Lec 4: Government And Entitlement Programs: Intro, Medicaid Flashcards
Why entitlement programs?
Service
AND
Groups at risk unable to access employer based health care (poor and elderly)
Military Coverage includes _____ and _______
Active duty
Military personnel and families
3 types of military coverage:
US Dept of Defense
Military treatment facilities
TRICARE
What is TRICARE?
Managed health care plans
Differ in terms of eligibility, provider access and cost-sharing
Verteran’s coverage is for _____ and ______
Veterans and their families
Who are eligible to enroll for coverage under the US Dept. of Veteran’s Affairs?
Veterans….
Access to veteran’s services are determined by what?
Assigned priority levels
Under veteran’s coverage, what do we mean by an integrated health system?
Ability to manage care and systems
Military and Veteran’s Coverage are 2 different systems, T/F?
True
Military and Veterans coverage are both funded by?
Congressional action
Transitions for active duty to veterans is not seamless because there are issues in ________
Sharing data
What are two other major federal government insurances?
Federal Employee Health Benefits Program
Indian Health Services
Who gets FEHBP?
Current and retired federal employees and families
What are 3 differences between Medicare and Medicaid?
Coverage
Funding
Administration
Medicaid was enacted in _____ as companion legislation to Medicare Parts ___ and ___
1965
A and B
Medicaid entitles eligible individuals to defined set of ______
benefits
Medicaid guarantees participating states federal matching funds on ____________
Open ended basis
Medicaid is means-tested with focus on welfare population including:
Children, Single parents with dependent children
Aged, Blind, and Disabled
Who is Medicaid jointly financed by?
Federal and state gov’t
Medicaid triangle: what is on inside? What is at top? Left? Right? Bottom?
Inside: individual mandate, health insurance market reforms Top: Universal coverage Left: Employer sponsored coverage Bottom: Medicaid coverage Right: Exchanges
What does sCHIP stand for?
State children’s health insurance program
SCHIP is a partnership between who?
Federal government and states
SCHIP provides health insurance coverage for who?
Targeted low income children under 19 who are not eligible for Medicaid
Who has oversight of sCHIP? And what do they establish?
CMS
They establish broad eligibility and benefit guidelines
The covered benefits until sCHIP are :
Mandatory
Option (rehab, PT)
Charts: Medicaid pays a lot of money for:
LTC
Charts: who is the largest group covered under Medicaid?
Children
Charts: Who is the most money spent on?
Disabled and elderly
Charts: More money is spent in the _______
Least money is spent in the _____
Northeast
Least spent in southeast
