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North Carolina Course Update December 2022

North Carolina Medicare Supplement/Long-Term Care course will be updated on December 15, 2022, with 2023 dollar amounts. Continue reading for additional information and to view the North Carolina Medicare Supplement/Long-Term Care course addendum.

>  North Carolina Medicare Supplement/Long-Term Care Addendum


Medicare Supplement/Long-Term Care


Addendum: for use with North Carolina Medicare Supplement/Long-Term Care online ExamFX course and study guide version 26976en, per regulatory updates effective 01/01/2023.

The following are content revisions with updated dollar amounts for 2023:

MEDICARE PART A

Part A Premium

Most people don't pay a monthly premium for Part A. If you buy Part A, you'll pay up to $506 each month.

Hospital Inpatient Deductible

You pay:

  • $1,600 deductible for each benefit period
  • Days 1-60: $0 coinsurance for each benefit period
  • Days 61-90: $400 coinsurance per day of each benefit period
  • Days 91 and beyond: $800 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over insured’s lifetime)
  • Beyond lifetime reserve days: all costs

Skilled Nursing Facility Coinsurance
  • Days 1–20: $0 for each benefit period
  • Days 21–100: $200 coinsurance per day of each benefit period
  • Days 101 and beyond: all costs

MEDICARE PART B

Premium
  • $164.90 each month

Deductible
  • $226 per year


MEDICARE PART D

Premium

The Part D monthly premium varies by plan (higher-income consumers may pay more)

  • $32.74 (national base beneficiary premium)

Deductible
  • $505

Drug Costs
  • For the amounts between $505 and $4,660, Medicare pays for drug costs
  • Coverage gap: from $4,660, plan enrollee pays 25% for brand-name or generic drugs until true out-of-pocket spending reaches $7,400
  • After plan enrollee reaches $7,400 in true out-of-pocket spending, Medicare pays about 95% of drug costs

Catastrophic Coverage
  • Insured pays the greater of $4.15 for generic drugs and $10.35 for name brand drugs, or 5% of retail cost, whichever is higher

LONG-TERM CARE

State Mandated Benefits
  • Benefits paid under a federally qualified plan are not taxable if the amount paid does not exceed the federal per diem amounts ($420)


Medicare in General

B. Enrollment

6. General Enrollment Period – new coverage start date

Beginning January 1, 2023, if a person signs up for Medicare during the month they turn 65, during the last 3 months of their Initial Enrollment Period, or during the General Enrollment Period, coverage starts the on first day of the month after signing up.

7. Special Enrollment Period – additional qualifying events

Beginning January 1, 2023, a person may be eligible for a Special Enrollment Period if they miss an enrollment period because of certain exceptional circumstances, like being impacted by a natural disaster or an emergency, incarceration, or losing Medicaid coverage.