North Carolina Medicare Supplement and Long-Term Care Insurance
Licensing Exam
Practice Examination 2025/2026
150+ Original Practice Questions with Correct Answer✓s and Rationales
1. Which of the following best describes the primary purpose of Medicare Part A?
A) Coverage for outpatient physician services
B) Coverage for prescription drugs
C) Coverage for inpatient hospital care, skilled nursing facility care, hospice, and some home health
services
D) Coverage for dental, vision, and hearing services
Correct Answer✓: C
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.
www.ncdoi.gov
Part B covers outpatient services, Part D covers prescription drugs, and routine dental/vision/hearing
are generally not covered by Original Medicare.
2. A North Carolina resident who is eligible for Medicare due to disability and is under age 65 has the
right to purchase which Medicare Supplement plans under state law?
A) Any standardized plan A-N
B) Only Plans A, D, or G
C) Only Plan F
D) Only high-deductible Plan G
Correct Answer✓: B
Rationale: North Carolina G.S. 58-54-45 guarantees that individuals under age 65 who qualify for
Medicare due to disability are eligible to purchase Medigap Plans A, D, or G effective January 1, 2020.
www.ncdoi.gov
This is a state-specific protection beyond federal requirements.
3. The Medicare Supplement Open Enrollment Period begins when a beneficiary is:
A) Age 65 and enrolled in any health insurance
,B) Age 65 or older AND enrolled in Medicare Part B
C) First diagnosed with a chronic condition
D) Discharged from a hospital stay
Correct Answer✓: B
Rationale: The Medigap Open Enrollment Period is a one-time, six-month period that begins the first
month a person is both 65 or older AND enrolled in Medicare Part B.
www.ncdoi.gov
During this period, beneficiaries have guaranteed issue rights.
4. Which statement about Medicare Supplement pre-existing condition waiting periods is CORRECT?
A) Insurers may impose waiting periods up to 12 months regardless of prior coverage
B) Waiting periods cannot exceed 6 months and must be waived with 6 months of creditable coverage
C) Pre-existing condition exclusions are prohibited in all Medicare Supplement policies
D) Waiting periods apply only to applicants under age 65
Correct Answer✓: B
Rationale: During the Open Enrollment Period, an insurance company may impose a pre-existing
condition waiting period, but it cannot be longer than six months. This waiting period must be waived
if the beneficiary has prior creditable coverage for six months.
www.ncdoi.gov
5. What does "creditable coverage" mean in the context of Medicare Supplement insurance?
A) Coverage that has been approved by the NAIC
B) Health coverage that meets minimum standards and can reduce waiting periods
C) Any insurance policy purchased through a licensed agent
D) Coverage that includes prescription drug benefits
Correct Answer✓: B
Rationale: Creditable coverage refers to health coverage (group plans, individual policies, Medicare,
Medicaid, etc.) that meets certain standards. Having creditable coverage can reduce or eliminate pre-
existing condition waiting periods when applying for Medicare Supplement insurance. [[NAIC Model
Regulation]]
6. Which of the following is NOT a standardized Medicare Supplement plan letter currently available
for new enrollees?
A) Plan G
,B) Plan N
C) Plan F (for those newly eligible for Medicare on or after January 1, 2020)
D) Plan A
Correct Answer✓: C
Rationale: Plans C and F are not available to individuals who become newly eligible for Medicare on or
after January 1, 2020, due to federal legislation prohibiting these plans from covering the Part B
deductible for new enrollees.
www.ncdoi.gov
Existing policyholders may keep their Plans C or F.
7. Under North Carolina law, what must a Medicare Supplement policy provide regarding coverage for
individuals with disabilities under 65?
A) The same premium rates as those 65 and older
B) Guaranteed availability of at least Plans A, D, or G
C) Coverage for all standardized plans at no additional cost
D) Automatic enrollment in Plan G
Correct Answer✓: B
Rationale: North Carolina legislation (G.S. 58-54-45) mandates that Medicare-eligible individuals
under 65 due to disability must be offered Medigap Plans A, D, or G.
www.ncdoi.gov
Premiums may still be higher for this population.
8. Which Medicare part covers medically necessary outpatient services, preventive care, and physician
visits?
A) Part A
B) Part B
C) Part C
D) Part D
Correct Answer✓: B
Rationale: Medicare Part B is medical insurance that covers outpatient care, preventive services,
physician services, durable medical equipment, and some home health services.
www.ncdoi.gov
, 9. What is the primary difference between Medicare Advantage (Part C) and Original Medicare with a
Medigap policy?
A) Medicare Advantage replaces Original Medicare and is offered by private insurers; Medigap
supplements Original Medicare
B) Medicare Advantage covers only hospital care; Medigap covers only physician services
C) Medicare Advantage is free; Medigap requires premiums
D) There is no difference; they are the same product
Correct Answer✓: A
Rationale: Medicare Advantage (Part C) is an alternative to Original Medicare offered by private
insurers that provides all Part A and Part B benefits, often with additional benefits. Medigap policies
work alongside Original Medicare to help pay cost-sharing.
www.ncdoi.gov
You cannot have both a Medigap policy and a Medicare Advantage plan simultaneously.
10. Which of the following situations would trigger a Special Enrollment Period for Medicare
Supplement insurance in North Carolina?
A) Turning 65 while still employed with group health coverage
B) Losing employer group health coverage that was primary to Medicare
C) Moving to a different zip code within North Carolina
D) All of the above
Correct Answer✓: D
Rationale: Special Enrollment Periods for Medigap may be triggered by various circumstances
including: turning 65 while covered by employer insurance, losing creditable coverage, moving out of
a plan's service area, or other qualifying events. [[NAIC Model Regulation, Section 12]]
11. What is the "birthday rule" in North Carolina regarding Medicare Supplement policies?
A) Beneficiaries can change plans any time during their birthday month
B) Beneficiaries have a 30-day period following their birthday each year to switch to a plan with equal
or lesser benefits without medical underwriting
C) Premiums are reduced for beneficiaries who enroll during their birthday month
D) Agents can only sell policies during the beneficiary's birthday month
Correct Answer✓: B
Licensing Exam
Practice Examination 2025/2026
150+ Original Practice Questions with Correct Answer✓s and Rationales
1. Which of the following best describes the primary purpose of Medicare Part A?
A) Coverage for outpatient physician services
B) Coverage for prescription drugs
C) Coverage for inpatient hospital care, skilled nursing facility care, hospice, and some home health
services
D) Coverage for dental, vision, and hearing services
Correct Answer✓: C
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.
www.ncdoi.gov
Part B covers outpatient services, Part D covers prescription drugs, and routine dental/vision/hearing
are generally not covered by Original Medicare.
2. A North Carolina resident who is eligible for Medicare due to disability and is under age 65 has the
right to purchase which Medicare Supplement plans under state law?
A) Any standardized plan A-N
B) Only Plans A, D, or G
C) Only Plan F
D) Only high-deductible Plan G
Correct Answer✓: B
Rationale: North Carolina G.S. 58-54-45 guarantees that individuals under age 65 who qualify for
Medicare due to disability are eligible to purchase Medigap Plans A, D, or G effective January 1, 2020.
www.ncdoi.gov
This is a state-specific protection beyond federal requirements.
3. The Medicare Supplement Open Enrollment Period begins when a beneficiary is:
A) Age 65 and enrolled in any health insurance
,B) Age 65 or older AND enrolled in Medicare Part B
C) First diagnosed with a chronic condition
D) Discharged from a hospital stay
Correct Answer✓: B
Rationale: The Medigap Open Enrollment Period is a one-time, six-month period that begins the first
month a person is both 65 or older AND enrolled in Medicare Part B.
www.ncdoi.gov
During this period, beneficiaries have guaranteed issue rights.
4. Which statement about Medicare Supplement pre-existing condition waiting periods is CORRECT?
A) Insurers may impose waiting periods up to 12 months regardless of prior coverage
B) Waiting periods cannot exceed 6 months and must be waived with 6 months of creditable coverage
C) Pre-existing condition exclusions are prohibited in all Medicare Supplement policies
D) Waiting periods apply only to applicants under age 65
Correct Answer✓: B
Rationale: During the Open Enrollment Period, an insurance company may impose a pre-existing
condition waiting period, but it cannot be longer than six months. This waiting period must be waived
if the beneficiary has prior creditable coverage for six months.
www.ncdoi.gov
5. What does "creditable coverage" mean in the context of Medicare Supplement insurance?
A) Coverage that has been approved by the NAIC
B) Health coverage that meets minimum standards and can reduce waiting periods
C) Any insurance policy purchased through a licensed agent
D) Coverage that includes prescription drug benefits
Correct Answer✓: B
Rationale: Creditable coverage refers to health coverage (group plans, individual policies, Medicare,
Medicaid, etc.) that meets certain standards. Having creditable coverage can reduce or eliminate pre-
existing condition waiting periods when applying for Medicare Supplement insurance. [[NAIC Model
Regulation]]
6. Which of the following is NOT a standardized Medicare Supplement plan letter currently available
for new enrollees?
A) Plan G
,B) Plan N
C) Plan F (for those newly eligible for Medicare on or after January 1, 2020)
D) Plan A
Correct Answer✓: C
Rationale: Plans C and F are not available to individuals who become newly eligible for Medicare on or
after January 1, 2020, due to federal legislation prohibiting these plans from covering the Part B
deductible for new enrollees.
www.ncdoi.gov
Existing policyholders may keep their Plans C or F.
7. Under North Carolina law, what must a Medicare Supplement policy provide regarding coverage for
individuals with disabilities under 65?
A) The same premium rates as those 65 and older
B) Guaranteed availability of at least Plans A, D, or G
C) Coverage for all standardized plans at no additional cost
D) Automatic enrollment in Plan G
Correct Answer✓: B
Rationale: North Carolina legislation (G.S. 58-54-45) mandates that Medicare-eligible individuals
under 65 due to disability must be offered Medigap Plans A, D, or G.
www.ncdoi.gov
Premiums may still be higher for this population.
8. Which Medicare part covers medically necessary outpatient services, preventive care, and physician
visits?
A) Part A
B) Part B
C) Part C
D) Part D
Correct Answer✓: B
Rationale: Medicare Part B is medical insurance that covers outpatient care, preventive services,
physician services, durable medical equipment, and some home health services.
www.ncdoi.gov
, 9. What is the primary difference between Medicare Advantage (Part C) and Original Medicare with a
Medigap policy?
A) Medicare Advantage replaces Original Medicare and is offered by private insurers; Medigap
supplements Original Medicare
B) Medicare Advantage covers only hospital care; Medigap covers only physician services
C) Medicare Advantage is free; Medigap requires premiums
D) There is no difference; they are the same product
Correct Answer✓: A
Rationale: Medicare Advantage (Part C) is an alternative to Original Medicare offered by private
insurers that provides all Part A and Part B benefits, often with additional benefits. Medigap policies
work alongside Original Medicare to help pay cost-sharing.
www.ncdoi.gov
You cannot have both a Medigap policy and a Medicare Advantage plan simultaneously.
10. Which of the following situations would trigger a Special Enrollment Period for Medicare
Supplement insurance in North Carolina?
A) Turning 65 while still employed with group health coverage
B) Losing employer group health coverage that was primary to Medicare
C) Moving to a different zip code within North Carolina
D) All of the above
Correct Answer✓: D
Rationale: Special Enrollment Periods for Medigap may be triggered by various circumstances
including: turning 65 while covered by employer insurance, losing creditable coverage, moving out of
a plan's service area, or other qualifying events. [[NAIC Model Regulation, Section 12]]
11. What is the "birthday rule" in North Carolina regarding Medicare Supplement policies?
A) Beneficiaries can change plans any time during their birthday month
B) Beneficiaries have a 30-day period following their birthday each year to switch to a plan with equal
or lesser benefits without medical underwriting
C) Premiums are reduced for beneficiaries who enroll during their birthday month
D) Agents can only sell policies during the beneficiary's birthday month
Correct Answer✓: B
