PHSC 2 Lecture Notes - Lecture 9: Medigap, Prenatal Care, Managed Care
11 Feb 2020
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Document Summary
Title xix of the social security amendments of 1965. Medicaid - means tested: eligibility depends on individual or household means to pay for heakth care. A voluntary program for all states, all do participate now. Income eligibility & scope of benefits vary by state within national guidelines for participation (e. g. must cover prenatal care, children"s health, physician & hospital services) 100% fpg = federal poverty line calculated by government. A safety net program for those who qualify and would otherwise be uninsured. Special eligibility for children in households >200% fpl, pregnant women and the disabled. Most recipients pay sh out of pocket, but. Special programs with share of cost similar to a co-pay for some. Serves as the medi-gap insurance for low income elderly on medicare. Pays for much of nursing home care (up to 65%) Federal government will pay 100% of premium for those not currently covered through 2018, then then will pay 90%
