Public Health Insurance Programs: Medicare, Medicaid, and CHIP

Question 1

Who typically bears the responsibility of determining an applicant's eligibility for public health insurance programs?

Accepted Answer

The government agency administering the program

Answer

The individual's physician

Answer

The health insurance provider

Answer

The individual's employer

Question 2

Explain the fundamental difference between Medicare Part B and Part D.

Accepted Answer

Part B covers medical services, while Part D covers prescription drug coverage

Answer

Part B covers prescription drug coverage, while Part D covers medical services

Answer

Part B covers dental care, while Part D covers vision care

Answer

There is no significant difference between Medicare Part B and Part D

Question 3

Which individuals are considered likely to qualify for Medicaid coverage?

Accepted Answer

Single parents with multiple children and low incomes

Answer

Healthy adults with no dependents and stable employment

Answer

Retired individuals with substantial assets and investments

Answer

Disabled veterans receiving military benefits

Question 4

What does CHIP stand for?

Accepted Answer

Children's Health Insurance Program

Answer

Community Health Insurance Program

Answer

Comprehensive Health Insurance Plan

Answer

Child Health Improvement Program

Question 5

What is the primary factor used to determine eligibility for CHIP?

Accepted Answer

Income

Answer

Age

Answer

Disability status

Answer

Citizenship status

Question 6

What is a key difference between Medicare Part A and Part B?

Accepted Answer

Part A covers hospital care, while Part B covers medical services.

Answer

Part B covers hospital care, while Part A covers medical services.

Answer

Part A covers prescription drugs, while Part B covers durable medical equipment.

Answer

There is no difference between Medicare Part A and Part B.

Question 7

Medicare Part A covers expenses related to:

Accepted Answer

Hospital stays

Answer

Doctor visits

Answer

Prescription drugs

Answer

Long-term care

Question 8

To ensure patients fully grasp the advantages and restrictions of public health insurance, which communication approach is most effective?

Accepted Answer

Giving patients a written overview of the information

Answer

Using complicated medical jargon and acronyms

Answer

Speaking quickly and assuming the patient understands

Question 9

Which public health insurance program is specifically designed for low-income children?

Accepted Answer

CHIP

Answer

Medicare

Answer

Medicaid

Answer

Tricare

Question 10

What is the primary objective of Medicaid?

Accepted Answer

To provide health insurance coverage for low-income individuals and families

Answer

To cover long-term care expenses for seniors

Answer

To pay for medical expenses for active military personnel

Answer

To supplement employer-sponsored health insurance plans

Question 11

How is the funding for Medicare Part B primarily obtained?

Accepted Answer

Through a combination of premiums and taxes

Answer

Through general tax revenue

Answer

Through monthly premiums paid by enrollees

Answer

Through employer contributions

Question 12

What is the overarching goal of public health insurance programs?

Accepted Answer

To ensure access to affordable healthcare for all eligible individuals and families

Answer

To reduce healthcare costs for individuals

Answer

To provide financial assistance to healthcare providers

Answer

To eliminate the need for private health insurance

Question 13

Which of the following factors does NOT determine eligibility for Medicare Part A?

Accepted Answer

Income level

Answer

Age

Answer

Disability status

Answer

Work history

Question 14

What is the primary purpose of health insurance exchanges created by the Affordable Care Act?

Accepted Answer

To provide a marketplace for purchasing individual health insurance

Answer

To expand Medicaid eligibility

Answer

To regulate health insurance companies

Answer

To subsidize health insurance premiums

Question 15

Which of the following is NOT a method for applying for Medicaid?

Accepted Answer

Through a licensed health insurance agent

Answer

Online

Answer

By phone

Answer

In person

Question 16

What is the primary source of funding for Medicare?

Accepted Answer

Federal payroll taxes

Answer

State income taxes

Answer

Premiums paid by beneficiaries

Answer

Private insurance companies

Question 17

What is the key difference between Medicare Part A and Part B?

Accepted Answer

Part A covers hospital care, while Part B covers doctor visits and outpatient services

Answer

Part A is for people over 65, while Part B is for people of all ages

Answer

Part A is funded by taxes, while Part B is funded by premiums

Answer

There is no significant difference between Part A and Part B

Question 18

Describe the coverage provided by Medicare Part A and Part B, highlighting their differences.

Accepted Answer

Part A: Inpatient hospital care, skilled nursing facility stays, hospice care, home health care; Part B: Outpatient medical services, durable medical equipment, preventive care

Answer

Part B: Long-term care services; Part A: Prescription drug costs

Answer

Part A: Vision and dental care; Part B: Mental health services

Answer

Part B: Inpatient hospital care; Part A: Outpatient medical services

Question 19

Which of the following is NOT a government-sponsored health insurance program?

Accepted Answer

Blue Cross Blue Shield

Answer

Medicare

Answer

Medicaid

Answer

CHIP

Question 20

Which of the following is NOT a benefit of Medicaid?

Accepted Answer

Private room in the hospital

Answer

Hospitalization

Answer

Prescription drug coverage

Answer

Dental and vision care

Question 21

What is the primary purpose of the Children's Health Insurance Program (CHIP)?

Accepted Answer

To provide health insurance to low-income children

Answer

To offer supplemental insurance to adults

Answer

To cover uninsured senior citizens

Answer

To provide long-term care services

Question 22

Which of the following is NOT a potential challenge associated with public health insurance?

Accepted Answer

Comprehensive coverage for all medical needs

Answer

Limited access to certain providers

Answer

Long wait times for appointments

Answer

High out-of-pocket costs

Question 23

According to the ethical principle of confidentiality, how should public health insurance information be handled?

Accepted Answer

Kept private unless legally required or the patient agrees to its release.

Answer

Shared with other healthcare providers without the patient's knowledge.

Answer

Used for personal gain or to benefit a third party.

Answer

Released if deemed to be in the patient's best interest.

Question 24

Which of the following is a federally-funded health insurance program in the United States primarily intended for low-income families and individuals?

Accepted Answer

Medicaid

Answer

Medicare

Answer

CHIP

Answer

Private Health Insurance

Question 25

What is the primary focus of Medicare coverage?

Accepted Answer

Providing health insurance to individuals aged 65 and older, as well as younger individuals with certain disabilities

Answer

Providing health insurance to low-income families and individuals

Answer

Providing health insurance to children

Answer

Providing long-term care for seniors

Question 26

Who is eligible for CHIP?

Accepted Answer

Children and pregnant women with low incomes

Answer

Seniors with low incomes

Answer

Individuals with disabilities

Answer

Unemployed individuals

Question 27

Which of the following factors is NOT typically considered when determining eligibility for Medicare?

Accepted Answer

Employment status

Answer

Age

Answer

Disability status

Answer

Income (for certain programs)

Question 28

How do Medicare Part A and Part B coverage differ?

Accepted Answer

Part A covers hospital stays while Part B covers doctor's visits

Answer

Part A covers long-term care while Part B covers prescription drugs

Answer

Part A covers preventive care while Part B covers major medical services

Answer

There is no substantial difference between Part A and Part B coverage

Question 29

What is the purpose of premium subsidies in health insurance?

Accepted Answer

To reduce monthly health insurance costs for those with lower incomes

Answer

To increase the benefits provided by health insurance

Answer

To extend coverage to a wider population

Answer

To eliminate deductibles and copays

Question 30

Which of the following is NOT generally considered a challenge associated with public health insurance programs?

Accepted Answer

Overutilization of services

Answer

Funding limitations

Answer

Eligibility restrictions

Answer

Complexity of enrollment processes (for some individuals)

Question 31

Which of the following services is NOT covered under Medicare Part A?

Accepted Answer

Routine physical exams

Answer

Home health care

Answer

Skilled nursing facility care

Answer

Hospital stays

Question 32

Who is eligible for Medicaid coverage?

Accepted Answer

Low-income individuals and families meeting specific income and asset criteria

Answer

Individuals with disabilities, regardless of income

Answer

Seniors over the age of 65, regardless of income

Question 33

What is the primary purpose of the Children's Health Insurance Program (CHIP)?

Accepted Answer

To provide affordable health insurance coverage to children from families with incomes above Medicaid eligibility but below private insurance affordability.

Answer

To provide health insurance coverage to individuals with disabilities

Answer

To provide health insurance coverage to pregnant women

Question 34

Which of the following individuals is considered 'dually eligible'?

Accepted Answer

An individual who qualifies for both Medicare and Medicaid coverage

Answer

An individual who qualifies for Medicaid but not Medicare

Answer

An individual who qualifies for Medicare but not Medicaid

Question 35

What is a key responsibility of a medical assistant in determining patient eligibility for public health insurance programs?

Accepted Answer

Gathering patient information, verifying documentation, and assisting with application completion

Answer

Providing legal advice to patients

Answer

Making the final eligibility decision

Question 36

Which of the following individuals is eligible for Medicare Part A coverage?

Accepted Answer

A U.S. citizen aged 65 or older

Answer

A non-U.S. citizen under the age of 65

Answer

A U.S. citizen under the age of 65

Answer

A non-U.S. citizen aged 65 or older

Question 37

What is the purpose of the Children's Health Insurance Program (CHIP)?

Accepted Answer

To provide health insurance to children from families with incomes too high for Medicaid but too low for private insurance.

Answer

To provide health insurance to children with pre-existing medical conditions.

Answer

To provide health insurance to children who live in underinsured communities.

Answer

To provide health insurance to adults from families with incomes too high for Medicaid but too low for private insurance.

Question 38

Which of the following statements about public health insurance is true?

Accepted Answer

Public health insurance programs are funded by a combination of taxpayer dollars and premiums paid by beneficiaries.

Answer

Public health insurance programs are funded solely by premiums paid by beneficiaries.

Answer

Public health insurance programs are not funded by the government.

Answer

Public health insurance programs are funded solely by taxpayer dollars.

Question 39

What is a deductible in the context of health insurance?

Accepted Answer

The amount the insured must pay out-of-pocket before the insurance company begins to pay for covered medical expenses.

Answer

The maximum amount that the insurance company will pay for covered medical expenses.

Answer

The monthly premium paid by the insured to maintain coverage.

Answer

The percentage of covered medical expenses that the insured is responsible for paying.

Question 40

Which of the following services is typically not covered by Medicare Part B?

Accepted Answer

Dental care

Answer

Outpatient surgery

Answer

Doctor's visits

Answer

Prescription drugs

Question 41

What is the purpose of prior authorization in health insurance?

Accepted Answer

To ensure that medical services are medically necessary and appropriate before they are covered by the insurance company.

Answer

To prevent fraud and abuse of the health insurance system.

Answer

To reduce the cost of health insurance for the individual.

Answer

To speed up the processing of health insurance claims.

Question 42

What is the role of a medical assistant in determining eligibility for public health insurance programs?

Accepted Answer

To gather patient information, verify eligibility requirements, and assist with the application process.

Answer

To provide medical care to patients who are eligible for public health insurance programs.

Answer

To make the final decision on eligibility.

Answer

To advocate for patients who are denied eligibility.