North Carolina Medicare Supplement and Long-
Term Care Insurance Exam | Complete Actual
Exam Study Guide with Verified Questions and
Correct Answers (Rationales Included) | Latest
Updated Version 2026/2027- Already Graded A+
Question 1
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
Answer: A
Rationale: Individuals not eligible for premium-free Part A may apply during the
initial enrollment period, general enrollment period, or special enrollment period.
Question 2
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
Answer: A
Rationale: Medicare makes a conditional payment when another payer may be
responsible, and later seeks recovery from the other payer.
Question 3
Insurers must offer inflation protection in which of the following policies?
A. Medicare Part C
B. Medigap
pg. 1
,C. Long-Term Care
D. Medicaid
Answer: C
Rationale: Long-term care policies must offer inflation protection to help benefits keep
pace with rising healthcare costs.
Question 4
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
Answer: D
Rationale: The utilization review program safeguards against unnecessary and
inappropriate medical care rendered to Medicaid recipients.
Question 5
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. Coverage cannot reimburse insureds for medical expenses or services covered by
Medicare
Answer: C
Rationale: Long-term care policies do not accrue cash value; they are health insurance
policies that provide coverage for custodial care.
Question 6
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
pg. 2
, Answer: B
Rationale: Intermediaries handle claims from hospitals, skilled nursing facilities,
home health agencies, and hospices.
Question 7
What is the term for private organizations that administer Medicare Part B benefits?
A. Carriers
B. Medical Providers
C. Intermediaries
D. Peer review organizations
Answer: A
Rationale: Carriers are private organizations that administer Medicare Part B benefits.
Question 8
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
Answer: D
Rationale: A 60-day free look period is not required; the standard free look period for
Medigap is typically 30 days.
Question 9
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
Answer: D
Rationale: Guaranteed renewable or noncancelable provisions are required, not
optional, in long-term care policies.
pg. 3
Term Care Insurance Exam | Complete Actual
Exam Study Guide with Verified Questions and
Correct Answers (Rationales Included) | Latest
Updated Version 2026/2027- Already Graded A+
Question 1
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
Answer: A
Rationale: Individuals not eligible for premium-free Part A may apply during the
initial enrollment period, general enrollment period, or special enrollment period.
Question 2
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
Answer: A
Rationale: Medicare makes a conditional payment when another payer may be
responsible, and later seeks recovery from the other payer.
Question 3
Insurers must offer inflation protection in which of the following policies?
A. Medicare Part C
B. Medigap
pg. 1
,C. Long-Term Care
D. Medicaid
Answer: C
Rationale: Long-term care policies must offer inflation protection to help benefits keep
pace with rising healthcare costs.
Question 4
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
Answer: D
Rationale: The utilization review program safeguards against unnecessary and
inappropriate medical care rendered to Medicaid recipients.
Question 5
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. Coverage cannot reimburse insureds for medical expenses or services covered by
Medicare
Answer: C
Rationale: Long-term care policies do not accrue cash value; they are health insurance
policies that provide coverage for custodial care.
Question 6
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
pg. 2
, Answer: B
Rationale: Intermediaries handle claims from hospitals, skilled nursing facilities,
home health agencies, and hospices.
Question 7
What is the term for private organizations that administer Medicare Part B benefits?
A. Carriers
B. Medical Providers
C. Intermediaries
D. Peer review organizations
Answer: A
Rationale: Carriers are private organizations that administer Medicare Part B benefits.
Question 8
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
Answer: D
Rationale: A 60-day free look period is not required; the standard free look period for
Medigap is typically 30 days.
Question 9
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
Answer: D
Rationale: Guaranteed renewable or noncancelable provisions are required, not
optional, in long-term care policies.
pg. 3
