CHAPTER 6 MEDICARE AND
MEDICAID EXAM ACTUAL UPDATED QUESTIONS AND VERIFIED
ANSWERS
How much does the CMS spend each year? - ANSWER over 1 trillion dollars
(646B to medicare and 545B to medicaid)
Who funds Medicaid? - ANSWER -Funded jointly by Fed/State
-Contributes minimum of 50% (83% in poorest states)
-Based on per-capita income in ea. state
*State determines payment rates for MDs,and health plans
What 2 groups are eligible for medicaid? - ANSWER 1)Categorically Needy
2)Medically Needy
Categorically Needy - ANSWER -Children and low income adults who qualify for AFDC
-AFDC= aid for families with dependent children
-Low income, aged, blind, disabled (SSI)
Medically Needy - ANSWER Meet the financial reqs for categorically
What is spend down? - ANSWER -Spend-Down: if someone monthly income exceeds the
maximum payment amount they must pay a certain amount before benefits kick in for each
month
MEDICAID EXAM ACTUAL UPDATED QUESTIONS AND VERIFIED
ANSWERS
How much does the CMS spend each year? - ANSWER over 1 trillion dollars
(646B to medicare and 545B to medicaid)
Who funds Medicaid? - ANSWER -Funded jointly by Fed/State
-Contributes minimum of 50% (83% in poorest states)
-Based on per-capita income in ea. state
*State determines payment rates for MDs,and health plans
What 2 groups are eligible for medicaid? - ANSWER 1)Categorically Needy
2)Medically Needy
Categorically Needy - ANSWER -Children and low income adults who qualify for AFDC
-AFDC= aid for families with dependent children
-Low income, aged, blind, disabled (SSI)
Medically Needy - ANSWER Meet the financial reqs for categorically
What is spend down? - ANSWER -Spend-Down: if someone monthly income exceeds the
maximum payment amount they must pay a certain amount before benefits kick in for each
month
