PUBH 6012 Quiz 3| Questions and Answers |Complete Solutions Graded A+ |100% Correct
State variations in medicaid individual state policies for eligibility, cost sharing, provider
reimbursement and additional coverage. State did not have to expand medicaid
State variation in premium and cost sharing may charge premium for enrollees with incomes
greater than 150% of FPL, may charge cost sharing up to maximums that vary by income
Medicaid Wavers (from ACA) these allow states an avenue to test various approaches to
medicaid that differ from the federal government
State Responses to program options in medicaid Fed gov sets minimum standards but states
have flexibility in many areas: eligibility, benefits, premiums and cost sharing, delivery system
and provider payments, waivers
CHIP congressional intent to reduce number of uninsured children, build on medicaid but
not as an entitelment and give states flexibility
Medicare Part A (aka Hospital Insurance or HI) Provides hospital insurance automatically @
age 65 (if FICA qualified) @ no fee but may have deductible & co-pay. (only premiums oif they
made payroll contributions to medicare
Medicare Part B Outpatient care. Extends Medicare to supplemental treatments, and
physicians and preventive services. Part B is funded by general revenues and beneficiary
premiums
Medicare Part C Medicare Advantage Program, allows beneficiaries to enroll in a private
plans such as an HMP o a PPO as an alternative to traditional Medicare
Medicare Part D outpatient prescription drug benefit. voluntary and delivered through
private plans. Part D enrollees generally pay a monthly premium and cost sharing for
prescriptions
State variations in medicaid individual state policies for eligibility, cost sharing, provider
reimbursement and additional coverage. State did not have to expand medicaid
State variation in premium and cost sharing may charge premium for enrollees with incomes
greater than 150% of FPL, may charge cost sharing up to maximums that vary by income
Medicaid Wavers (from ACA) these allow states an avenue to test various approaches to
medicaid that differ from the federal government
State Responses to program options in medicaid Fed gov sets minimum standards but states
have flexibility in many areas: eligibility, benefits, premiums and cost sharing, delivery system
and provider payments, waivers
CHIP congressional intent to reduce number of uninsured children, build on medicaid but
not as an entitelment and give states flexibility
Medicare Part A (aka Hospital Insurance or HI) Provides hospital insurance automatically @
age 65 (if FICA qualified) @ no fee but may have deductible & co-pay. (only premiums oif they
made payroll contributions to medicare
Medicare Part B Outpatient care. Extends Medicare to supplemental treatments, and
physicians and preventive services. Part B is funded by general revenues and beneficiary
premiums
Medicare Part C Medicare Advantage Program, allows beneficiaries to enroll in a private
plans such as an HMP o a PPO as an alternative to traditional Medicare
Medicare Part D outpatient prescription drug benefit. voluntary and delivered through
private plans. Part D enrollees generally pay a monthly premium and cost sharing for
prescriptions
