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A 部分是医院保险，覆盖住院、合格住院后的有限专业护理机构护理、临终关怀和部分家庭健康服务。B 部分覆盖门诊和医生服务。

B 部分是医疗保险，覆盖门诊服务、医生就诊、预防性护理和耐用医疗设备。A 部分用于住院医院服务。

C 部分称为 Medicare Advantage，由与 CMS 签约的私人保险公司提供，包含 A、B 部分所有福利，通常还包括药物覆盖。Medigap 是补充保险，不属于 Medicare 本身。

D 部分是处方药福利，由私人保险公司出售，受益人必须已有 A 部分或 B 部分才能注册。如今出售的 Medigap 保单不包括药物覆盖。

未满 65 岁的人在领取 SSDI 福利 24 个月后有资格获得 Medicare。ALS 和终末期肾病是例外，可以更早获得资格。

ALS 可立即加入 Medicare，无需 24 个月等待期。终末期肾病也有特别规则。其他大多数慢性病仍需 24 个月 SSDI 等待期。

IEP 是围绕 65 岁生日的 7 个月窗口：出生月份前 3 个月、出生月份本身和出生月份后 3 个月。

AEP 每年从 10 月 15 日持续到 12 月 7 日。在此期间，受益人可加入、转换或退出下一个日历年的 Medicare Advantage 或 D 部分计划。

B 部分晚注册罚款是每延迟一个完整 12 个月期间，标准 B 部分保费增加 10%，并持续与 B 部分一样长的时间。

D 部分晚注册罚款为每月按全国基准受益人保费的 1% 计算，对应于首次有资格后未持有可信药物覆盖的月份，并持续与 D 部分一样长的时间。

联邦法律将 Medigap 标准化为 10 个字母计划：A、B、C、D、F、G、K、L、M 和 N。在同一个州内，每个字母对应的福利在所有保险公司中必须相同。

F 计划（以及 C 计划）不能出售给 2020 年 1 月 1 日及之后首次有资格的 Medicare 受益人，因为这些计划覆盖了 B 部分自付额，国会通过 MACRA 取消了新购买者的这项福利。2020 年前已注册者可以保留。

联邦 Medigap 开放注册期是一次性的 6 个月窗口，从受益人同时年满 65 岁且已加入 B 部分的第一个月开始。在此期间保险公司不能使用医疗核保。

加州生日规则允许现有 Medigap 保单持有人每年在生日窗口内，向任何保险公司转换福利相等或更少的 Medigap 计划，无需医疗核保。

保险法 §789.10 要求在与老年人（65 岁及以上）在其家中讨论人寿保险或年金前，至少提前 24 小时递交书面通知。通知必须列明出席人员和将讨论的产品。

保险法 §10127.10 规定，对 65 岁及以上者出售的人寿保险和年金合同有 30 天自由检查期，是适用于较年轻买家 10 天期间的三倍。

保险法 §787 禁止针对老年人的高压或误导性手段。把销售演示伪装成教育性免费午餐研讨会的做法不被允许；销售活动必须在邀请函和现场予以披露。

保险法 §785.10 禁止对出售给老年人的人寿保险或年金产品进行不必要的替换（twisting 或 churning）。替换必须对客户合适并妥善记录，而非由代理人的佣金驱动。

California Insurance Code §789.10 规定，在与 65 岁或以上老年客户进行入户推销以介绍寿险或年金产品之前，代理人须以书面形式送达通知，载明所有到场人员姓名、日期与时间、有权要求他人在场的权利、以及随时终止约见的权利。该通知须至少提前 24 小时送达——或者，经老年客户同意后，可在约见当时门口送达。该 24 小时「冷静期」通知旨在防止突袭式高压销售。选项 B 与 14 天年金披露预备期混淆。选项 D 与 A 系臆造的其他时限。

California Insurance Code §10127.10 规定，向 60 岁或以上人士签发或交付的任何个人寿险或年金保单，享有 30 天退回权。若在收到保单后 30 天内退回，该老年人有权获得已缴保费的全额退还（对于变额年金/变额寿险，若选择，可退还合同价值；但对固定寿险保单的标准规则为全额退保费）。选项 B 与「退保」混淆，而非试看期。选项 C 金额错误——加州禁止在试看期内扣除行政费。选项 A 把按比例取消与试看期混为一谈。30 天老年试看期是加州的标志性消费者保护，与 §10127.9 下针对较年轻购买者的标准 10 天期不同。

California Insurance Code §10234.93（以及加州采纳的 NAIC 《年金交易适当性示范法》）要求代理人有合理依据相信所推荐的年金，结合消费者的年龄、财务状况、流动性需要、财务目标、预期用途、时间范围和现有资产，是适当的。对一位 78 岁、2 年内即有流动性需求的客户使用 9 年退保期，未通过时间范围与流动性两项检验——退保费用恰好会在需要资金时侵蚀本金。选项 A 错误地假设税延对所有人都有利。选项 D——签署的声明无法治愈一个在结构上不适当的销售。选项 B——8 小时年金培训是必备条件，但完成培训并不能使不适当的推荐合法化。

「Twisting」是为代理人本人而非客户的经济利益，诱使保单或年金被替换的欺骗性做法。California Insurance Code §781 禁止以替换为目的进行不实陈述；§10234.93 对年金的适当性与替换义务作出具体规定——在客户年满 65 岁时依 §785-789.10 进一步加严。Twisting 属不公平贸易行为，可导致罚款、暂停执照及赔偿。选项 A「回扣」是与客户分享佣金（依 §750 亦被禁止）。选项 B「诽谤」是对其他保险公司作不实陈述。选项 D「胁迫」是强迫购买搭售产品。仅 Twisting 描述了为佣金而滥用替换的行为。

加州《长期护理保险改革法》（Insurance Code §10232 et seq.）及其配套法规要求，申请人在投保申请之时或之前收到标准化的「《长期护理保险购买者指南》」（也称 Taking Care of Tomorrow 指南）「以及」一份个性化的「Outline of Coverage（承保范围概要）」，外加 Shopper's Guide。Buyer's Guide 阐释一般 LTC 概念；Outline of Coverage 总结具体保单的给付、除外与保费。选项 D 适用于「年金」，而非 LTC。选项 C 错——加州在 LTC 的售前披露上属最严格之列。选项 B——表格 1099-LTC 是「税务」表格（领取给付后才寄出），HIPAA 隐私通知与医疗信息相关，而非 LTC 投保前披露。

加州老年人保险保护体系叠加多项法规：(a) California Insurance Code §10127.10 对向年满 60 岁人士交付的任何个人寿险或年金保单提供 30 天 free-look 退回权，按全额保费退还；(b) §10127.13 要求年金披露文件（合同摘要、Buyer's Guide）；(c) §10234.93 施加年金适当性义务和替换披露；(d) §789.10 要求事先提供入户推销通知；(e) §785-787 一般规范面向老年人的推销。选项 C 忽视老年人附加保护。选项 D 忽视年金披露。选项 A 错误；老年人保护「同时」适用于固定与可变年金（可变年金还需符合 SEC/FINRA 的招募说明书要求）。30 天老年人 free-look 是加州最具特色的消费者权利之一。

依 California Insurance Code §10509.4 和 CDI 替换规章（10 CCR §2698.30 et seq.），「替换」交易——广义定义为：购买新保单时涉及对现有寿险或年金合同的「停止、退保、失效、丧失或以其他方式减少利益」——触发严格的通知与比较要求。展业人必须：(1) 出示并取得签字的「Notice Regarding Replacement」；(2) 列出每一份被替换合同；(3) 将通知「同时」提交给现有与替换保险公司；(4) 提供书面比较信息。选项 A 错误；口头、事后建议违反规则。选项 B 编造展业人自由裁量权。选项 D 错误；在「同一」保险公司发生的「内部」替换仍受替换规则约束（仅有限例外）。对老年人替换的审查尤为严格。

依 California Insurance Code §10127.10，30 天老年人 free-look 适用于发给 60 岁及以上人士的个人寿险「以及」年金合同（包括可变年金）。可变年金带来独特问题：子账户投资表现可能导致退还价值与保费不一致。加州规章及多数公司备案以下列方式响应：(1) 退还「合同价值」（可能高于或低于保费）；和/或 (2) 要求 free-look 期内的保费分配至稳定的「货币市场子账户」，使消费者获得全额保费退还。选项 A 对可变产品的「简单退还保费」夸大其词。选项 B 编造 50% 的规则。选项 C 错误；可变年金「不」豁免——它们同时受加州 free-look 规则和联邦 SEC/FINRA 撤销权约束。

Medicare is a federal program that primarily covers people age 65 and older (and certain younger people with disabilities or end-stage renal disease), regardless of income. Medicaid is a joint federal-state program that provides coverage based on financial need (low income and limited assets). Calling Medicare needs-based and state-funded while calling Medicaid age-based reverses the two programs. Neither is purely age-based without regard to income (Medicaid is means-tested), and neither is run by the Social Security Administration; the drug-only and hospital-only descriptions misstate both programs, since Medicare has multiple parts (A, B, C, D) covering hospital, medical, and drug benefits.

Medicare Part A is hospital insurance, covering inpatient hospital stays, skilled nursing facility care following a hospitalization, hospice care, and certain home health services. Physician office visits and outpatient care fall under Part B, prescription drugs under Part D, and routine vision and dental are generally not covered by Original Medicare. Part A is usually premium-free for those who paid Medicare taxes long enough, and remembering that Part A equals hospital coverage is a core exam fact.

Medicare Part B is medical insurance, covering physician services, outpatient hospital care, durable medical equipment, and a range of preventive services; beneficiaries pay a monthly premium for it. Inpatient hospital care is Part A, prescription drugs are Part D, and long-term custodial care is largely not covered by Medicare at all. Knowing that Part B handles doctor and outpatient services, while Part A handles hospital stays, is essential for advising Medicare-eligible clients.

Medicare Part D is the prescription drug benefit, delivered through private insurers approved by Medicare, and it helps beneficiaries pay for outpatient medications. Inpatient hospital care is Part A, hospice is also under Part A, and custodial nursing home care is generally not a Medicare benefit. Part D was added to fill the prescription drug gap in Original Medicare, and beneficiaries choose a stand-alone drug plan or get drug coverage bundled into a Medicare Advantage plan.

Medicare Advantage (Part C) plans are offered by private insurers approved by Medicare and provide Part A and Part B benefits together, frequently adding extras such as drug, dental, or vision coverage, often through an HMO or PPO network. They are not the same as Medigap (which supplements Original Medicare), are not run directly by the government, and cover far more than drugs alone. Part C is an alternative way to receive Medicare benefits through a private plan.

Medigap policies supplement Original Medicare by paying some of the out-of-pocket costs Medicare does not, such as deductibles, coinsurance, and copayments, and they are sold as standardized plans so consumers can compare them easily. They do not replace Medicare, are not primarily drug plans, and do not cover long-term custodial care. Medigap works alongside Original Medicare, filling its gaps, and cannot be paired with a Medicare Advantage plan at the same time.

Medicaid is a joint federal-state program that provides health coverage to low-income individuals and families based on financial need (limited income and assets), with the federal government and states sharing the cost. It is not purely federal or age-based (that description fits Medicare), is not premium-funded by recipients, and is not open to everyone regardless of income, because it is means-tested. Medicaid is also the largest payer for long-term custodial care in the United States, a gap Medicare largely leaves uncovered.

Part A is premium-free for those with a sufficient work history of Medicare payroll taxes (about 40 quarters). It is not means-tested, optional, or funded by Part B.

Part B covers physician and outpatient services, tests, and durable medical equipment. Inpatient hospital care is Part A, and drugs are Part D; Medicare does not cover long-term custodial care.

Part B is optional and requires a monthly premium, commonly withheld from the enrollee's Social Security check. It is not free, disability-only, or employer-funded.

Part C lets beneficiaries receive their Medicare benefits through approved private plans that bundle Parts A and B, frequently adding extras like drug or dental coverage. It is not government drug coverage or a Medicaid supplement.

Medicare pays for medically necessary care but not ongoing custodial long-term care, which is a major reason people buy LTC insurance. Hospital stays, doctor visits, and lab tests are covered.

Medigap plans are federally standardized by letter, so the same plan letter provides identical core benefits regardless of insurer, making them easy to compare. They are sold by private insurers, not the government, and are not drug plans.

The Medigap open enrollment period lasts 6 months from when someone is 65 and enrolled in Part B, and during it insurers cannot use medical underwriting to deny or rate coverage.

Medigap fills gaps in Original Medicare, like deductibles and coinsurance, and by law cannot duplicate benefits Medicare pays. It does not replace Medicare, substitute for Part D, or cover long-term custodial care.

Under the Medicare Secondary Payer rules, a large employer's group plan pays first (primary) for an active employee 65+, and Medicare pays second. The group plan is not secondary or the only payer in this situation.