Questions
How long is an open enrollment period for Medicare supplement policies?
A90 days
B6 months
C1 year
D30 days
Correct! An open enrollment period is a 6-month period that guarantees the applicants the right to buy Medigap once they first sign up for Medicare Part B.
5: Which of the following provisions must be included on the first page of a Medicare supplement policy, which states the insurer’s right to change premium amounts?
A Premium provision
B Insurer's rights
C Coverage limitations
D Continuation provision
The renewal provision, also known as a continuation provision, must be included on the first page of Medicare supplement policies. This provision explains the right of the insurer to alter premium amounts.
1: Which of the following Medicare supplement plans would be available to a reasonably healthy 91-year-old female?
A A–N
B K & L only
C A only
D A–C only
All Medicare supplement plans (A–N) must be made available to qualifying applicants, regardless of age.
2: Issue age policy premiums increase in response to which of the following factors?
A Increased deductible
B Inflation
C Age
D Increased benefits
The premiums of issue age policies can only increase in response to an increase in benefits.
4: Shortly after a replacement transaction on a Medicare supplement policy, the insured decided to cancel the policy, but is unsure whether the free-look provision applies. The insured could find that information in the
A Certificate of Coverage.
B Notice Regarding Replacement.
C Policy application.
D Buyer's Guide.
The Notice Regarding Replacement must inform the applicant of the 30-day free-look provision of the replacing policy.
5: All of the following statements about Medicare supplement insurance policies are correct EXCEPT
A They cover the cost of extended nursing home care.
B They cover Medicare deductibles and copayments.
C They supplement Medicare benefits.
D They are issued by private insurers.
Medicare supplement policies (Medigap) do not cover the cost of extended nursing home care. Medigap plans are designed to fill the gap in coverage attributable to Medicare’s deductibles, copayment requirements, and benefit periods. These plans are issued by private insurance companies.
8: Employer health plans must provide primary coverage for individuals with end-stage renal disease before Medicare becomes primary for how many months?
A 12 months
B 24 months
C 30 months
D 36 months
The Omnibus Budget Reconciliation Act of 1990 as amended by the Balanced Budget Act of 1997 requires the employer health plan to provide primary coverage for 30 months for individuals with end-stage renal (kidney) disease before Medicare becomes primary.
1: A 70-year-old individual who bought a Part B Medicare policy 2 months ago just began kidney dialysis treatments this week. The individual is now applying for a Medicare supplement policy, which would begin in 8 months. Which of the following could the insurer do to avoid paying for the dialysis?
A Deny the supplement policy
B Charge a higher premium
C Declare a pre-existing condition
D Permanently exclude coverage for dialysis
If an applicant is aged 65 or greater and applies for Medicare supplement coverage while covered under Part B Medicare insurance, an insurer cannot alter the price of coverage based on prior claims experience or health status, provided that the application was made during the first 6 months of Part B coverage. The insurer may, however, exclude benefits during the first 6 months based upon a pre-existing condition for which the policyholder received treatment during the 6 months before it became effective.
7: When a person applies for Medicare supplement insurance, whose responsibility is it to confirm that the applicant does not already have accident or sickness insurance in force?
A Insurer
B State government
C Active physician
D Agent
Although it is illegal for an applicant to intentionally misrepresent himself in an insurance application, it is the insurer’s ultimate responsibility to make sure that the applicant does not already have another accident or sickness policy in force.
8: All of the following statements about Medicare supplement insurance policies are correct EXCEPT
A They cover Medicare deductibles and copayments.
B They supplement Medicare benefits.
C They are issued by private insurers.
D They cover the cost of extended nursing home care.
Medicare supplement policies (Medigap) do not cover the cost of extended nursing home care. Medigap plans are designed to fill the gap in coverage attributable to Medicare’s deductibles, copayment requirements, and benefit periods. These plans are issued by private insurance companies.
12: Shortly after a replacement transaction on a Medicare supplement policy, the insured decided to cancel the policy, but is unsure whether the free-look provision applies. The insured could find that information in the
A Policy application.
B Buyer's Guide.
C Certificate of Coverage.
D Notice Regarding Replacement.
The Notice Regarding Replacement must inform the applicant of the 30-day free-look provision of the replacing policy.
1: According to OBRA, what is the minimum number of employees required to constitute a large group?
A 20
B 50
C 100
D 15
There must be at least 100 employees in order to qualify for OBRA large-group status. The act states that plans must provide primary coverage for disabled individuals under age 65 who are not retired.
6: A 70-year-old individual who bought a Part B Medicare policy 2 months ago just began kidney dialysis treatments this week. The individual is now applying for a Medicare supplement policy, which would begin in 8 months. Which of the following could the insurer do to avoid paying for the dialysis?
A Declare a pre-existing condition
B Permanently exclude coverage for dialysis
C Deny the supplement policy
D Charge a higher premium
If an applicant is aged 65 or greater and applies for Medicare supplement coverage while covered under Part B Medicare insurance, an insurer cannot alter the price of coverage based on prior claims experience or health status, provided that the application was made during the first 6 months of Part B coverage. The insurer may, however, exclude benefits during the first 6 months based upon a pre-existing condition for which the policyholder received treatment during the 6 months before it became effective.
9: Who must sign the notice regarding replacement?
A Applicant only
B Agent only
C Both the applicant and agent
D Both the agent and the insurer
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.
10: The Medicare supplement renewal commissions paid in the third year must be as high as the commission of which year?
A 1st
B 2nd
C 3rd
D 4th
The commission provided in renewal years must be the same as the commission in the second year and must be provided for no fewer than 5 renewal years.
11: When an employee is still employed upon reaching age 65 and eligible for Medicare, which of the following is the employee's option?
A Enroll in Medicare when eligible; otherwise, Medicare benefits will be forfeited.
B Wait until the next birthday to enroll
C Remain on the group health insurance plan and defer eligibility for Medicare until retirement
D Enroll in Medicare, while the company must provide additional retirement benefits
If an employee is still employed upon reaching age 65, federal laws require keeping the employee on the group health insurance rolls and deferring their eligibility for Medicare until retirement. The employee has the right to reject the company's plan and elect Medicare but the company can offer no incentives for switching to Medicare.
13: An individual purchased a Medicare supplement policy in March and decided to replace it 2 months later. His history of coronary artery disease is considered a pre-existing condition. Which of the following is true?
A The pre-existing condition waiting period fulfilled in 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 permanently excluded from the new policy.
C In replacement, pre-existing conditions must be waived, so sickness relating to coronary artery disease will be covered upon the policy's effective date.
D Because this is a new policy, the pre-existing condition waiting period starts over.
When an insured replaces one Medicare supplement policy with another, the pre-existing conditions waiting period does not start over. All types of waiting and elimination periods are carried over, not restarted, since that time was served with the original policy.
15: In which Medicare supplemental policies are the core benefits found?
A Plans A–D only
B All plans
C Plans A and B only
D Plan A only
The benefits in Plan A are considered to be core benefits and must be included in the other types. Therefore, all types contain the core benefits offered by Plan A.