©FYNDLAY 2024/2025 ALL RIGHTS RESERVED 11:08AM. A+
NC Medicare/LTC Exam Questions And
Answers |Latest 2025 | Guaranteed Pass.
LTC policies may not include - Answer✔the right to refuse to renew upon age or deterioration
of health.
Medicare Supplement policies must maintain minimum loss ratios - Answer✔(75% Group, and
65% Individual) through annual audited reports to DOI.
If inadequate loss ratios - Answer✔refunds or premium credits are required to be made.
LTC must provide benefits for a minimum of - Answer✔12 months and cannot provide skilled
care only.
LTC insurers must provide ____ days advance notice of cancellation to both insured and
alternate-named person. - Answer✔30
LTC Outline of coverage must be delivered no later than - Answer✔at policy delivery.
After admission to a custodial facility most LTC policies have a ______ - Answer✔Elimination
Period ("Time Deductible")
Medicare enrollment is done at - Answer✔local Social Security offices.
Medicare Supplement policies are designed primarily to cover the - Answer✔"cost-sharing"
features of Medicare.
Home Health benefits cover DME's ____%. - Answer✔80
Medicare in-patient Psychiatric benefits are limited to - Answer✔190 days lifetime.
Medicare SNF benefits are structured how? - Answer✔100 days per benefit period. Days 1-20
with no copayment; Days 21-100 are 1/8 of the Part A Deductible.
13) The Medicare Part A benefit period (spell of illness) for hospital and SNF ends - Answer✔60
days after discharge.
14) Medicare provides Days 1-90 on a - Answer✔non-exhaustible basis for each benefit period.
15) The exhaustible Reserve Day percentage is - Answer✔50%.
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, ©FYNDLAY 2024/2025 ALL RIGHTS RESERVED 11:08AM. A+
16) Medicare Part A Hospital is the only one with an exhaustible benefit - Answer✔(60 days
lifetime after Days 1-90).
17) Medicare Part A SNF benefit requires 3 days in the hospital before admission; - Answer✔the
patient must go within 30 days of discharge, and a doctor must certify need daily.
18) _________ monitors the quality of health care in CMS approved facilities - Answer✔The
state funded QIO (or PRO), made up of doctors and other health care professionals .
19) The Medicare Administrative Contractor (Part B) issues the MSN, it determines -
Answer✔approved charges, and pays 80% of approved charges to the provider, but does not
seek refunds of overcharges from providers.
20) Providers must submit claims to the MAC within - Answer✔one year or face a reduction in
payment.
21) The "Free-look" for both Medicare Supplement and LTC is - Answer✔30 days.
22) If the insurer wishes to reduce benefits on an existing policy, written agreement by the
owner/insured is required. - Answer✔
23) If a Medicare beneficiary elects to stay in an Employer Group Plan (EGP), - Answer✔the plan
will be primary payer and Medicare will be secondary payer.
24) Medicare Part A Home Health benefits must be provided on an - Answer✔intermittent
basis, i.e., no more than an 8-hour shift for no more than 21 consecutive days.
25) Medicare Part A Home Health does not provide - Answer✔homemaker services.
26) Medicare Part A does not cover - Answer✔elective cosmetic surgery, private duty nursing,
routine dental or rest cures.
27) Medicare will cover services in a non-certified facility only for - Answer✔life-threatening
emergencies.
28) To enroll in Medicare Part C, the beneficiary must first enroll in - Answer✔Part A and B.
29) To purchase a Medicare Supplement policy, the Medicare beneficiary must first have -
Answer✔Medicare Part A and Part B.
30) Having Medicare Part C eliminates the need for - Answer✔Medicare Supplement insurance.
31) Medicare Part D may be obtained as stand-alone, or as - Answer✔part of a Medicare
Advantage (Part C) plan, but not both.
32) Medicaid will only pay for custodial nursing home care if - Answer✔there is both a financial
need and doctor's certification of that level of care.
2
NC Medicare/LTC Exam Questions And
Answers |Latest 2025 | Guaranteed Pass.
LTC policies may not include - Answer✔the right to refuse to renew upon age or deterioration
of health.
Medicare Supplement policies must maintain minimum loss ratios - Answer✔(75% Group, and
65% Individual) through annual audited reports to DOI.
If inadequate loss ratios - Answer✔refunds or premium credits are required to be made.
LTC must provide benefits for a minimum of - Answer✔12 months and cannot provide skilled
care only.
LTC insurers must provide ____ days advance notice of cancellation to both insured and
alternate-named person. - Answer✔30
LTC Outline of coverage must be delivered no later than - Answer✔at policy delivery.
After admission to a custodial facility most LTC policies have a ______ - Answer✔Elimination
Period ("Time Deductible")
Medicare enrollment is done at - Answer✔local Social Security offices.
Medicare Supplement policies are designed primarily to cover the - Answer✔"cost-sharing"
features of Medicare.
Home Health benefits cover DME's ____%. - Answer✔80
Medicare in-patient Psychiatric benefits are limited to - Answer✔190 days lifetime.
Medicare SNF benefits are structured how? - Answer✔100 days per benefit period. Days 1-20
with no copayment; Days 21-100 are 1/8 of the Part A Deductible.
13) The Medicare Part A benefit period (spell of illness) for hospital and SNF ends - Answer✔60
days after discharge.
14) Medicare provides Days 1-90 on a - Answer✔non-exhaustible basis for each benefit period.
15) The exhaustible Reserve Day percentage is - Answer✔50%.
1
, ©FYNDLAY 2024/2025 ALL RIGHTS RESERVED 11:08AM. A+
16) Medicare Part A Hospital is the only one with an exhaustible benefit - Answer✔(60 days
lifetime after Days 1-90).
17) Medicare Part A SNF benefit requires 3 days in the hospital before admission; - Answer✔the
patient must go within 30 days of discharge, and a doctor must certify need daily.
18) _________ monitors the quality of health care in CMS approved facilities - Answer✔The
state funded QIO (or PRO), made up of doctors and other health care professionals .
19) The Medicare Administrative Contractor (Part B) issues the MSN, it determines -
Answer✔approved charges, and pays 80% of approved charges to the provider, but does not
seek refunds of overcharges from providers.
20) Providers must submit claims to the MAC within - Answer✔one year or face a reduction in
payment.
21) The "Free-look" for both Medicare Supplement and LTC is - Answer✔30 days.
22) If the insurer wishes to reduce benefits on an existing policy, written agreement by the
owner/insured is required. - Answer✔
23) If a Medicare beneficiary elects to stay in an Employer Group Plan (EGP), - Answer✔the plan
will be primary payer and Medicare will be secondary payer.
24) Medicare Part A Home Health benefits must be provided on an - Answer✔intermittent
basis, i.e., no more than an 8-hour shift for no more than 21 consecutive days.
25) Medicare Part A Home Health does not provide - Answer✔homemaker services.
26) Medicare Part A does not cover - Answer✔elective cosmetic surgery, private duty nursing,
routine dental or rest cures.
27) Medicare will cover services in a non-certified facility only for - Answer✔life-threatening
emergencies.
28) To enroll in Medicare Part C, the beneficiary must first enroll in - Answer✔Part A and B.
29) To purchase a Medicare Supplement policy, the Medicare beneficiary must first have -
Answer✔Medicare Part A and Part B.
30) Having Medicare Part C eliminates the need for - Answer✔Medicare Supplement insurance.
31) Medicare Part D may be obtained as stand-alone, or as - Answer✔part of a Medicare
Advantage (Part C) plan, but not both.
32) Medicaid will only pay for custodial nursing home care if - Answer✔there is both a financial
need and doctor's certification of that level of care.
2
