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Chapter 1. Introduction to Medicare and Medicaid

Which of the following is true regarding the role of the ­Center for Medicare and Medicaid (CMS)?

a. Both Medicare and Medicaid are federal programs ­managed directly by CMS.

b. CMS has no role in regulating or managing either ­Medicare or Medicaid.

c. CMS manages Medicaid from a federal perspective, but each state develops and manages its own Medicare insurance programs with no involvement of CMS.

d. CMS plays a regulatory and financial role in Medicaid and Medicare programs, although Medicaid is primarily a state-administered program.

Answer d.

Select the best answer below regarding the drug program authorized by the Medicare Modernization Act of 2003.

a. Part B medical benefit prescription outpatient drug coverage

b. Part C home healthcare prescription drug benefits

c. Part D outpatient prescription drug benefit coverage

d. Part A inpatient prescription drug benefit coverage

Answer c.

Select the best answer below regarding Medicare and ­Medicaid programs.

a. Medicare was developed as health insurance primarily for low-income individuals and families, mostly children and single parents. Medicaid is only for severely disabled individuals.

b. Medicaid provides coverage only for individuals and families classified as dual eligibles, meaning that one member of the family is above 65 years old, and one is below 65 years.

c. Medicaid is intended primarily for citizens 65 years and older, and Medicaid is for low-income individuals, families, and children. About 10 million disabled individuals are eligible for both programs.

d. Medicare and Medicaid eligibility requirements are identical, and individuals can choose from either program (but not both) according to the states in which they reside.

Answer c.

Please select the best answer below regarding the various Medicare parts.

a. Medicare Part A includes inpatient medical services; Part D covers outpatient prescription drugs.

b. Medicare Part C includes inpatient medical services; Part B covers outpatient prescription drugs, and home healthcare drugs.

c. Medicare Part D includes home healthcare medical benefit drugs, and Part A includes inpatient medical services, but excludes home healthcare drugs.

d. Specialty ...

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