INS-INX7506 - Medicare Supplement and Long Term Care
Course Description
This course is designed to instruct students in the Medicare Supplement and Long Term Care insurancetopics to meet the prelicensing education requirements for Insurance Agents as prescribed by the North
Carolina Department of Insurance- Agent Services Division.
Course Outline
I. Understanding Medicare
A. Terms and Concepts
B. Enrollment
C. Concepts
D. Payment of Claims
II. Medicare Part A (Hospital Insurance), Original Medicare
A. Inpatient Hospital Care
B. Skilled Nursing Facility (SNF) care
C. Home Health Care
D. Hospice Care
E. Provide Claim Filing
F. Additional Part A Services
III. Part B (Medical Insurance), Original Medicare
A. Deductible
B. Coinsurance
C. Covered Services
D. Other Covered Services
E. Assignment Payment Method
F. Medicare Summary Notice
IV. Medicare Part C
A. Medicare Advantage
V. Medicare Part D
A. Eligibility
B. Minimum Standards
C. Prescription Plan Options
D. Other Group and Retirement Plans
VI. Medicare Supplement Policies (MEDIGAP)
A. Eligibility
B. Standardized Medicare Supplement Plans
C. Renewability
D. Preexisting Conditions
E. Minimum Requirements
F. Exclusions
G. Marketing and Selling of Medigap Policies
H. Statutes and Regulations
VII. Medicaid
A. Definition
B. Eligibility
C. Administration
D. Spending Down
E. Spousal Impoverishment
F. Medicare-Aid
VIII. Long Term Care Policies
A. Definition
B. Benefits
C. Renewability
D. Additional Features
E. Premiums
F. Preexisting Conditions
G. Outline of Coverage and Shopper's Guide
H. Policy Summary
I. Loss Ratios
J. Exclusions
K. Tax Considerations
L. Long-Term Care Market
M. Partnership Plans
N. Long-Term Care Insurance: Ref: Chapter 58, Article 55; HIPAA
O. Regulations: Long-Term Care: Ref: 11 NCAC 12.1002 through 12.1026,12.0555
Learner Outcomes
Completion students should be able to explain Medicare A & B and Medicaid to potential clients; aidthe client in selecting the Medicare Supplement and Long Term Care products necessary to supplement
Medicare A & B; apply North Carolina and Federal laws to the Agent/Client relationship; and complete the
Medicare Supplement Long term Care License Exam. Classes require 100% attendance.
Notes
Method of instruction - Lecture
Evaluation - Class Exam
Textbook Required