Medicare/Medicaid

Question 1

eligibility criteria

Answer 1

factors that determine whether people can receive benefits from specific programs

Question 2

age-based entitlement programs

Answer 2

programs that all adults are automatically entitled to receive benefits based on their age, not on their financial or health needs. Social Security and Medicare are examples.

Question 3

universal and categorical benefits

Answer 3

age-based programs available as a social right to all persons belonging to a designated category, e.g., those over a certain age

Question 4

needs-based programs

Answer 4

decide eligibility by financial need

Question 5

selective benefits

Answer 5

determined on a case-by-case basis

Question 6

contributary plans

Answer 6

older adults are entitled to these benefits based on their mandatory contributions into the system as a paid worker throughout their lives

Question 7

discretionary funding (TANF)

Answer 7

Congress has to approve its funding annually and the amount varies from year to year

ex: TANF for low-income children and parents

Question 8

graying of the federal budget

Answer 8

wide array of federal budget going to programs etc for the older population

Question 9

retirement savings plan vs. safety net

Answer 9

social security used to be a safety net of financial support to help them survive since they didn’t think to save for retirement or didn’t think they would live that long or growing debt

Question 10

social adequacy

Answer 10

shared societal obligation to provide a basic standard of living for all who are eligible, regardless of the size of their payroll contributions

Question 11

individual equity

Answer 11

people receive benefits such as Social Security based on their earned right –payroll deductions

Question 12

Social Security benefits

Answer 12

• frees middle generation from financial support to older relatives
• ensures compensatory income, regardless of age, to those who experience sudden income loss
• ensures basic protection for the neediest members of society regardless of age

Question 13

long term care

Answer 13

long-term care
includes at home care, institutional care (nursing homes)
your needs can change over time high/low

Question 14

acute care

Answer 14

active but short-term treatment for episode of injury or illness, urgent medical condition, or recovery from surgery
can just include a doctor’s visit

Question 15

Medicare

Answer 15

social insurance system based on age available to all adults age 65+

federal funding

beneficiaries earn access by virtue of paying payroll taxes throughout the years of employment. it is intended to provide financial protection against the costs of acute or short-term care by hospitals and physicians

• Medicare reform: Medicare Part D, the Medicare Modernization, Improvement and Prescription and Drug Act

Question 16

Medicare limitations

Answer 16

covers acute or short-term care but does not reimburse for long-term services and supports for older persons with chronic illness

• only covers about 47% of older adults’ health care expenses

Question 17

Medicare-funded home healthcare

Answer 17

only 4% of healthcare expenditures covered are for home healthcare – must have a medical based need (cannot just be assistance with ADLs)

only for a short amount of time (injury etc)
“rehab center”

Question 18

Medicaid

Answer 18

federal and state means-tested program
for poor and needy
don’t need to pay into it

– biggest payer of long term care (nursing home/”rehab center”)

Question 19

medi-medi’s

Answer 19

older adults covered by medicare and medicaid

Question 20

medicare

Answer 20

elders only, acute care emphasis, some evolution, complicated/hard to navigate

Question 21

medicaid

Answer 21

any age, more social than health originally, limited long-term care emphasis, complicated/hard to navigate

Question 22

Long-Term care Insurance

Answer 22

private long-term care insurance (LTC) aim to address gaps in home and skilled nursing care funding but do not cover all LTSS costs, EXPENSIVE

Question 23

medi-gap

Answer 23

supplement insurance covers, medicare deductible and co-pays, items and services not covered by Medicare (hearing aids and eye glasses), charges exceeding amt approved by medicare

Question 24

On Lok

Answer 24

first of models to integrate different sectors together into a single system of social care]]give support at home to people on the brink of nursing homes/rehab centers