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What is the best definition of the term "health insurance premium"?
The amount health insurance companies charge by month for coverage; the premium is the monthly fee all enrollees pay in order to have health insurance coverage.
Do you have to pay your premium monthly, even if you don't use the insurance?
What is an "annual health insurance deductible"?
The amount of health care expenses you must pay each year yourself before your insurance begins to pay; a type of cost sharing feature often included in a health insurance policy
What is the annual out of pocket limit?
The most you will have to pay in deductibles, copays, and coinsurance for covered care received in network for the year; Health plans sold through the Marketplace and most employer health plans must cap the amount you are required to pay each year in deductibles, copays, and coinsurance for covered services received in network
Approx. what percent of Americans receive health insurance coverage through Medicaid at some point during the year?
About 20%; Medicaid plays an important role by providing health insurance to nearly 1 in 5 individuals and families across the country who do not have access to other affordable coverage options
The Medicaid program is the same in all states. T or F
False. States have flexibility to design their own Medicaid programs within broad federal guidelines.
Of the nearly 63 million people served by Medicaid each year, approx. how many are children
One-half; In federal fiscal year 2010, just under 50 percent (49%) of all Medicaid enrollees (about 32 million) were children
Which group accounts for most Medicaid spending?
Elderly and disabled adults; Although elderly and disabled adults only make up 1/4 of Medicaid beneficiaries, they account for 66% of total costs.
How does the recent growth in Medicaid spending per person compare to the growth in private health insurance premiums per person
Medicaid spending grew slower than private health insurance premiums ; After accounting for enrollment growth, analyses show that Medicaid has been able to keep cost increases below that of other sectors of the health care system and in 2012, spending growth slowed to near record lows, reflecting the slow-down in enrollment growth
Which type of coverage is the primary payer for long-term care services and supports for elderly and disabled individuals
Medicaid ; Medicaid is the primary payer for long-term care services and supports for low-income individuals across the age spectrum
What time of assistance does Medicaid provide for Medicare beneficiaries
Medicaid pays for Medicare premiums and copays for low-income beneficiaries & Medicaid pays for health care services not covered by Medicare, such as home and community based services ; Medicaid plays an important role for over 9 million low-income Medicaid beneficiaries, know as "dual eligible" beneficiaries, by filling in the gaps in Medicare's benefit package
Medicaid is a government run health care delivery system, and provides enrollees access to public health care facilities only. T or F
False ; Medicaid is a publicly financed insurance program that provides enrollees access to physicians, hospitals and other providers who serve the general population, including those with private insurance
Now that the ACA coverage provisions are in effect, who becomes newly eligible for Medicaid in the states adopting Medicaid expansion
As of 2014 the ACA Medicaid expansion provides a new coverage pathway for millions of currently and formerly uninsured low income adults, including childless adults who have been historically excluded from Medicaid coverage
In the states not expanding Medicaid, non-elderly adults below 100% of the federal poverty level will likely
Remain uninsured and continue to face access and financial barriers to care; In order to qualify for premium tax credits in the new marketplaces, people need to be at or above 100% of the federal poverty level because prior to the 2012 Supreme Court decision that effectively made the Medicaid expansion optional for states, it was assumed that all individuals up to 138% of the federal poverty level would be covered by Medicaid in all states.
Approximately what share of the federal budget goes toward Medicare, the federal program that provides health insurance to elderly and disabled Americans across all income levels
14% ; In 2013, Medicare accounted for 14 percent of total federal spending.
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