Lec 4: Government And Entitlement Programs: Intro, Medicaid

Question 1

Why entitlement programs?

Answer 1

Service
AND
Groups at risk unable to access employer based health care (poor and elderly)

Question 2

Military Coverage includes _____ and _______

Answer 2

Active duty

Military personnel and families

Question 3

3 types of military coverage:

Answer 3

US Dept of Defense
Military treatment facilities
TRICARE

Question 4

What is TRICARE?

Answer 4

Managed health care plans

Differ in terms of eligibility, provider access and cost-sharing

Question 5

Verteran’s coverage is for _____ and ______

Answer 5

Veterans and their families

Question 6

Who are eligible to enroll for coverage under the US Dept. of Veteran’s Affairs?

Answer 6

Veterans….

Question 7

Access to veteran’s services are determined by what?

Answer 7

Assigned priority levels

Question 8

Under veteran’s coverage, what do we mean by an integrated health system?

Answer 8

Ability to manage care and systems

Question 9

Military and Veteran’s Coverage are 2 different systems, T/F?

Answer 9

True

Question 10

Military and Veterans coverage are both funded by?

Answer 10

Congressional action

Question 11

Transitions for active duty to veterans is not seamless because there are issues in ________

Answer 11

Sharing data

Question 12

What are two other major federal government insurances?

Answer 12

Federal Employee Health Benefits Program

Indian Health Services

Question 13

Who gets FEHBP?

Answer 13

Current and retired federal employees and families

Question 14

What are 3 differences between Medicare and Medicaid?

Answer 14

Coverage
Funding
Administration

Question 15

Medicaid was enacted in _____ as companion legislation to Medicare Parts ___ and ___

Answer 15

1965

A and B

Question 16

Medicaid entitles eligible individuals to defined set of ______

Answer 16

benefits

Question 17

Medicaid guarantees participating states federal matching funds on ____________

Answer 17

Open ended basis

Question 18

Medicaid is means-tested with focus on welfare population including:

Answer 18

Children, Single parents with dependent children

Aged, Blind, and Disabled

Question 19

Who is Medicaid jointly financed by?

Answer 19

Federal and state gov’t

Question 20

Medicaid triangle: what is on inside? What is at top? Left? Right? Bottom?

Answer 20

Inside: individual mandate, health insurance market reforms
Top: Universal coverage
Left: Employer sponsored coverage
Bottom: Medicaid coverage
Right: Exchanges

Question 21

What does sCHIP stand for?

Answer 21

State children’s health insurance program

Question 22

SCHIP is a partnership between who?

Answer 22

Federal government and states

Question 23

SCHIP provides health insurance coverage for who?

Answer 23

Targeted low income children under 19 who are not eligible for Medicaid

Question 24

Who has oversight of sCHIP? And what do they establish?

Answer 24

CMS

They establish broad eligibility and benefit guidelines

Question 25

The covered benefits until sCHIP are :

Answer 25

Mandatory

Option (rehab, PT)

Question 26

Charts: Medicaid pays a lot of money for:

Answer 26

LTC

Question 27

Charts: who is the largest group covered under Medicaid?

Answer 27

Children

Question 28

Charts: Who is the most money spent on?

Answer 28

Disabled and elderly

Question 29

Charts: More money is spent in the _______

Least money is spent in the _____

Answer 29

Northeast

Least spent in southeast