Public Health Insurance in the US
Public insurance programs are ___programs
categorical programs
Medicare is a health insurance program for...
people 65 or older, people under the age of 65 with certain disabilities such as ALS, people of all ages with end-stage renal disease
dual eligible
people eligible for both Medicare and Medicare
What are the 2 main categories of health insurance?
private insurance, public insurance
Public insurance services are provided mostly through what kind of providers?
private providers
What perspective does public insurance reflect?
social justice persepctive
Medicaid eligibility is determined by who?
states within federal guidelines
What services does medicare not cover
vision, dental care, hearing aids, many long-term services
in order to be eligible for CHIP in Missouri family gross income must be over __% but less than __%
150% less than 300%
What medicare coverage is considered volunteer coverage a) Part A b) Part B c) Part C d) Part D
b) Part B
Medicaid is under what title of the Social Security Act A) title 18 b) title 19 c) title 16 d) title 21
b) title 19
CHIP is available to families with incomes up to ___% of federal poverty level a) 100% b) 150% c) 200% d) 120 %
c) 200%
What medicare coverage is considered Medicare Advantage? a) Part A b) Part B c) Part C d) Part D
c) Part C
Which public health plan is paid for through government funds? a) Medicare b) Medicaid c) CHIP
a) Medicare
How is Federal Medical Assistance Percentage (FMAP) determined?
annually based on average per capita income level
What does CHIP stand for?
Children's Health Insurance program
If dually eligible, who pays for many of the out of pocket costs? Medicaid or medicare?
Medicaid
Which insurance coverage plan is different for different states? Medicare or Medicaid?
Medicaid
The public health insurance program for people over 65 and those younger than 65 with certain disabilities is which; Medicaid or Medicare?
Medicare
Medicare Part C
Medicare advantage; includes all benefits and services of A and B, run by medicare-approved private insurance companies, usually includes part d, may include extra benefits and services at extra costs
What administration is strictly provided for by the government?
Veterans administration
Medicare coverage part D
Voluntary program offering coverage to part a or b enrollees, helps cover cost of prescription drugs, run by medicare-approved private insurance companies, doughnut hole
Medicare coverage Part B
Voluntary program that covers doctors services, outpatient care, preventive services, diagnostic tests, some therapies, durable medical equipment
CHIP provides healthcare to children up to the age of __ who would otherwise not qualify a) 19 b) 18 c) 21 d) 16
a) 19
Which public health plans criteria are set at a federal level? a) medicare b) Medicaid c) CHIP
a) Medicare
What medicare coverage is considered hospital insurance? a) Part A b) Part B c) Part C d) Part D
a) part A
Medicaid is specifically designed for a) poor b) rich c) people 65 or older d) people with disabilities
a) poor
What title of the social security act is medicare under? a) title 18 b) title 16 c) title 17 d) title 19
a) title 18
4 factors contributing to the financial problem
aging of baby boom generation, reduction in ratio of workers to retirees, health care cost inflation, NOT administrative costs
In Missouri how long do families have to be uninsured to receive CHIP? a) 5 months b) 6 months c) 7 months d) 8 months
b) 6 months
James is 35 and has end-stage renal disease. What type of public insurance is he eligible for? a) Medicaid b) medicare c) SCHIP d) not eligible
b) medicare
about how many different programs of Medicaid are there) a)1 b) 25 c) 50 d) 0
c) 50
Which public insurance program was enacted under the balanced budget act of 1997? a) medicare b) Medicaid c) CHIP
c) CHIP
What medicare coverage includes all benefits and services covered under part a and b a) Part A b) Part B c) Part C d) Part D
c) Part C
What medicare coverage helps cover cost of prescription drugs? a) Part A b) Part B c) Part C d) Part D
d) Part D
Who runs Medicaid? a) federal government b) state government c) local government d) a and b
d) a and b
What title of the Social Security Act is CHIP under? a) title 18 b) title 19 c) title 16 d) title 21
d) title 21
Categorical programs of Medicaid limit coverage in 4 different ways
families with children, pregnant women, age, blind or disabled
Who finances CHIP?
federal and state funds
Medicare criteria are set at a _____ level
federal level
Medicare coverage part A
hospital insurance that covers inpatient hospital care, skilled nursing care, home health care, hospice care
How are expenditures controlled
limiting eligible services, price per services, limits on services, and cost-sharing
How is Medicaid funded?
Federal Medical Assistance Percentage (FMAP), and federal government
