PUBH 6012 Exam 2 Questions and Answers |Complete Solutions Graded A+ |100% Correct
who predominantly falls in medicaid coverage gap adults in states that did not expand
medicaid (typically fall in the south) ; majority are working and work for small companies, or
agricultural or service sectors where employer sponsored insurance options are lacking . they
can't afford private insurance but they make too much for medicaid
how does federal govt enforce mandatory benefits of medicaid federal matching of funds
requires states to offer certain benefits; there are optional benefits that states can add that
might come with more funding
EPSDT early periodic screening diagnosis treatment (defines scope of benefits for different
targeted populations of medicaid)
can medicaid be used as supplemental insurance for those on medicare yes. it can cover
their premium and cost sharing costs
is medicaid an entitlement program yes
How is Medicaid financed? -Partly by state and partly by federal government
-Every state must provide basic health services to receive federal funds
NO premiums or deductible for patients
progressive financing structure that uses tax revenue from higher income individuals to pay for
care of lower income individuals
t/f a significant portion of medicaid spending goes to paying for long term care true about
40 percent
FMAP *federal medical assistance percentage*
, % of money spent on medicaid that the fed govt will reimburse the state with . varies
significantly from state to state based on their per-capita income and the services and eligibility
the states set forth in their medicaid program
what group accounts for the most medicaid spending disabled (despite making up smallest
portion of beneficiaries)
what eligible group accounts for least medicaid spending children (despite making up almost
40 percent of beneficiaries)
who is primarily responsible for administering medicaid the states. they set policies for
eligibility requirements, cost sharing, provider payment structure, optional additional coverage,
waivers
what is the goal of CHIP reduce the number of uninsured children
is CHIP an entitlement program no it is a block grant that is reauthorized every ten years
(states have more flexibility to use the funds)
who is eligible for CHIP children not otherwise eligible for Medicaid, up to 300 percent of
FPL, i.e. covers children above federal poverty level set by Medicaid
Based on state choice, allows coverage for pregnant women, immigrant pregnant women and
children, and children of state employees
what benefits does CHIP include EPSDT benefits relevant to children, CHIPRA
(reauthorization) also imposed dental coverage and mental health parity
are there premiums and cost sharing in CHIP yes, state can set these on a sliding scale within
set federal limits (i.e. you need to be above certain percentages of the FPL before you will be
required to pay premiums)
who predominantly falls in medicaid coverage gap adults in states that did not expand
medicaid (typically fall in the south) ; majority are working and work for small companies, or
agricultural or service sectors where employer sponsored insurance options are lacking . they
can't afford private insurance but they make too much for medicaid
how does federal govt enforce mandatory benefits of medicaid federal matching of funds
requires states to offer certain benefits; there are optional benefits that states can add that
might come with more funding
EPSDT early periodic screening diagnosis treatment (defines scope of benefits for different
targeted populations of medicaid)
can medicaid be used as supplemental insurance for those on medicare yes. it can cover
their premium and cost sharing costs
is medicaid an entitlement program yes
How is Medicaid financed? -Partly by state and partly by federal government
-Every state must provide basic health services to receive federal funds
NO premiums or deductible for patients
progressive financing structure that uses tax revenue from higher income individuals to pay for
care of lower income individuals
t/f a significant portion of medicaid spending goes to paying for long term care true about
40 percent
FMAP *federal medical assistance percentage*
, % of money spent on medicaid that the fed govt will reimburse the state with . varies
significantly from state to state based on their per-capita income and the services and eligibility
the states set forth in their medicaid program
what group accounts for the most medicaid spending disabled (despite making up smallest
portion of beneficiaries)
what eligible group accounts for least medicaid spending children (despite making up almost
40 percent of beneficiaries)
who is primarily responsible for administering medicaid the states. they set policies for
eligibility requirements, cost sharing, provider payment structure, optional additional coverage,
waivers
what is the goal of CHIP reduce the number of uninsured children
is CHIP an entitlement program no it is a block grant that is reauthorized every ten years
(states have more flexibility to use the funds)
who is eligible for CHIP children not otherwise eligible for Medicaid, up to 300 percent of
FPL, i.e. covers children above federal poverty level set by Medicaid
Based on state choice, allows coverage for pregnant women, immigrant pregnant women and
children, and children of state employees
what benefits does CHIP include EPSDT benefits relevant to children, CHIPRA
(reauthorization) also imposed dental coverage and mental health parity
are there premiums and cost sharing in CHIP yes, state can set these on a sliding scale within
set federal limits (i.e. you need to be above certain percentages of the FPL before you will be
required to pay premiums)
