NC MediCare SuppleMeNt & loNg terM Care iNSuraNCe liCeNSiNg exaM
NeweSt 2025/2026 with CoMplete QueStioNS aNd CorreCt aNSwerS
|already graded a+||BraNd New VerSioN!
Medicare Part A - aNSwer--hospital coverage
-no premium requirements for those with 40 "work credits" of FICA or Self Employment tax credits.
-Those who don't qualify can voluntarily participate by paying a monthly premium
Medicare Part B - aNSwer-The part of the Medicare program that pays for physician services, outpatient
hospital services, durable medical equipment, and other services and supplies.
-Has a monthly premium of $135.50 in 2019 which is deducted from SS check.
-Part B enrollment is optional. You can reject Part B by signing a rejection form.
Medicare Part C - aNSwer-Medicare Advantage Plans that are offered through private insurance
companies that provide both hospital and physician coverage and possible prescriptions - financed by
Social Security and monthly premiums
Medicare Eligibility - aNSwer--Over age 65 who have earned 40 "work credits" in order to receive
premium free part A benefits
-Permanently disabled prior to age 65 for at least 24 months
-ESRD or kidney disease requiring dialysis or kidney transplant
Medicare enrollment requirements - aNSwer-Part A & B are automatically conducted by SSA when
individual age 65+ enrolls for their Social Security retirement benefits
Initial Enrollment Period - aNSwer-7 month period straddling 3 months before and ends 3 months after
the individual turns 65, including the birthday month.
, Medicare - aNSwer-Health insurance for those over age 65, people under 65 with certain disabilities &
those with ESRD (end stage renal disease - permanent kidney failure requiring dialysis or kidney
transplant)
CMS - aNSwer-Centers for Medicare and Medicaid Services administers the Medicare program. Social
Security Administration handles most of the enrollment & plays a role in claims appeal process.
MAC - aNSwer-Medicare Administrative Contractor - company contracted to administer Part A & Part B
claims.
-If enrollment is during the 3 mos prior to 65th birthday, coverage begins on 1st day of 65th birthday
month
-If enrollment is during or after 65th birthday month, coverage begins on 1st day of month after enrollment
General Enrollment Period - aNSwer-Medicare enrollment period - January 1st through March 31st
annually.
-Coverage begins July 1st of that year
-Monthly premium for part B may go up 10% for each full 12 month period that you're eligible but didn't
sign up.
Special Enrollment Period - aNSwer-Individual can enroll at 8 months beginning with the month
employment ends or when group coverage ends whichever is earlier without subject to late enrollment
surcharge
Medicare as a secondary or primary payer - aNSwer--Medicare is the secondary payer for the 'working
aged' who has a group health plan if the group has 20+ enrollees
-For single employer with <20 employees with a group health plan, Medicare is the primary payer.
-If individual retains coverage thru the group plan, the group contract is the primary unless person is
retired & still covered under the group plan. In that case, Medicare is the primary.
-If individual rejects the employer plan, Medicare is the primary payer
Medicare as a secondary payer - aNSwer--In cases of Workers' Comp when it applies to an injury or
illness
- In cases where no-fault insurance or liability insurance is available as primary payer.
NeweSt 2025/2026 with CoMplete QueStioNS aNd CorreCt aNSwerS
|already graded a+||BraNd New VerSioN!
Medicare Part A - aNSwer--hospital coverage
-no premium requirements for those with 40 "work credits" of FICA or Self Employment tax credits.
-Those who don't qualify can voluntarily participate by paying a monthly premium
Medicare Part B - aNSwer-The part of the Medicare program that pays for physician services, outpatient
hospital services, durable medical equipment, and other services and supplies.
-Has a monthly premium of $135.50 in 2019 which is deducted from SS check.
-Part B enrollment is optional. You can reject Part B by signing a rejection form.
Medicare Part C - aNSwer-Medicare Advantage Plans that are offered through private insurance
companies that provide both hospital and physician coverage and possible prescriptions - financed by
Social Security and monthly premiums
Medicare Eligibility - aNSwer--Over age 65 who have earned 40 "work credits" in order to receive
premium free part A benefits
-Permanently disabled prior to age 65 for at least 24 months
-ESRD or kidney disease requiring dialysis or kidney transplant
Medicare enrollment requirements - aNSwer-Part A & B are automatically conducted by SSA when
individual age 65+ enrolls for their Social Security retirement benefits
Initial Enrollment Period - aNSwer-7 month period straddling 3 months before and ends 3 months after
the individual turns 65, including the birthday month.
, Medicare - aNSwer-Health insurance for those over age 65, people under 65 with certain disabilities &
those with ESRD (end stage renal disease - permanent kidney failure requiring dialysis or kidney
transplant)
CMS - aNSwer-Centers for Medicare and Medicaid Services administers the Medicare program. Social
Security Administration handles most of the enrollment & plays a role in claims appeal process.
MAC - aNSwer-Medicare Administrative Contractor - company contracted to administer Part A & Part B
claims.
-If enrollment is during the 3 mos prior to 65th birthday, coverage begins on 1st day of 65th birthday
month
-If enrollment is during or after 65th birthday month, coverage begins on 1st day of month after enrollment
General Enrollment Period - aNSwer-Medicare enrollment period - January 1st through March 31st
annually.
-Coverage begins July 1st of that year
-Monthly premium for part B may go up 10% for each full 12 month period that you're eligible but didn't
sign up.
Special Enrollment Period - aNSwer-Individual can enroll at 8 months beginning with the month
employment ends or when group coverage ends whichever is earlier without subject to late enrollment
surcharge
Medicare as a secondary or primary payer - aNSwer--Medicare is the secondary payer for the 'working
aged' who has a group health plan if the group has 20+ enrollees
-For single employer with <20 employees with a group health plan, Medicare is the primary payer.
-If individual retains coverage thru the group plan, the group contract is the primary unless person is
retired & still covered under the group plan. In that case, Medicare is the primary.
-If individual rejects the employer plan, Medicare is the primary payer
Medicare as a secondary payer - aNSwer--In cases of Workers' Comp when it applies to an injury or
illness
- In cases where no-fault insurance or liability insurance is available as primary payer.
