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
A North Carolina agent is compensated for helping a beneficiary switch from one Medicare Advantage plan to another. Which compensation rule applies?
Answer: The agent receives a renewal commission rate for the switch
CMS rules require that plan-to-plan switches (internal or external) be compensated at the renewal rate, not the higher initial enrollment rate.
What is the primary purpose of North Carolina's SHIIP (Seniors' Health Insurance Information Program)?
Answer: To provide free, unbiased Medicare counseling to beneficiaries
SHIIP is a free state program staffed by trained volunteers who provide objective Medicare and health insurance counseling to North Carolina seniors.
A North Carolina Medicare beneficiary is dual-eligible (Medicare and Medicaid). Which plan type is specifically designed to coordinate their benefits?
Answer: Dual Eligible Special Needs Plan (D-SNP)
Dual Eligible Special Needs Plans (D-SNPs) are designed to coordinate Medicare and Medicaid benefits for beneficiaries who qualify for both programs.
Under North Carolina regulations, how must a Medicare Advantage agent document a telephonic enrollment?
Answer: The agent must record the call with the beneficiary's verbal consent
For telephonic enrollments, CMS requires a recorded call confirming the beneficiary's enrollment request, with the recording retained as documentation.
A North Carolina beneficiary loses employer group health coverage mid-year. What type of Medicare enrollment period does this trigger?
Answer: Special Enrollment Period
Losing employer group health coverage is a qualifying life event that triggers a Special Enrollment Period (SEP) allowing Medicare enrollment outside standard windows.
Which statement about Medicare Supplement Plan N in North Carolina is accurate?
Answer: Plan N requires copays for some office and emergency room visits
Medigap Plan N has cost-sharing in the form of copays for physician office visits (up to $20) and ER visits (up to $50 if not admitted), and does not cover Part B excess charges.
What is the maximum number of consecutive months a North Carolina beneficiary can be enrolled in a Medicare Medical Savings Account (MSA) plan before they must re-enroll?
Answer: MSA plans have no re-enrollment requirement; enrollment continues automatically
Medicare MSA plan enrollment continues automatically year to year unless the beneficiary actively disenrolls or switches during an enrollment period.