Option D is incorrect; there is no minimum coverage duration
requirement for partnership policies.
Page 2
,3. A Medigap policyholder has Plan F (issued before 2020) and is hospitalized for 15
days. Medicare Part A covers days 1-60 after the deductible. The policyholder
receives a hospital bill for the Part A inpatient hospital deductible for 2025. Which
of the following correctly describes Medigap Plan F's coverage of this deductible?
A. Plan F pays the Part A deductible in full, as it covers all Medicare cost-sharing.
B. Plan F pays 80% of the Part A deductible after the policyholder meets the Part B
deductible.
C. Plan F does not cover the Part A deductible because it was eliminated for new policies
after 2020.
D. Plan F covers the Part A deductible only if the policyholder has met the annual
out-of-pocket limit.
Answer: A. Plan F pays the Part A deductible in full, as it covers all Medicare
cost-sharing.
Medigap Plan F (issued before 2020) covers the Part A inpatient hospital deductible, as
well as all other Medicare cost-sharing. Option A is correct. Option B is incorrect
because Plan F covers 100% of the deductible. Option C is incorrect; the deductible still
exists and Plan F covers it. Option D is incorrect; there is no out-of-pocket limit for
Plan F.
Page 3
, 4. An insurance producer is counseling a client who is eligible for Medicare due to
disability. The client has been on Social Security Disability Insurance (SSDI) for 24
months and is now enrolling in Medicare Part B. The client wants to purchase a
Medigap policy. Under federal law, what is the client's Medigap open enrollment
period?
A. The open enrollment period begins when the client first enrolls in Part B and lasts for 6
months.
B. The open enrollment period begins when the client's SSDI benefits start and lasts for 12
months.
C. The client has a one-time 63-day open enrollment period after Medicare Part A and Part B
are effective.
D. There is no open enrollment period for disabled beneficiaries; they must rely on
guaranteed issue rights.
Answer: A. The open enrollment period begins when the client first enrolls in Part
B and lasts for 6 months.
For beneficiaries under 65, the Medigap open enrollment period begins when they first
enroll in Part B and lasts for 6 months. Option A is correct. Option B is incorrect
because the period starts with Part B enrollment, not SSDI. Option C is incorrect; the
period is 6 months, not 63 days. Option D is incorrect; disabled beneficiaries have the
same open enrollment rights as those 65 and older.
Page 4
CERTIFICATION 2025/2026 EXAM QUESTIONS - 90
Questions and Answers Already Graded A+ Premium Exam
Tested And Verified
Subject Area Medicare Supplement and Long-Term Care Insurance
Description This rigorous examination assesses mastery of Medicare Supplement (Medigap)
and Long-Term Care (LTC) insurance principles, including federal and North
Carolina regulations, policy provisions, underwriting, claims, and ethical
standards. It requires integration of actuarial concepts, legal frameworks, and
consumer protections.
Expected Grade A+
Total Questions 90
Duration 3 hours
Learning Outcomes 1. Analyze Medigap plan types and their standardized benefits.
2. Evaluate LTC insurance policy features and inflation protection.
3. Interpret North Carolina-specific regulations and consumer protections.
4. Apply ethical and suitability standards in sales and claims.
5. Differentiate Medicare Advantage, Medigap, and LTC coordination.
Accreditation Meets North Carolina Department of Insurance certification standards for
Medicare Supplement and Long-Term Care insurance producers.
Page 1
,1. A beneficiary is enrolled in Original Medicare Part A and Part B and wishes to
purchase a Medicare Supplement (Medigap) policy. The insurer issues the policy
with a pre-existing condition waiting period. Under federal law, which of the
following conditions must be met to reduce or eliminate the waiting period?
A. The beneficiary must have had at least 6 months of continuous prior creditable coverage,
and the waiting period is reduced by the length of that coverage.
B. The waiting period is automatically waived if the beneficiary applies within 6 months of
first enrolling in Part B.
C. The waiting period cannot exceed 3 months for any condition, regardless of prior
coverage.
D. The waiting period applies only to conditions not disclosed on the application; disclosed
conditions are covered immediately.
Answer: A. The beneficiary must have had at least 6 months of continuous prior
creditable coverage, and the waiting period is reduced by the length of that
coverage.
Under the Health Insurance Portability and Accountability Act (HIPAA), creditable
coverage reduces the pre-existing condition waiting period. Option A correctly states
that the waiting period is reduced by the length of prior creditable coverage. Option B
is incorrect because the open enrollment period guarantees issue but does not waive the
waiting period. Option C is false; the maximum waiting period is 6 months. Option D is
false; the waiting period applies to all pre-existing conditions regardless of disclosure.
2. An insurer is designing a Long-Term Care insurance policy for the North Carolina
market. To comply with the state's partnership program requirements, the policy
must include which of the following features?
A. A 5% compound annual inflation benefit rider for all policyholders.
B. A provision that the policy's benefits are automatically adjusted for inflation at a rate
equal to the Consumer Price Index (CPI).
C. A guarantee that the policyholder's assets are disregarded for Medicaid eligibility up to
the amount of benefits paid.
D. A requirement that the policy covers at least 5 years of skilled nursing facility care.
Answer: C. A guarantee that the policyholder's assets are disregarded for
Medicaid eligibility up to the amount of benefits paid.
North Carolina's Long-Term Care Partnership Program requires that policies include
asset disregard equal to the amount of benefits paid. This allows policyholders to
protect assets for Medicaid eligibility. Option A is incorrect because compound
inflation riders are not mandatory for all policies. Option B is incorrect; inflation
adjustment options vary. Option D is incorrect; there is no minimum coverage duration
requirement for partnership policies.
Page 2
,3. A Medigap policyholder has Plan F (issued before 2020) and is hospitalized for 15
days. Medicare Part A covers days 1-60 after the deductible. The policyholder
receives a hospital bill for the Part A inpatient hospital deductible for 2025. Which
of the following correctly describes Medigap Plan F's coverage of this deductible?
A. Plan F pays the Part A deductible in full, as it covers all Medicare cost-sharing.
B. Plan F pays 80% of the Part A deductible after the policyholder meets the Part B
deductible.
C. Plan F does not cover the Part A deductible because it was eliminated for new policies
after 2020.
D. Plan F covers the Part A deductible only if the policyholder has met the annual
out-of-pocket limit.
Answer: A. Plan F pays the Part A deductible in full, as it covers all Medicare
cost-sharing.
Medigap Plan F (issued before 2020) covers the Part A inpatient hospital deductible, as
well as all other Medicare cost-sharing. Option A is correct. Option B is incorrect
because Plan F covers 100% of the deductible. Option C is incorrect; the deductible still
exists and Plan F covers it. Option D is incorrect; there is no out-of-pocket limit for
Plan F.
Page 3
, 4. An insurance producer is counseling a client who is eligible for Medicare due to
disability. The client has been on Social Security Disability Insurance (SSDI) for 24
months and is now enrolling in Medicare Part B. The client wants to purchase a
Medigap policy. Under federal law, what is the client's Medigap open enrollment
period?
A. The open enrollment period begins when the client first enrolls in Part B and lasts for 6
months.
B. The open enrollment period begins when the client's SSDI benefits start and lasts for 12
months.
C. The client has a one-time 63-day open enrollment period after Medicare Part A and Part B
are effective.
D. There is no open enrollment period for disabled beneficiaries; they must rely on
guaranteed issue rights.
Answer: A. The open enrollment period begins when the client first enrolls in Part
B and lasts for 6 months.
For beneficiaries under 65, the Medigap open enrollment period begins when they first
enroll in Part B and lasts for 6 months. Option A is correct. Option B is incorrect
because the period starts with Part B enrollment, not SSDI. Option C is incorrect; the
period is 6 months, not 63 days. Option D is incorrect; disabled beneficiaries have the
same open enrollment rights as those 65 and older.
Page 4
