Med sup questions

According to North Carolina law, the person who seeks to contract for a Medigap insurance policy is known as A. The applicant B. The beneficiary C. A prospect D. The insured

A An applicant is a person who seeks an individual Medigap policy or in case of a group but I got policy, the certificate holder

Medigap policies don't not cover A. Long term care B. Preventive medical care C. Excess charges under the Medicare approved amount D. The first 100 days In a skilled nursing facility

A Medicare supplement insurance, or Medigap, does not cover long-term care. Medicare does cover some preventative care and some of the excess charges, known as part b balance billing for patients who are treated by a provider that does not accept assignment. Medigap covers some of the patients cost for up to 100 days in a skilled nursing facility

A patient covered by Medigap plan a enters the hospital for a 61 days day. Which of the following benefits is covered by his Medigap policy? A. All expenses B. Part B deductible C. Part a deductible D. Part a copayment

A Medigap plan a consistent basic or core benefits. The only deductible covered is the first 3 pints of blood. Plan a will pay the copayment for days 61 to 90 and 91 to 150

Medigap plan a includes A. Core benefits only B. The Medicare part B deductible C. The coinsurance for care in a skilled nursing facility D. The hospital insurance part a deductible

A Policy a is the core benefit package. Part a coinsurance for the 61st through the 90th day of hospitalization and Medicare benefit., Part a coinsurance for the 91st through the 1/50 day, party expenses for an extra 365 days in the hospital, part a and part B insurance deductible for the cost of the first three Pints of blood, and part B coinsurance which is 20% of the allowed charges

What a Medicare supplement policy is guaranteed renewable, that means A. The company must automatically renew the policy as long as the premium is paid B. The policy is non-cancelable C. The policy is grandfathered D. The company may not raise the premium

A The law says that an insurance company must automatically renew a Medigap policy as long as premiums are paid. If the insurance company becomes insolvent, the insured has the right to buy Medigap plan a, B, C, or F from another company

An individual purchases a Medicare supplement policy in March and decides to replace it with another in May. His history of coronary artery disease is considered to be pre-existing condition. Which of the following is true? A. The pre-existing condition waiting. That he served on the old policy will be transferred to the new policy, the new one picking up where the old one left off B. Coronary artery disease coverage will be excluded from the policy C. The rules of replacement dictate the pre-existing conditions must be waived in the renewal policy therefore, the individual can be covered for sickness relating to the coronary artery disease of panda policies effective date D. Because this is a new policy the pre-existing condition waiting period starts over

A When the issued replaces one Medicare supplement policy with another, the pre-existing conditions waiting period does not start over. All types of weeding and illumination periods are carried over, not restarted, since the time was served with the original policy

The outline of coverage for Medicare supplement policies is A. A generic informational brochure B. A summary of the policy apply for or issued C. A copy of the contractual provisions D. The buyers guide published by the national Association of insurance commissioners

B A statement that the outline of coverage is a summary of the policy issued or applied for and that the policy should be consulted to determine governing contractual provisions Is to be included in the outline of coverage

A 41-year-old Insured who has Lou Gehrig's disease (ALS) just became eligible for Social Security disability benefits. When would the insured be eligible for Medicare? A. After the six month elimination period B. The first month the insured receives disability benefits from Social Security C. 24 months after receiving disability from Social Security D. At age 65

B And insured under age 65 who has Lou Gehrig's disease (ALS) Is eligible the first month of receiving disability benefits from Social Security

Individuals enrolled in Medicare advantage plans do not need a Medicare supplement policy because A. The coverages are Identical B. Medicare supplement is part of Medicare advantage C. They would have to pay extra co-pays and deductibles D. They are not eligible

B Medicare supplement is a part of Medicare advantage

Which of the following describes the renewability of a Medicare supplement policy? A. Non-renewable B. Guaranteed renewable C. This varies from insurer to insurer D. Conditionally renewable

B Medicare supplements must be at least guaranteed renewable

A woman has Medicare ANB. She would like to purchase a policy that duplicate some of the Medicare benefits and collect twice should a sickness or injury occur. What are her options A. If she has Medicaid, she can purchaseAmerica policy that duplicates Medicaid benefits B. She cannot purchase a policy that duplicates Medicare benefits C. She can purchase a policy but can only collect one D. She can purchase a policy for duplicates Medicare benefits and can collect twice

B Policies in force In North Carolina cannot contain benefits that duplicate benefits provided by Medicare

According to North Carolina law, and informational brochure must be delivered to the prospective insured concurrently with delivery of the outline of coverage. The informational brochure for direct response insurance policy may be delivered A. At the time of policy delivery B. Upon request of the prospective insured but no later than the time of delivery C. Concurrently with the outline of coverage D. Upon request of the prospect

B The informational brochure, currently titled choosing a medigap Policy (current addition) And published by the national Association of insurance commissioners, must be delivered at the prospective insurance request, but no later than the time of delivery for direct response insurance. Direct response policies are those sold strictly by mail or through the media

An outline of coverage for Medicare supplement policy must be delivered to the applicant A. When the policy is placed B. At the time the policy is delivered C. At the time of policy application D. When the policy is approved

C Medicare supplement insurance policies may not be delivered in North Carolina unless an outline of the coverage is delivered to the applicant at the time the application Is made

Except in the case of direct response insurance policies, the outline of coverage for a Medigap policy must be delivered to the applicant A. When the policy is issued B. Before the presentation C. At the time the application is made D. When the policy is delivered

C No policy or certificate of Medicare supplement and Sherance may be delivered in North Carolina unless an outline of coverage is delivered to the applicant at the time the application is made

And enroll he has a Medigap policy that is non-cancelable. This means that A. The policy is guaranteed renewable B. The company must renew the policy but has the right to raise the premium C. The company cannot change anything about the contract including the premium D. The company can cancel the policy but cannot raise the premium

C Non-cancelable means that there's nothing about the contract that can be changed including the premium, and the insured cannot cancel the contract

Which of the following is true regarding a notice of free examination with medigap policies A. It is only required with group policies B. It must be filed with Department of insurance C. It must be printed on the first page D. It must be given to the applicant within 30 days of the application submission date

C Policies or certificates must have a notice prominently printed on the first page of or attached to the policy or certificate stating that the applicant has the right to return policy or certificate within 30 days of this delivery and to have the premium refunded if, after examination of the policy or certificate the applicant is not satisfied for any reason

65-year-old man is being treated for heart disease. His Medicare part a and part B started November 1. Before the state he had no health insurance coverage. On March 1 he buys a Medigap policy. His Medigap insurance company refuses to cover his heart disease condition. How long is the pre-existing condition waiting period for this heart disease in the medigap policy? A. Four months B. Zero months C. Two months D. Six months

C The insured will have to wait two months for the Medigap policy to cover his heart disease because he had credible coverage for four months before his Medicare policy became effective. During a two month period after the Medicare pays it share the insured will have to pay the rest of the cost for the care of his heart disease

Medigap plans a-n must include A. Part a deductible B. Part B deductible C. Prescription drugs D. Basic or core benefits

D Basic core benefits are included in all plans

Show me a sign notice regarding replacement A. Both the agent and insurer B. Applicant only C. Agent only D. Both the applicant and agent

D Before issuing a replacement policy, the insurer must furnish the applicant with a notice regarding replacement, which must be signed by both the applicant and the agent

Certain kinds of previous health insurance coverage that can be used to shorten or eliminate a pre-existing condition waiting period is called A. Guaranteed renewable B. Donut hole C. Corridor deductible D. Creditable coverage

D Creditable coverage is certain kinds of previous health insurance coverage that can be used to shorten or eliminate pre-existing condition waiting.

All advertising for the sale of Medigap insurance in the state Has to have the approval of which of the following A. The Better Business Bureau B. The local Chamber of Commerce C. Federal trade commission D. The commissioner of insurance

D Every ensure providing medicare supplement insurance or benefits in North Carolina must provide a copy of any Medicare supplement advertisement intended for the use in North Carolina, weather Through written, radio, or television medium, to the commissioner for review or approval

A man has a Medigap policy. The premium increases each year because he is a year older. In addition, the premium is also adjusted for inflation. The method used to calculate his premium is known as A. Annual increase rating B. Cost of living adjustment C. Issue age D. Attained age

D If the company uses the attained age premium calculation method, the premium is based on current age and will increase as the insured grows older

What are the disclosure requirements for Medicare supplement policy is issued at attained age? A. The policies must have an information brochure provided with the outline of coverage B. Medicare supplement policies cannot be issued at Attained age C. The disclosure must include the information that would help the buyers understanding of Medicare D. The rate structures must be fully disclosed at the time of application

D Insurers cannot use attained age is a scripture or methodology for Medicare supplement rates unless the structure of methodology is fully disclosed to the applicant at the time of application, or to the insured at the time of delivery for purchase by mail order

Which type of Medicare policy requires insurance do use specific healthcare providers and hospitals (network providers), except in emergency situations? A. Medicare advantage B. Medicare part a C. Preferred D. Medicare select

D Medicare select policies require insured's to use specific healthcare providers in hospitals, except in emergency situations. In return, the insured pays lower premium amounts

And insured has a Medicare supplement. Well the insured have to pay for 60 day hospital care? A. zero dollars B. $352 C. $704 D. $1408

D Medicare supplement plan a covers only core or basic benefits. It does not pay for inpatient hospital deductible. The only deductible covered is the first 3 pints of blood. The insured would have to pay 1408

Every insurer provide a number to get policies or certificates in North Carolina is required to file the policies rates, reading schedules, and supporting documentation. A. When the policy is approved by the Department of insurance B. At least once every 3 years C. Only when there is a premium increase or change in plan D. Annually

D Not every insurer providing policies or certificates in North Carolina must annually file at rates, rating schedule And documentation

An insurer who has a Medigap policy Plan B is covered for A. Skilled nursing facility copayments B. Preventive care C. Basic benefits only D. Medicare part a deductible and basic benefits

D Plan B covers the basic benefits and the part a deductible

If an issuer has discontinued a policy form, the Issuer may not resubmit for approval of the same form for at least how many years? A. One year B. Three years C. Four years D. Five years

D The discontinued form may not be resubmitted for approval for five years

According to a pre-existing provision in Medicare supplement policies, and ensure cannot deny a claim for issues incurred more than how many months from the effective date of coverage A. Nine months B. Three months C. 12 months D. Six months

D The waiting period for a pre-existing illness cannot exceed six months from the policies issue date

And insured is covered under a Medicare policy that provides a list of network healthcare providers that the insured must use to receive coverage. In exchange for this limitation, the insured is offered a lower premium. Which type of Medicare policy does the insured own? A. Medicare advantage B. Medicare select C. Medicare part a D. Medicare supplement

b Medicare select policies require insurance to use specific healthcare providers in hospitals, except in emergency situations. In return, the insured pays lower premium amounts