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Navigator State Certification Exam
Questions with Correct Verified Answers,
Already Passed! (Complete & Accurate)
Family Planning Eligibility Program - ANS ✓is an Indiana Medicaid
program that allows eligible men and women the ability to receive certain
family planning services and supplies for the primary purpose of
preventing or delaying pregnancy
Federal Poverty Level - ANS ✓is a figure released each year by the federal
government that estimates the minimum amount an individual or family
would need to make to cover basic living expenses. Measure reflects
income and household size, and changes annually. For 2014, the FPL for a
single person is $973 per month, and $1,988 per month for a family of four.
Health Maintenance Organization (HMO)- - ANS ✓is a designation given
to health insurers offering products or services in any market segment
(individual, small group, large group, or self-insured) in order to also
provide or arrange for the delivery of health care services to enrolees on a
prepaid basis. Individuals covered under a HMO will have a prescribed set
of providers that may provide covered services. Except for certain services,
including emergency services, HMOs are not required to cover services
provided by out of network providers.
Healthy Indiana Plan (HIP) - ANS ✓is Indiana's health coverage program
for Hoosier adults between the ages of 19-64 whose incomes are at or
below 100% FPL and who are not covered by Medicare or other Minimum
Essential Coverage (MEC). HIP is authorized through an 1115 Waiver with
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the federal Centres for Medicare & Medicaid Services (CMS). Covered
individuals and the State make monthly contributions to a POWER Account.
Home and Community Based Services (HCBS) Waiver- - ANS
✓authorized under Section 1915(c) of the Social Security Act, is an Indiana
Medicaid waiver designed to provide an array of services to enrolees to
prevent institutionalization. The HCBS waiver "waives" the requirement of
an admission to an institution in order for Medicaid to pay for the needed
home and community-based services. The different types of HCBS waivers
that Indiana offers are outlined in Table 20.
Hoosier Health Wise (HHW) - ANS ✓is Indiana Medicaid's program for
low income families, pregnant women and children under the age of 19.
Indiana Application for Health Coverage (IAHC) - ANS ✓- is an
application for an Indiana Health Coverage Program (IHCP) which may be
submitted to DFR either online through the Benefits Portal, by phone, fax,
mail, or in-person at a local DFR office. The different methods for
submitting an IAHC, as well as contact information, are listed in Table 68.
Indiana Healthcare Coverage Program (IHCP - ANS ✓is a term that
refers to any of the several programs operated under Indiana Medicaid,
which have been developed to address the medical needs of the low
income, aged, disabled, blind, pregnant, and other populations meeting the
eligibility criteria. Each IHCP has different criteria for eligibility. Types of
IHCPs include, but are not limited to, Hoosier Healthwise, Healthy Indiana
Plan (HIP), Care Select, Traditional Medicaid, and home and community
based waiver services (HCBS)
Managed Care Entity (MCE - ANS ✓(also referred to as Managed Care
Organization (MCO)) is a general term used to describe health plans that
are designed to control the quality and cost of healthcare delivery. The
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term includes models such as a Health maintenance Organization (HMO) or
a Preferred Provider Organization (PPO). In Indiana Medicaid, benefits are
delivered in the Hoosier Healthwise and HIP through MCEs for some
populations.
Medicaid- - ANS ✓is a means tested federal-state entitlement program
enacted in 1965 by Title XIX of the Social Security Act. It provides free or
low-cost health insurance coverage to individuals meeting the States'
eligibility criteria which are developed within the parameters established
by the federal government. Medicaid offers federal matching funds to states
for costs incurred in paying health care providers for serving eligible
individuals.
Medicaid Review Team (MRT) - ANS ✓is a group that determines a
Medicaid applicant's eligibility for Indiana Medicaid based on a disability.
To meet the disability requirement, a person must have a significant
impairment that is expected to last a minimum of 12 months. The MRT
makes this determination and notifies the DFR of its decision.
Medicare Savings Program - ANS ✓is a Medicaid program that helps
Medicare beneficiaries pay for Medicare premiums and cost-sharing. There
are four different categories of the Medicare Savings Program described in
Table 22.
M.E.D Works - ANS ✓- is Indiana's health care program for working people
with disabilities. M.E.D. Work's members pay premiums based on their
income and receive full Medicaid benefits.
Miller Trust - ANS ✓(also referred to as Qualified Income Trust (QIT)) is a
legal arrangement for holding funds that allows an individual with income
that exceeds 300 percent of the federal Supplemental Security Income
benefit rate (also known as the Special Income Limit-$2,163 monthly in
Navigator State Certification
Navigator
Navigator State Certification Exam
Questions with Correct Verified Answers,
Already Passed! (Complete & Accurate)
Family Planning Eligibility Program - ANS ✓is an Indiana Medicaid
program that allows eligible men and women the ability to receive certain
family planning services and supplies for the primary purpose of
preventing or delaying pregnancy
Federal Poverty Level - ANS ✓is a figure released each year by the federal
government that estimates the minimum amount an individual or family
would need to make to cover basic living expenses. Measure reflects
income and household size, and changes annually. For 2014, the FPL for a
single person is $973 per month, and $1,988 per month for a family of four.
Health Maintenance Organization (HMO)- - ANS ✓is a designation given
to health insurers offering products or services in any market segment
(individual, small group, large group, or self-insured) in order to also
provide or arrange for the delivery of health care services to enrolees on a
prepaid basis. Individuals covered under a HMO will have a prescribed set
of providers that may provide covered services. Except for certain services,
including emergency services, HMOs are not required to cover services
provided by out of network providers.
Healthy Indiana Plan (HIP) - ANS ✓is Indiana's health coverage program
for Hoosier adults between the ages of 19-64 whose incomes are at or
below 100% FPL and who are not covered by Medicare or other Minimum
Essential Coverage (MEC). HIP is authorized through an 1115 Waiver with
Navigator State Certification
, 2
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the federal Centres for Medicare & Medicaid Services (CMS). Covered
individuals and the State make monthly contributions to a POWER Account.
Home and Community Based Services (HCBS) Waiver- - ANS
✓authorized under Section 1915(c) of the Social Security Act, is an Indiana
Medicaid waiver designed to provide an array of services to enrolees to
prevent institutionalization. The HCBS waiver "waives" the requirement of
an admission to an institution in order for Medicaid to pay for the needed
home and community-based services. The different types of HCBS waivers
that Indiana offers are outlined in Table 20.
Hoosier Health Wise (HHW) - ANS ✓is Indiana Medicaid's program for
low income families, pregnant women and children under the age of 19.
Indiana Application for Health Coverage (IAHC) - ANS ✓- is an
application for an Indiana Health Coverage Program (IHCP) which may be
submitted to DFR either online through the Benefits Portal, by phone, fax,
mail, or in-person at a local DFR office. The different methods for
submitting an IAHC, as well as contact information, are listed in Table 68.
Indiana Healthcare Coverage Program (IHCP - ANS ✓is a term that
refers to any of the several programs operated under Indiana Medicaid,
which have been developed to address the medical needs of the low
income, aged, disabled, blind, pregnant, and other populations meeting the
eligibility criteria. Each IHCP has different criteria for eligibility. Types of
IHCPs include, but are not limited to, Hoosier Healthwise, Healthy Indiana
Plan (HIP), Care Select, Traditional Medicaid, and home and community
based waiver services (HCBS)
Managed Care Entity (MCE - ANS ✓(also referred to as Managed Care
Organization (MCO)) is a general term used to describe health plans that
are designed to control the quality and cost of healthcare delivery. The
Navigator State Certification
, 3
Navigator
term includes models such as a Health maintenance Organization (HMO) or
a Preferred Provider Organization (PPO). In Indiana Medicaid, benefits are
delivered in the Hoosier Healthwise and HIP through MCEs for some
populations.
Medicaid- - ANS ✓is a means tested federal-state entitlement program
enacted in 1965 by Title XIX of the Social Security Act. It provides free or
low-cost health insurance coverage to individuals meeting the States'
eligibility criteria which are developed within the parameters established
by the federal government. Medicaid offers federal matching funds to states
for costs incurred in paying health care providers for serving eligible
individuals.
Medicaid Review Team (MRT) - ANS ✓is a group that determines a
Medicaid applicant's eligibility for Indiana Medicaid based on a disability.
To meet the disability requirement, a person must have a significant
impairment that is expected to last a minimum of 12 months. The MRT
makes this determination and notifies the DFR of its decision.
Medicare Savings Program - ANS ✓is a Medicaid program that helps
Medicare beneficiaries pay for Medicare premiums and cost-sharing. There
are four different categories of the Medicare Savings Program described in
Table 22.
M.E.D Works - ANS ✓- is Indiana's health care program for working people
with disabilities. M.E.D. Work's members pay premiums based on their
income and receive full Medicaid benefits.
Miller Trust - ANS ✓(also referred to as Qualified Income Trust (QIT)) is a
legal arrangement for holding funds that allows an individual with income
that exceeds 300 percent of the federal Supplemental Security Income
benefit rate (also known as the Special Income Limit-$2,163 monthly in
Navigator State Certification
