Managed Care and Government Programs

Which factor determines the cost-effectiveness of each type of managed care?

• The individual's healthcare need and the coverage included in the specific plan

• The type of managed care plan chosen

• The availability of public health insurance programs

• The cost of healthcare services in the specific region

What are the two main government programs that provide public medical assistance?

• Medicaid and Medicare

• TRICARE and Veterans’ Health Administration

• Military Health System and Medicaid

• Medicare and Veterans’ Health Administration

Who qualifies for Medicaid?

• Low-income individuals and families, low-income pregnant women, families with adopted or foster children, blind or disabled adults, adults and children with certain chronic or debilitating diseases, adults and children who receive social security benefits

• Low-income individuals and families, low-income pregnant women, families with adopted or foster children, blind or disabled adults, adults and children with certain chronic or debilitating diseases, adults and children who receive Medicare benefits

• Low-income individuals and families, low-income pregnant women, families with adopted or foster children, blind or disabled adults, adults and children with certain chronic or debilitating diseases, adults and children who receive Medicaid benefits

• Low-income individuals and families, low-income pregnant women, families with adopted or foster children, blind or disabled adults, adults and children with certain chronic or debilitating diseases, adults and children who receive TRICARE benefits

What services are typically covered by Medicaid?

• Inpatient and outpatient hospital services, prenatal care, child vaccines, pediatric services, physician services, diagnostic testing

• Inpatient and outpatient hospital services, prenatal care, child vaccines, pediatric services, physician services, mental health services

• Inpatient and outpatient hospital services, prenatal care, child vaccines, pediatric services, physician services, dental care

• Inpatient and outpatient hospital services, prenatal care, child vaccines, pediatric services, physician services, prescription drugs

What is the main difference between Medicaid and Medicare?

• Medicaid is a needs-based program, while Medicare is an entitlement program

• Medicaid provides coverage for individuals 65 or older, while Medicare provides coverage for low-income individuals

• Medicaid covers all healthcare expenses, while Medicare only covers a portion

• Medicaid is administered by the federal government, while Medicare is administered by the states

Which of the following services are provided by Medicare Part A?

• Prescription drug coverage

• Outpatient services

• Hospital care

• Rehabilitation and physical therapy

What is the purpose of Medicaid expansion under the ACA?

• To provide healthcare coverage to individuals with end-stage renal disease

• To allow non-disabled adults to qualify for Medicaid

• To administer healthcare services to active duty military members

• To cover all healthcare expenses for individuals 65 or older

Which program provides medical services to active duty and retired military members?

• Medicaid

• TRICARE

• VHA

• Medicare

What is the purpose of Medigap insurance?

• To cover the remaining healthcare expenses not covered by Medicare

• To provide healthcare coverage to low-income individuals

• To administer diagnostic testing and X-rays

• To provide rehabilitation and physical therapy services