Medicaid Eligibility
Modified Adjusted Gross Income (MAGI)
How much of the federal poverty level does your income need to qualify as a low-income family?
138% FPL
What does CHIP stand for?
Children's Health Insurance Program
Who qualifies for Medicare?
65+, end-stage renal disease, disability
Name members of EBoard. (100 points for each one)
Srilekha
Nic
Tina
Kate
Kyle
Avi
Ryan
What are non-financial eligibilites of Medicaid?
must be resident of state, lawful permanent resident, and have SSN
Immigrants must wait ___ years after receiving qualified immigrations status to receive Medicaid and Chip Coverage.
5
Does CHIP have presumptive eligibility?
Yes
True or False: If you have medicare, private insurer can sell a marketplace plan even if they know consumer has medicare coverage.
False
When is our next social?
This Thursday!
What is presumptive eligibility?
allows states to designate certain "qualified entities" to immediately enroll individuals who are likely eligible under a state’s Medicaid eligibility guidelines for a temporary period of time.
True or False: all medicaid coverage is considered Minimum Essential Coverage (MEC)
False
Who is CHIP for?
Uninsured children up to age 19 whose family income is too high for them to qualify for Medicaid
Low-income pregnant individuals and/or newborns in some states who don’t qualify for Medicaid
What is Part A, B, C, and D?
B: Medical Insurance
C: Medicare Advantage Plans
D: Prescription Drugs
What's my name?
Srilekha
What are the 4 mandatory eligibility groups?
Low-Income Pregnant Individuals; Children in Low-Income Households; Low-Income parents or caretaker relatives; Elderly, blind, and disabled individuals
Can you get medicaid coverage if you don't have satisfactory immigration status? How?
May be able to get limited medicaid coverage for treatment of an emergency medical condition.
New mothers who lose insurance qualify for marketplace special enrollment period of __ days.
60
What part can have no premium?
Part A
What are our three branches?
Social + Fundraising
Projects
Events
What are the optional eligibility groups?
children of family at higher income levels, "medically needly" consumers, consumers in medical institutions who have income 300% of SSI
What counts as a medical emergency condition?
Places consumer health in serious jeopardy
Causing serious impairment to bodily functions
Causing serious dysfunction of bodily organ or part
Name 3 services or benefits that CHIP covers
Routine checkups
Immunizations
Doctor visits
Prescriptions
Dental and vision care
Inpatient and outpatient hospital care
Laboratory and X-ray services
Emergency services
COVID-19 testing, treatment, and vaccinations
Joel has Part A medicare but wants Premium Tax Credits or Cost Sharing Reductions. Is this possible? If not, what do you recommend he does.
No.
Medicare Savings Programs (MSPs)
Qualified Medicare Beneficiary Program (QMB) covers everything
Specific low-income medicare beneficiary (SLMB) program covers part B premiums
Qualifying Individual (QI) program cover part B premiums
Qualified Disabled and working individuals (QDWI) program that pays for Part A
What are requirements to be a new member?
3 hours of SCHO Event
2 hours shadowing
Video
No more than 2 absences
Meet 2x with big-little