NC MEDICARE SUPPLEMENT AND LONG TERM
CARE INSURANCE LICENSING TEST 2025/2026
BANK CURRENTLY TESTING COMPLETE
ACTUAL QUESTIONS WITH DETAILED
VERIFIED ANSWERS EXPERT VERIFIED
/ALREADY GRADED A+
A 5-day inpatient stay, provided on occasional basis to
relieve the primary caregiver of terminally ill patient to
give caregivers a break
-Pays 95% if Medicare approved charge with patient
paying 5%. - ....ANSWER...inpatient respite care
The community spouse (noninstitutionalized) may retain a
sufficient amount of resources to stay above the federal
poverty line. - ....ANSWER...Spousal Impoverishment
Protection
an individual who is entitled to Medicare Part A and/or
Part B, and also eligible for some form of Medicaid benefit.
- ....ANSWER...Dual eligible
,A summary sent to the patient from Medicare that
summarizes all services provided over a period of time
with an explanation of benefits provided
-Sent quarterly- shows actual charge, approved am't, pt
responsibility, deductible met. - ....ANSWER...Medicare
Summary Notice (MSN)
Will pay Medicare premiums, deductibles, copays and
coinsurance amountsfor beneficiaries who meet low-
income, low-asset eligibility criteria.
-Does NOT cover excess charges from non participating
doctor - ....ANSWER...QMB-Qualified Medicare
Beneficiary
-Nursing & doctors' services
-Home health aide & homemaker services
-Drugs used for pain or symptom relief (If drugs are
administered on outpatient basis, patient must pay 5%
but no more than $5 per Rx)
-Medical supplies & appliances
, -Physical, occupational & speech therapy
-Medical social services & counseling -
....ANSWER...Hospice benefits include
-Optional with premium payments
-Annual deductible of $185 plus 3 pt blood deductible.
-After deductible, 80/20 coinsurance
-Benefit is based on approved charges (UCR) -
....ANSWER...Medicare Part B benefits
Agrees to accept Medicare assignment payment method.
-Patient pays 20% coinsurance after deductible. -
....ANSWER...Participating Doctor
Doctor does not accept Medicare assignment
-Allowed to charge more i.e. "Excess Charge" that what
Medicare approves
-Patient responsible for all charges in excess of the 80%
approved charge by Medicare
-Can accept assignment on a case by case basis -
....ANSWER...Non-Participating Doctor
CARE INSURANCE LICENSING TEST 2025/2026
BANK CURRENTLY TESTING COMPLETE
ACTUAL QUESTIONS WITH DETAILED
VERIFIED ANSWERS EXPERT VERIFIED
/ALREADY GRADED A+
A 5-day inpatient stay, provided on occasional basis to
relieve the primary caregiver of terminally ill patient to
give caregivers a break
-Pays 95% if Medicare approved charge with patient
paying 5%. - ....ANSWER...inpatient respite care
The community spouse (noninstitutionalized) may retain a
sufficient amount of resources to stay above the federal
poverty line. - ....ANSWER...Spousal Impoverishment
Protection
an individual who is entitled to Medicare Part A and/or
Part B, and also eligible for some form of Medicaid benefit.
- ....ANSWER...Dual eligible
,A summary sent to the patient from Medicare that
summarizes all services provided over a period of time
with an explanation of benefits provided
-Sent quarterly- shows actual charge, approved am't, pt
responsibility, deductible met. - ....ANSWER...Medicare
Summary Notice (MSN)
Will pay Medicare premiums, deductibles, copays and
coinsurance amountsfor beneficiaries who meet low-
income, low-asset eligibility criteria.
-Does NOT cover excess charges from non participating
doctor - ....ANSWER...QMB-Qualified Medicare
Beneficiary
-Nursing & doctors' services
-Home health aide & homemaker services
-Drugs used for pain or symptom relief (If drugs are
administered on outpatient basis, patient must pay 5%
but no more than $5 per Rx)
-Medical supplies & appliances
, -Physical, occupational & speech therapy
-Medical social services & counseling -
....ANSWER...Hospice benefits include
-Optional with premium payments
-Annual deductible of $185 plus 3 pt blood deductible.
-After deductible, 80/20 coinsurance
-Benefit is based on approved charges (UCR) -
....ANSWER...Medicare Part B benefits
Agrees to accept Medicare assignment payment method.
-Patient pays 20% coinsurance after deductible. -
....ANSWER...Participating Doctor
Doctor does not accept Medicare assignment
-Allowed to charge more i.e. "Excess Charge" that what
Medicare approves
-Patient responsible for all charges in excess of the 80%
approved charge by Medicare
-Can accept assignment on a case by case basis -
....ANSWER...Non-Participating Doctor
