6 - Medigap

Question 1

A Medicare Supplement Policy (also known as a __________) is a health insurance policy sold by private insurance companies to fill in the coverage gaps in Original Medicare.

Answer 1

-Medigap Policy

Question 2

Medicare Supplements cannot be purchased or sold (by an insurer) unless the applicant for the policy is enrolled in Medicare Parts _______-

Answer 2

-A and B

Question 3

If S enrolls in a Medicare Supplement on her 65th birthday and she has a heart condition, how long can the Medigap insurer waive the pre-existing condition?

Answer 3

-6 months after the issue date

Question 4

Which of the following is the “rule” regarding pre-existing conditions when enrolling in a Medicare Supplement (Medigap) Plan?

Answer 4

-Six and Six Rule

Question 5

Medicare Supplement (Medigap) Plan ___ is also offered as “high-deductible” plan.

Answer 5

-F

Question 6

If a person has a Medicare Supplement (Medigap) Plan M what percent of the Medicare Benefit Period deductible is he or she required to pay?

Answer 6

-50%

Question 7

Medicare Supplement (Medigap) Plan L pays what percentage of the co-insurance for Medicare-approved Hospice care?

Answer 7

-75%

Question 8

Medigap insurers doing business in North Carolina MUST offer which of the following Medicare Supplement (Medigap) Plans?

Answer 8

-Plan A only

Question 9

A “Time Limit on Certain Defenses” also known as a “contestable period” in a Medigap cannot be any longer than _______ from the date of issue of the policy.

Answer 9

-2 years

Question 10

A Medicare Supplement (Medigap) Plan can add an additional _______ lifetime reserve days that may be used after the Medicare Part A Lifetime Reserve Days are used.

Answer 10

-365

Question 11

Medicare Supplement (Medigap) Plans are regulated by:

Answer 11

• Federal Law

- NC Insurance Law

Question 12

If a person has a Medicare Supplement (Medigap) Plan L what percent of the Medicare Benefit Period deductible will he or she be responsible to pay?

Answer 12

-25%

Question 13

Medicare Supplement (Medigap) Plans that cover foreign travel emergency care can provide up to an aggregate maximum of ________.

Answer 13

-$50,000

Question 14

Medicare Supplement (Medigap) Plan M will pay what percent of the Medicare Part A deductible?

Answer 14

-50%

Question 15

Medicare Supplement (Medigap) Plan K pays what percentage of the co-insurance for Medicare-approved Hospice care?

Answer 15

-50%

Question 16

Medigap policies are “guaranteed renewable” annually:

Answer 16

-By paying required premiums as indicated in the policy

Question 17

If a Medicare Supplement insured begins receiving Medicaid Benefits, the insured may, within 90 days, request a suspension of premiums and benefits under the policy for up to ________.

Answer 17

-2 years

Question 18

Medicare Supplement (Medigap) Plans have an “open enrollment” period of how long after enrollment in Medicare Part B?

Answer 18

-6 months

Question 19

Medicare Supplement (Medigap) Plan L will pay what percent of the Medicare Part A deductible?

Answer 19

-75%

Question 20

A Medicare Supplement policy must have a minimum ______ unconditional refund of premium provision (free look) from the date of delivery.

Answer 20

-30 day

Question 21

North Carolina state regulations require that all Medicare Supplement (Medigap) Plan sold in the state must have a “loss ratio” of at least ____% on individual Medicare Supplement (Medigap) policies and ___% on a group Medicare Supplement (Medigap) Plan.

Answer 21

-65% and 75%