Flashcards in Session 9 Deck (25):
What is the public health insurance program for low-income children, adults, and persons with disabilities?
How is Medicaid funded?
Jointly by federal gov and state
True or False? In general, states have the freedom to administer the Medicaid program the way they choose.
States use _______ to establish Medicaid eligibility.
Medicaid was enacted in 1965 (Johnson Administration) through the __________ amendment to the Social Security Act.
True or False? At the federal level, Medicaid is administered by the Centers for Medicare and Medicaid Services (CMS).
True or False? States are required to participate but must still follow a limited number of federal guidelines for insuring low-income individuals.
False. States are not required to participate but must still follow a limited number of federal guidelines for insuring low-income individuals.
What is designed to provide comprehensive and preventive health care services for children under age 21 who are enrolled in Medicaid?
Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)
What are the three state requirements for EPSDT?
Inform all eligible recipients that benefits exist
Provide/arrange for screening services for children
Arrange (directly or through referral) for corrective treatment
What are the five EPSDT services?
Screening (general health and immunizations)
Other services, as needed
What is the public health insurance program for near-poor children?
Children's Health Insurance Program (CHIP)
What are the three similarities between CHIP and Medicaid?
- Funded jointly by the federal government and the states – states receive additional funds above and beyond those allocated for - Medicaid
States use means-testing to establish eligibility
- CHIP is also administered by CMS at the federal level
What are the three ways states can use CHIP?
- Administer a separate program from Medicaid
- Expand Medicaid coverage using a higher FPL cut-off
- Combine both programs into one
True or False? Dental coverage in Medicaid relies on FQHCs and other not-for-profit group practices to fill the void.
True or False? 48% of children eligible for Medicaid receive any dental service. (less than half) And even less than 48% receive preventive care.
True or False? Less than 1 in 5 receive treatment for dental disease.
What is a Federal health insurance program for
adults aged 65 years and older (largest proportion),
younger persons with disabilities, and persons with end-stage renal disease?
What program represents an entitlement program
(employees are taxed over their lifetime and eligibility is not based on income)?
Medicare was enacted in 1965 (Johnson Administration) through ________ of the Social Security Act.
What includes inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care services
Medicare Part A
What includes specified doctor’s services, outpatient care, medical supplies, and preventive services (Medical Insurance)?
Medicare Part B
Medicare parts A and B is referred to as ______.
What includes coverage provided by private companies that contract with Medicare to provide Part A and Part B services; some other services are sometimes provided including prescription drugs
(Medicare advantage plan)?
Medicare Part C
What provides coverage for prescription medications through private insurance companies and other private organizations approved by Medicare (Prescription Drug Coverage)?
Medicare Part D