NAVIGATOR STATE VERIFIED FINAL PAPER 2026
SOLVED QUESTIONS AND FULL SOLUTION
UPDATED
◉ Authorized Representatives (ARs) are not required to be certified
as Navigators?
Answer: True
◉ 115C waiver
Answer: is a vehicle by which the Centers for Medicare & Medicaid
Services (CMS) may waive certain Medicaid and Children's Health
Insurance Program (CHIP) regulations, allowing a state to test new
or existing ways to deliver and pay for health care services under
these two programs. In Indiana, the Healthy Indiana Plan (HIP)
operates under an 1115 (c) waiver.
◉ 1634 Status
Answer: is a federal designation given to states for determining
Medicaid eligibility for the aged, blind, and disabled populations.
Under this program, recipients of Supplemental Security Income
(SSI) through the federal Social Security Administration (SSA) obtain
automatic Medicaid enrollment and need not complete a separate
state Medicaid application. In addition, 1634 Status states may, but
are not required to, operate a Medicaid spend-down program.
Indiana became a 1634 Status state in 2013.
,◉ Authorized Representative
Answer: is an individual or organization designated by a Medicaid or
insurance affordability program applicant or beneficiary to act
responsibly on his or her behalf to assist with the individual's
application and renewal of eligibility and other ongoing
communications. Authorized representatives may be authorized to
sign an application on the applicant's behalf, complete and submit a
renewal form and receive copies of the applicant or beneficiary's
notices and other communications from the Medicaid agency.
◉ Auto Assignment
Answer: is the process by which an individual who does not select a
Hoosier Healthwise (HHW) or Healthy Indiana Plan (HIP) Managed
Care Entity (MCE) at the time of the HHW or HIP application, or
within fourteen (14) days of the submission of the application, is
automatically assigned to a Managed Care Entity.
◉ Behavioral & Primary Healthcare coordination Program (BPHC)
Answer: is a program that provides access to Medicaid
Rehabilitation Option (MRO) services to individuals with Serious
Mental Illness (SMI) whose income would otherwise be too high to
qualify for Medicaid coverage. A person deemed eligible for BPHC
receives full Medicaid benefits.
◉ Benefits Portal
, Answer: is a website developed and managed by the Indiana
Department of Family Resources (DFR) by which Hoosier insurance
consumers may apply for Indiana Health Coverage Programs
(IHCPs) as well as check the status of pending applications. The DFR
Benefits Portal is located at
www.ifcem.com/CitizenPortal/application.do.
◉ Care Management Organization (CMO)
Answer: is an organization contracted with Indiana Health Coverage
Programs (IHCPs) to perform the care management, prior
authorization, and utilization management of physical, behavioral,
and transportation services for members in Care Select. The CMO
manages care for Care Select members through its network of
Primary Medical Providers (PMPs), specialists, and other providers.
Currently, MDwise and Advantage Health Solutions serve as
Indiana's Care Management Organizations.
◉ Care Select
Answer: is an optional health care program for Indiana Medicaid
enrollees who have special health needs or would benefit from
specialized attention. Care Select includes comprehensive care
coordination for members. Individuals eligible for Care Select
include those who are eligible for Medicaid on the basis of being
aged, blind, disabled, a ward of the court or foster child or a child
receiving adoptive services or adoption assistance and have a
specific medical condition.
SOLVED QUESTIONS AND FULL SOLUTION
UPDATED
◉ Authorized Representatives (ARs) are not required to be certified
as Navigators?
Answer: True
◉ 115C waiver
Answer: is a vehicle by which the Centers for Medicare & Medicaid
Services (CMS) may waive certain Medicaid and Children's Health
Insurance Program (CHIP) regulations, allowing a state to test new
or existing ways to deliver and pay for health care services under
these two programs. In Indiana, the Healthy Indiana Plan (HIP)
operates under an 1115 (c) waiver.
◉ 1634 Status
Answer: is a federal designation given to states for determining
Medicaid eligibility for the aged, blind, and disabled populations.
Under this program, recipients of Supplemental Security Income
(SSI) through the federal Social Security Administration (SSA) obtain
automatic Medicaid enrollment and need not complete a separate
state Medicaid application. In addition, 1634 Status states may, but
are not required to, operate a Medicaid spend-down program.
Indiana became a 1634 Status state in 2013.
,◉ Authorized Representative
Answer: is an individual or organization designated by a Medicaid or
insurance affordability program applicant or beneficiary to act
responsibly on his or her behalf to assist with the individual's
application and renewal of eligibility and other ongoing
communications. Authorized representatives may be authorized to
sign an application on the applicant's behalf, complete and submit a
renewal form and receive copies of the applicant or beneficiary's
notices and other communications from the Medicaid agency.
◉ Auto Assignment
Answer: is the process by which an individual who does not select a
Hoosier Healthwise (HHW) or Healthy Indiana Plan (HIP) Managed
Care Entity (MCE) at the time of the HHW or HIP application, or
within fourteen (14) days of the submission of the application, is
automatically assigned to a Managed Care Entity.
◉ Behavioral & Primary Healthcare coordination Program (BPHC)
Answer: is a program that provides access to Medicaid
Rehabilitation Option (MRO) services to individuals with Serious
Mental Illness (SMI) whose income would otherwise be too high to
qualify for Medicaid coverage. A person deemed eligible for BPHC
receives full Medicaid benefits.
◉ Benefits Portal
, Answer: is a website developed and managed by the Indiana
Department of Family Resources (DFR) by which Hoosier insurance
consumers may apply for Indiana Health Coverage Programs
(IHCPs) as well as check the status of pending applications. The DFR
Benefits Portal is located at
www.ifcem.com/CitizenPortal/application.do.
◉ Care Management Organization (CMO)
Answer: is an organization contracted with Indiana Health Coverage
Programs (IHCPs) to perform the care management, prior
authorization, and utilization management of physical, behavioral,
and transportation services for members in Care Select. The CMO
manages care for Care Select members through its network of
Primary Medical Providers (PMPs), specialists, and other providers.
Currently, MDwise and Advantage Health Solutions serve as
Indiana's Care Management Organizations.
◉ Care Select
Answer: is an optional health care program for Indiana Medicaid
enrollees who have special health needs or would benefit from
specialized attention. Care Select includes comprehensive care
coordination for members. Individuals eligible for Care Select
include those who are eligible for Medicaid on the basis of being
aged, blind, disabled, a ward of the court or foster child or a child
receiving adoptive services or adoption assistance and have a
specific medical condition.
