North Carolina Medicare Supplement and Long-Term
Care Exam 2025/2026
Comprehensive Practice Exam with Verified Correct
Answer✓s & Rationales
180+ Original Practice Questions for Student
Examination Preparation
1. Which part of Medicare primarily covers inpatient hospital care, skilled nursing facility care,
hospice, and some home health services?
A) Part A
B) Part B
C) Part C
D) Part D
Correct Answer✓: A) Part A
Rationale: Medicare Part A is hospital insurance that covers inpatient hospital stays, care in a skilled
nursing facility, hospice care, and some home health care
.
. Part B covers outpatient/medical services, Part C is Medicare Advantage (private plan alternative),
and Part D covers prescription drugs. Understanding the distinct coverage areas of each Medicare part
is foundational for Medicare Supplement sales.
2. The Medicare Part B monthly premium is typically:
A) Paid by the federal government for all beneficiaries
B) Deducted from the beneficiary's Social Security benefit payment
,C) Paid annually in a lump sum to the insurance company
D) Waived for beneficiaries over age 75
Correct Answer✓: B) Deducted from the beneficiary's Social Security benefit payment
Rationale: For most beneficiaries, the Medicare Part B premium is automatically deducted from their
monthly Social Security benefit payment
.
. If a beneficiary does not receive Social Security, they receive a quarterly bill. This payment structure
is important for agents to explain when discussing total costs of Medicare coverage with clients.
3. What is the Medicare Part A deductible for inpatient hospital care in a benefit period for 2025?
A) $1,632
B) $226
C) $5,500
D) $0; there is no deductible
Correct Answer✓: A) $1,632
Rationale: The Medicare Part A inpatient hospital deductible for 2025 is $1,632 per benefit period
.
. A benefit period begins the day you're admitted and ends when you haven't received inpatient care
for 60 consecutive days. This amount changes annually; agents must reference current-year figures
when counseling clients.
4. Which statement about Medicare Part B coverage is CORRECT?
A) Part B has no annual deductible
B) Part B covers 100% of approved charges after the deductible is met
C) Part B generally covers 80% of approved charges after the deductible is met
D) Part B coverage is only available to beneficiaries over age 65
,Correct Answer✓: C) Part B generally covers 80% of approved charges after the deductible is met
Rationale: After meeting the annual Part B deductible ($240 in 2025), Medicare typically pays 80% of
the Medicare-approved amount for most covered services, and the beneficiary is responsible for the
remaining 20% coinsurance
.
. This 20% gap is a primary reason beneficiaries purchase Medicare Supplement (Medigap) policies.
5. The Medicare Annual Election Period (AEP) for Medicare Advantage and Part D plans occurs:
A) January 1 - March 31 each year
B) April 1 - June 30 each year
C) October 15 - December 7 each year
D) Any time during the calendar year
Correct Answer✓: C) October 15 - December 7 each year
Rationale: The Annual Election Period (also called Open Enrollment for Medicare Advantage and Part
D) runs from October 15 to December 7 annually
.
. During this period, beneficiaries can join, switch, or drop Medicare Advantage or Part D plans. This is
distinct from the Medigap Open Enrollment Period, which is a one-time 6-month window.
6. Which of the following is NOT a requirement to be eligible for Medicare?
A) Age 65 or older
B) U.S. citizen or permanent legal resident for at least 5 continuous years
C) Having worked and paid Medicare taxes for at least 10 years (40 quarters)
D) Having a diagnosis of end-stage renal disease (ESRD) or ALS
Correct Answer✓: C) Having worked and paid Medicare taxes for at least 10 years (40 quarters)
, Rationale: While working 40 quarters qualifies a person for premium-free Part A, it is NOT a
requirement for Medicare eligibility overall. Individuals age 65+ who are citizens or permanent
residents (5+ years) can enroll in Medicare Part A (possibly with a premium) and Part B regardless of
work history
.
. ESRD and ALS also qualify individuals under 65.
7. What does "Medicare-approved amount" refer to?
A) The amount the beneficiary must pay out-of-pocket
B) The maximum amount a provider can charge a Medicare beneficiary
C) The amount Medicare will pay for a covered service after deductible
D) The amount a non-participating provider can balance bill
Correct Answer✓: B) The maximum amount a provider can charge a Medicare beneficiary
Rationale: The Medicare-approved amount is the maximum fee that Medicare will recognize for a
covered service
.
. For participating providers, this is the full payment (minus deductible/coinsurance). For non-
participating providers, they may charge up to 15% more (the "limiting charge"), but the approved
amount remains the baseline for Medicare's payment calculation.
8. Which Medicare part is administered by private insurance companies approved by Medicare?
A) Part A only
B) Part B only
C) Part C (Medicare Advantage)
D) Part D only
Correct Answer✓: C) Part C (Medicare Advantage)
Care Exam 2025/2026
Comprehensive Practice Exam with Verified Correct
Answer✓s & Rationales
180+ Original Practice Questions for Student
Examination Preparation
1. Which part of Medicare primarily covers inpatient hospital care, skilled nursing facility care,
hospice, and some home health services?
A) Part A
B) Part B
C) Part C
D) Part D
Correct Answer✓: A) Part A
Rationale: Medicare Part A is hospital insurance that covers inpatient hospital stays, care in a skilled
nursing facility, hospice care, and some home health care
.
. Part B covers outpatient/medical services, Part C is Medicare Advantage (private plan alternative),
and Part D covers prescription drugs. Understanding the distinct coverage areas of each Medicare part
is foundational for Medicare Supplement sales.
2. The Medicare Part B monthly premium is typically:
A) Paid by the federal government for all beneficiaries
B) Deducted from the beneficiary's Social Security benefit payment
,C) Paid annually in a lump sum to the insurance company
D) Waived for beneficiaries over age 75
Correct Answer✓: B) Deducted from the beneficiary's Social Security benefit payment
Rationale: For most beneficiaries, the Medicare Part B premium is automatically deducted from their
monthly Social Security benefit payment
.
. If a beneficiary does not receive Social Security, they receive a quarterly bill. This payment structure
is important for agents to explain when discussing total costs of Medicare coverage with clients.
3. What is the Medicare Part A deductible for inpatient hospital care in a benefit period for 2025?
A) $1,632
B) $226
C) $5,500
D) $0; there is no deductible
Correct Answer✓: A) $1,632
Rationale: The Medicare Part A inpatient hospital deductible for 2025 is $1,632 per benefit period
.
. A benefit period begins the day you're admitted and ends when you haven't received inpatient care
for 60 consecutive days. This amount changes annually; agents must reference current-year figures
when counseling clients.
4. Which statement about Medicare Part B coverage is CORRECT?
A) Part B has no annual deductible
B) Part B covers 100% of approved charges after the deductible is met
C) Part B generally covers 80% of approved charges after the deductible is met
D) Part B coverage is only available to beneficiaries over age 65
,Correct Answer✓: C) Part B generally covers 80% of approved charges after the deductible is met
Rationale: After meeting the annual Part B deductible ($240 in 2025), Medicare typically pays 80% of
the Medicare-approved amount for most covered services, and the beneficiary is responsible for the
remaining 20% coinsurance
.
. This 20% gap is a primary reason beneficiaries purchase Medicare Supplement (Medigap) policies.
5. The Medicare Annual Election Period (AEP) for Medicare Advantage and Part D plans occurs:
A) January 1 - March 31 each year
B) April 1 - June 30 each year
C) October 15 - December 7 each year
D) Any time during the calendar year
Correct Answer✓: C) October 15 - December 7 each year
Rationale: The Annual Election Period (also called Open Enrollment for Medicare Advantage and Part
D) runs from October 15 to December 7 annually
.
. During this period, beneficiaries can join, switch, or drop Medicare Advantage or Part D plans. This is
distinct from the Medigap Open Enrollment Period, which is a one-time 6-month window.
6. Which of the following is NOT a requirement to be eligible for Medicare?
A) Age 65 or older
B) U.S. citizen or permanent legal resident for at least 5 continuous years
C) Having worked and paid Medicare taxes for at least 10 years (40 quarters)
D) Having a diagnosis of end-stage renal disease (ESRD) or ALS
Correct Answer✓: C) Having worked and paid Medicare taxes for at least 10 years (40 quarters)
, Rationale: While working 40 quarters qualifies a person for premium-free Part A, it is NOT a
requirement for Medicare eligibility overall. Individuals age 65+ who are citizens or permanent
residents (5+ years) can enroll in Medicare Part A (possibly with a premium) and Part B regardless of
work history
.
. ESRD and ALS also qualify individuals under 65.
7. What does "Medicare-approved amount" refer to?
A) The amount the beneficiary must pay out-of-pocket
B) The maximum amount a provider can charge a Medicare beneficiary
C) The amount Medicare will pay for a covered service after deductible
D) The amount a non-participating provider can balance bill
Correct Answer✓: B) The maximum amount a provider can charge a Medicare beneficiary
Rationale: The Medicare-approved amount is the maximum fee that Medicare will recognize for a
covered service
.
. For participating providers, this is the full payment (minus deductible/coinsurance). For non-
participating providers, they may charge up to 15% more (the "limiting charge"), but the approved
amount remains the baseline for Medicare's payment calculation.
8. Which Medicare part is administered by private insurance companies approved by Medicare?
A) Part A only
B) Part B only
C) Part C (Medicare Advantage)
D) Part D only
Correct Answer✓: C) Part C (Medicare Advantage)
