Private Health Insurance
The name of the payment made to purchase health insurance.
What is a premium?
This is used to determine income eligibility criteria for Medicaid
What is the Federal Poverty Level (FPL)?
CHIP is this type of government program
What is a block grant program?
The two main types Medicare plans enrollees can choose from
What is traditional Medicare (Parts A and B) and Medicare Advantage (Part C)?
Theory X says that medical care is a unique good/service contrast Theory Y says this
What is medical care is just like other goods/services?
The name of the process where an individual or populations' characteristics are reviewed and used to determine how much to charge for medical insurance
What is medical underwriting?
A formula that determines what percentage of Medicaid costs the federal government will match—a percentage that can range from 50% to 78% depending on a state’s income level
What is the Federal Matching Assistance Percentage (FMAP)?
This rate is 90% for CHIP compared to between 50 and 80% for Medicaid
What is the FMAP?
The three major sources of funding for Medicare
What are payroll taxes, general tax revenues, and premiums?
When providers create more demand for a healthcare service than people would normally use
What is supplier-induced demand?
In this payment model, doctors are paid per service provided
What is Fee-for-Service (FFS)?
Under Medicaid, hospital care, physician services, and lab tests are known as these
What are mandatory benefits?
This law made it easier for children enrolled in CHIP to be screened for eligibility for other social services
What is the Affordable Care Act?
The term used for people who qualify for both Medicare and Medicaid
What is dual eligibles?
This cause of market failure occurs when a benefit is provided to everyone, even people who didn't pay for it
What is a public good?
This type of health plan offers lower costs when using in‑network providers but still allows out‑of‑network care at higher costs. It is also the most common type of managed care plan.
What is a PPO?
This law is why the federal government covers 90% of the cost of care for low income adults without children on Medicaid.
What is the Affordable Care Act (ACA)?
CHIP differs from Medicaid because Congress must periodically pass legislation to continue its funding, a process known as this.
What is reauthorization?
Medicare Advantage plans use this payment model
What is managed care?
When individuals use more healthcare because health insurance masks the true costs
What is a moral hazard?
In order to use an HSA, an individual must have this type of health insurance plan
What is a high deductible health plan (HDHP)?
They are: categorical, income, resources, residency, and immigration status
What are the Medicaid eligibility requirements?
These are the three ways a state can structure it's CHIP program
What are Medicaid expansion, separate CHIP, or hybrid plan?
ACA made this major change to Medicare
What is closed the doughnut hole?
Creating regulations, taxing unhealthy products, and providing health insurance are tools that the government uses when this happens?
What is market failure?