North Carolina Flashcards
7 cards from real AHIP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 North Carolina flashcards as text
In North Carolina, which state agency is primarily responsible for regulating Medicare Advantage plans?
Answer: North Carolina Department of Insurance
The North Carolina Department of Insurance (NCDOI) regulates insurance products including Medicare Advantage plans sold in the state.
A North Carolina beneficiary enrolled in a Medicare Advantage plan wants to switch to Original Medicare. Which enrollment period allows this outside of AEP?
Answer: Open Enrollment Period (OEP) from January 1 to March 31
The Medicare Advantage Open Enrollment Period (OEP), January 1–March 31, allows MA enrollees to switch to Original Medicare or a different MA plan once.
Which document must North Carolina agents provide to Medicare beneficiaries before discussing plan options at a sales appointment?
Answer: Scope of Appointment form
A Scope of Appointment (SOA) form must be completed before a sales appointment to document the topics the beneficiary agreed to discuss.
Under North Carolina law, what is the 'free look' period that allows a new Medicare Supplement policyholder to cancel and receive a full refund?
Answer: 30 days
North Carolina requires a 30-day free look period for Medicare Supplement (Medigap) policies, giving buyers time to review and return the policy for a full refund.
A North Carolina resident turns 65 and enrolls in Medicare Part B. How long is their guaranteed issue window for a Medicare Supplement plan?
Answer: 6 months
Federal law grants a 6-month Medigap Open Enrollment Period beginning the month a beneficiary is 65+ and enrolled in Part B, during which insurers cannot use medical underwriting.
A North Carolina Medicare Advantage plan must provide emergency care coverage at which locations?
Answer: Anywhere in the United States
CMS requires all Medicare Advantage plans to cover emergency and urgently needed care anywhere in the United States, regardless of network.
Which Part D cost-sharing feature protects North Carolina beneficiaries from catastrophic out-of-pocket drug spending each year?
Answer: Catastrophic coverage threshold
Once a beneficiary's true out-of-pocket drug costs reach the catastrophic threshold, they pay minimal cost-sharing for the remainder of the year.