Med Ins & Billing (Ch 9 & 10) - Review - Medicare/Medicaid Questions and Answers | Latest Version | 2024/2025 | Correct & Verified

Med Ins & Billing (Ch 9 & 10) - Review - Medicare/Medicaid Questions and Answers | Latest Version | 2024/2025 | Correct & Verified What is the Medicaid eligibility criteria? Eligibility for Medicaid is based on income, household size, disability status, and other factors. The program is designed to assist low-income individuals, including children, pregnant women, and elderly individuals. What services does Medicare Part A cover? Medicare Part A covers hospital stays, skilled nursing facility care, hospice care, and some home health services. What does Medicare Part B cover? Medicare Part B covers outpatient services such as doctor visits, preventive services, and medically necessary equipment and supplies. What is the purpose of Medicare Part C? 2 Medicare Part C, also known as Medicare Advantage, allows individuals to get their Medicare benefits through private insurance plans that may offer additional benefits such as dental, vision, and prescription drug coverage. What is Medicare Part D? Medicare Part D provides prescription drug coverage, helping to reduce the cost of prescription medications for Medicare beneficiaries. How are Medicare premiums determined? Medicare premiums are determined by income, with most people paying a standard monthly premium for Part B and Part D. Higher-income individuals may pay higher premiums. What is the Medicaid Managed Care Program? The Medicaid Managed Care Program is a way for states to deliver Medicaid benefits to beneficiaries through private insurance plans, with a focus on preventive care and care coordination. What is the Medicaid Expansion under the Affordable Care Act? 3 Medicaid Expansion under the Affordable Care Act allows states to extend Medicaid coverage to more low-income adults, expanding eligibility for Medicaid to individuals with incomes up to 138% of the federal poverty level. What is the Medicaid Home and Community-Based Services (HCBS) waiver? The Medicaid HCBS waiver allows states to provide long-term care services in home and community settings, rather than in institutional settings, for eligible individuals. What is the role of the Medicaid State Plan? The Medicaid State Plan outlines the services covered by the Medicaid program in each state and establishes eligibility requirements, benefits, and payment methods. What are the main parts of Medicare? Medicare consists of four parts: Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage), and Part D (prescription drug coverage). What is Medicaid?