NORTH CAROLINA MEDICARE
SUPPLEMENT & LONG-TERM CARE EXAM
(2025/2026)
1. How many standardized Medigap plans are available to new Medicare beneficiaries as of 2025 in
North Carolina?
A) 6
B) 8
C) 10
D) 12
Correct Answer: B (8)
Rationale: As of 2020, plans C and F are no longer available to new Medicare beneficiaries (those
eligible after Jan 1, 2020). Plans A, B, D, G, K, L, M, N remain, total 8.
2. Which Medigap plan offers the most comprehensive coverage, excluding the now-unavailable Plan
F for new enrollees?
A) Plan A
B) Plan G
C) Plan N
D) Plan D
Correct Answer: B (Plan G)
Rationale: Plan G covers everything Plan F covered except the Part B deductible. For new enrollees,
Plan G is the most comprehensive.
3. In North Carolina, during the Medigap Open Enrollment Period, an insurance company must:
A) Use medical underwriting
B) Charge a higher premium for pre-existing conditions
C) Issue a policy without regard to health status
,D) Require a waiting period for all conditions
Correct Answer: C (Issue a policy without regard to health status)
Rationale: The 6-month Medigap OEP starts when you turn 65 and enroll in Part B; insurers cannot
deny or charge more due to health.
4. What is the maximum waiting period for pre-existing conditions in a Medigap policy issued during
open enrollment?
A) 0 months
B) 3 months
C) 6 months
D) 12 months
Correct Answer: C (6 months)
Rationale: Even during OEP, a pre-existing condition exclusion can apply for up to 6 months if the
condition was treated in the prior 6 months.
5. North Carolina law requires Medigap insurers to offer which plan to individuals under age 65 on
Medicare due to disability?
A) Plan A only
B) Plan A and Plan B
C) Any plan they choose
D) No requirement – they can deny
Correct Answer: A (Plan A only)
Rationale: NC requires at least Plan A be offered to disabled Medicare beneficiaries under 65, though
some insurers offer more.
6. Which statement about Medigap Plan N is TRUE?
A) Covers Part B excess charges fully
,B) Requires copays up to
20
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C) Includes prescription drug coverage
D) No copays for any service
Correct Answer: B (Requires copays up to
20
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Rationale: Plan N has copays; Part B excess charges are not covered.
7. The “Birthday Rule” in North Carolina allows Medigap policyholders to:
A) Change plans without underwriting within 30 days of their birthday
B) Lower premiums automatically on their birthday
C) Add a dependent on their birthday
D) Cancel without penalty on their birthday
Correct Answer: A (Change plans without underwriting within 30 days of their birthday)
Rationale: NC has a unique Birthday Rule: within 30 days after your birthday, you can switch to a same
or lesser benefit Medigap plan with no medical underwriting.
8. Which federal law standardized Medigap plans?
SUPPLEMENT & LONG-TERM CARE EXAM
(2025/2026)
1. How many standardized Medigap plans are available to new Medicare beneficiaries as of 2025 in
North Carolina?
A) 6
B) 8
C) 10
D) 12
Correct Answer: B (8)
Rationale: As of 2020, plans C and F are no longer available to new Medicare beneficiaries (those
eligible after Jan 1, 2020). Plans A, B, D, G, K, L, M, N remain, total 8.
2. Which Medigap plan offers the most comprehensive coverage, excluding the now-unavailable Plan
F for new enrollees?
A) Plan A
B) Plan G
C) Plan N
D) Plan D
Correct Answer: B (Plan G)
Rationale: Plan G covers everything Plan F covered except the Part B deductible. For new enrollees,
Plan G is the most comprehensive.
3. In North Carolina, during the Medigap Open Enrollment Period, an insurance company must:
A) Use medical underwriting
B) Charge a higher premium for pre-existing conditions
C) Issue a policy without regard to health status
,D) Require a waiting period for all conditions
Correct Answer: C (Issue a policy without regard to health status)
Rationale: The 6-month Medigap OEP starts when you turn 65 and enroll in Part B; insurers cannot
deny or charge more due to health.
4. What is the maximum waiting period for pre-existing conditions in a Medigap policy issued during
open enrollment?
A) 0 months
B) 3 months
C) 6 months
D) 12 months
Correct Answer: C (6 months)
Rationale: Even during OEP, a pre-existing condition exclusion can apply for up to 6 months if the
condition was treated in the prior 6 months.
5. North Carolina law requires Medigap insurers to offer which plan to individuals under age 65 on
Medicare due to disability?
A) Plan A only
B) Plan A and Plan B
C) Any plan they choose
D) No requirement – they can deny
Correct Answer: A (Plan A only)
Rationale: NC requires at least Plan A be offered to disabled Medicare beneficiaries under 65, though
some insurers offer more.
6. Which statement about Medigap Plan N is TRUE?
A) Covers Part B excess charges fully
,B) Requires copays up to
20
f
o
r
o
f
f
i
c
e
v
i
s
i
t
s
a
n
d
20forofficevisitsand50 for ER
C) Includes prescription drug coverage
D) No copays for any service
Correct Answer: B (Requires copays up to
20
f
o
r
, o
f
f
i
c
e
v
i
s
i
t
s
a
n
d
20forofficevisitsand50 for ER)
Rationale: Plan N has copays; Part B excess charges are not covered.
7. The “Birthday Rule” in North Carolina allows Medigap policyholders to:
A) Change plans without underwriting within 30 days of their birthday
B) Lower premiums automatically on their birthday
C) Add a dependent on their birthday
D) Cancel without penalty on their birthday
Correct Answer: A (Change plans without underwriting within 30 days of their birthday)
Rationale: NC has a unique Birthday Rule: within 30 days after your birthday, you can switch to a same
or lesser benefit Medigap plan with no medical underwriting.
8. Which federal law standardized Medigap plans?
