Medicaid (NM)

Adam is a Medicare beneficiary and enrolled in his state's Medicaid program. When he submits a claim for covered services to both, how will Medicare and Medicaid pay the claim?

• Medicaid will be the primary insurer, and Medicare will be the secondary insurer.

• Medicare will pay the entire claim

• Medicare will be the primary insurer, and Medicaid will be the secondary insurer.

• Medicaid will pay the entire claim.

Answer explanation

Medicare is the primary insurer. Medicaid is the secondary insurer.

Which statement describes states' administration of Medicaid?

• Medicaid services vary from state to state.

• Medicaid services vary from county to county.

• Medicaid services are the same in every state.

• Medicaid services vary from city to city.

Answer explanation

Medicaid provides a range of health services for beneficiaries. These services vary from state to state.

What is the principal purpose of Medicaid?

• to establish a state-run health care agency

• to provide health care and health-related services to uninsurable people

• to provide health care and health-related services to people with low incomes

• to provide a low-cost alternative to private health insurance companies

Answer explanation

Medicaid was established in 1965 by the Social Security Act to provide health care and health-related services to people with low incomes. It is funded by the federal and state governments and administered by the states.

When a person applies for Medicaid, the limits and the types of income and assets counted vary depending on:

• whether the applicant has relatives who require support

• whether the applicant is at least 65 years of age

• whether the applicant previously applied for Medicaid assistance

• whether the applicant has a spouse who needs support

Answer explanation

The limits and the types of income and assets counted vary depending on, among other things, whether the applicant has a spouse who requires support.