Public Health Insurance in the US

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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


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