week 7 T&F

Data from 2003 indicate that total Medicaid and Medicare spending on the duals was lower than spending on the entire non-dual Medicare population.

false

Duals are less likely than non-duals to be living in an institutional setting.

false

Duals are less likely to need assistance with multiple ADLs (activities of daily living) compared to non-duals.

false

Federal law allows states offer Medicaid to limit enrollment or establish waiting lists.

false

Given the healthcare needs of the Medicaid population and the lower payments made to providers and hospitals, comparable private coverage would cost about as much as Medicare.

false

In 2009, Part D Medicare enrollees are required to pay out of pocket for 5% of the costs of their prescriptions once a total of $2,700 has been reached.

false

Medicaid financing is shared equally between state and federal governments.

false

Medicaid only covers low-income American including nearly 30 million low-income children and 8 million non-elderly people with disabilities, but no adults.

false

Medicaid program was enacted through Title 18 of the federal Social Security Act in 1965

false

Medicare has relatively low cost-sharing requirements, and limits out-of-pocket spending.

false

Missouri's MO HealthNet covers disabled individuals with income of <200% of the Federal Poverty Level (FPL)

false

Missouri's MO HealthNet covers pregnant women with incomes of <250% of the Federal Poverty Level (FPL)

false

Missouri's MO HealthNet pays for less than 40% of all nursing home care in the state

false

Missouri's MO HealthNet: covers 1 out of every 14 Missourians

false

Missouri's percentage of Medicaid cost is about 50%

false

Most people age 65 and older are entitled to Medicare Part A even if neither they nor their spouse are eligible for Social Security payments.

false

Part B beneficiaries pay the same Part B monthly premium regardless of their income.

false

The MO HealthNet premium requirements for children varies by parents income, but not by age of child.

false

The Medicare Modernization Act of 2003 (MMA) established a voluntary outpatient prescription drug benefit for people on Medicare, known as Part D, that went into effect in 1986

false

The largest source of Medicare financing is payroll taxes.

false

The single largest Medicaid recipient group is children, and they also account for the largest proportion of Medicaid spending.

false

To be eligible for Medicare one must be at least age 65 or older.

false

"Dual eligibles," are among the nation's most vulnerable of populations - seniors and non-elderly people with disabilities.

true

Among the non-elderly, however, duals are substantially more likely to have mental illness and mental retardation, compared to the non-dual disabled population.

true

Compared to private insurance Medicaid has more comprehensive benefits that have been designed to meet the needs of low-income and high-need populations such as transportation, durable medical equipment, case management and habilitation services.

true

Dual eligibles rely on Medicaid to pay Medicare premiums and cost-sharing and to cover critical benefits Medicare does not cover, such as long-term care.

true

Elderly duals were more likely to have a diagnosis of diabetes, heart disease, and lung disease as well as mental illness and Alzheimers disease.

true

Federal financing for Medicaid is guaranteed with no set limits.

true

In 2009, Part D Medicare enrollees are required to pay for 100% of the costs of their prescriptions amounting to between $2,700 and $6,154

true

Less than 50% of the states have set the Medicaid/CHIP income-eligibility level for children at or above 200 percent of the federal.

true

Low provider payment in some states and lower administrative costs contribute to Medicaid's lower overall costs.

true

Medicaid funds can be used to pay the fees associated with Medicare.

true

Medicaid is the largest source of funding (from patient revenues and supplemental payments) for community health centers and public hospitals, the nation's safety-net providers that serve the poor and uninsured.

true

Medicaid is the nation's primary health insurance program for low-income and high-need Americans.

true

Medicare Part C now accounts for 24% of benefit spending.

true

Medicare is financed by a combination of payroll taxes (41%), general revenues (39%), beneficiary premiums (12%), interest and other sources.

true

Medicare is the federal health insurance program created in 1965 for all people age 65 and older regardless of their income

true

Missouri's MO HealthNet covers 1 out of every 11 seniors over age 65

true

Missouri's MO HealthNet covers children in families with incomes <300% of the Federal Poverty Level (FPL)

true

Missouri's MO HealthNet covers those 65 and over with incomes of <85% of the Federal Poverty Level (FPS)

true

Missouri's MO HealthNet pays for about half of all births in the state

true

Missouri's MO HealthNet provides medical coverage to over 900,000 residents

true

Missouri's MO HealthNet: covers about 37% of Missouri's children

true

Most Medicaid spending is attributable to the program's elderly and disabled enrollees, who have extensive needs for both acute and long-term care.

true

Most children and parents covered by Medicaid are in working families.

true

On average, the federal government pays for 57 percent of Medicaid costs.

true

Part A is funded mainly by a dedicated tax of 2.9% of earnings paid by employers and employees (1.45% each) deposited into the Hospital Insurance Trust Fund.

true

Part B is funded by general revenues and beneficiary premiums ($96.40/month in 2009).

true

Part D is funded by general revenues, beneficiary premiums, and state payments.

true

Payroll taxes and general revenues account for about 80% of Medicare financing.

true

People under age 65 who receive Social Security Disability Insurance (SSDI) generally become eligible for Medicare after a two-year waiting period.

true

People who are eligible for both Medicare and Medicaid accounted for 40 percent of all Medicaid expenditures in 2006.

true

People who are eligible for both Medicare and Medicaid represent about 15% of all Medicaid enrollees

true

Since its enactment in 1965, Medicaid has functioned as the main payer of nursing home and other long-term care.

true

States also have broad authority to expand Medicaid beyond federal minimum standards, even though this will increase federal Medicaid expenditures

true

The Part D drug benefit is not covered under the original fee-for-service Medicare program. Instead, it is offered under private plans that contract with Medicare.

true

The federal government sets minimum eligibility levels for coverage and then states have the option to expand eligibility to higher incomes.

true

The federal share of Medicaid funding varies across states ranging from a minimum of 50 percent to 76 percent.

true