Federal Programs Overview
Which of the following is NOT a federal program that directly provides public financing for dental care?
A) Medicare
B) Medicaid
C) CHIP
D) Affordable Care Act
D) Affordable Care Act
Medicare, Medicaid, and CHIP are actual federal health programs that administer or directly fund health and/or dental care.
The ACA is a healthcare law, not a federal program in itself — though it made dental coverage more accessible through mandates (like pediatric dental as an Essential Health Benefit) and marketplace reforms.
T/F
Medicare provides dental coverage as a standard benefit.
False
Which of the following is a requirement for Medicaid eligibility?
A) U.S. citizenship
B) Age 65 or older
C) Employment status
D) None of the above
A) U.S. citizenship
What does CHIP stand for?
Children’s Health Insurance Program
What does FPL stand for in health policy?
Federal Poverty Level
T/F:
The Affordable Care Act does not include provisions for dental care coverage.
What is False
The ACA only mandates dental coverage for children as one of the 10 essential health benefits.
Adult dental coverage is not required under the ACA, though it may be offered optionally through stand-alone plans.
Which agency administers Medicare?
Centers for Medicare & Medicaid Services (CMS)
Medicaid is a joint program funded by the federal government and ________
State governments
CHIP covers dental services for children in families with incomes too high for Medicaid but too low for ________ insurance.
private
What is the primary purpose of the Federal Poverty Level (FPL)?
A) To determine eligibility for federal loans
B) To set income thresholds for public assistance programs
C) To measure the economic growth of the country
D) To calculate tax rates for low-income individuals
B) To set income thresholds for public assistance programs
The federal program that provides coverage for children who are ineligible for Medicaid but still need affordable health coverage is called __________.
CHIP (Children’s Health Insurance Program)
Medicare is primarily designed to provide health insurance for individuals aged _____ and older.
65
Which of the following groups is NOT required to be covered under Medicaid?
A) Low-income children
B) Pregnant women
C) Adults without dependent children
D) Individuals receiving Supplemental Security Income (SSI)
C) Adults without dependent children
CHIP provides health coverage for children. Which group of children is ineligible for CHIP?
A) Children in families with incomes below the federal poverty level
B) Children in families with incomes above Medicaid eligibility but below private insurance affordability
C) Children who are U.S. citizens or qualified immigrants
D) Children of undocumented immigrants
D) Children of undocumented immigrants
To qualify for Medicaid, applicants must have an income at or below a certain percentage of the ________.
Federal Poverty Level (FPL)
Name the three major federal programs that provide public financing for dental care.
The four major federal programs that provide public financing for dental care are:
Medicare (Title XVIII)
Medicaid (Title XIX)
Children’s Health Insurance Program (CHIP, Title XXI)
Which of the following is true about Medicare and dental services?
A) Medicare covers all routine dental care for beneficiaries
B) Medicare Part D provides comprehensive dental coverage
C) Medicare generally does not cover routine dental care, with limited exceptions
D) Medicare covers orthodontics for seniors
C) Medicare generally does not cover routine dental care, with limited exceptions
T/F
Medicaid provides dental coverage as part of its essential health benefits, but the services vary by state.
True
T/F
CHIP is fully funded by the federal government without any contribution from states.
False (CHIP is jointly funded by the federal and state governments.)
T/F
150% of the Federal Poverty Level (FPL) means that an individual’s income must be no more than one and a half times the current poverty threshold.
True
Match federal program to its primary target population:
Medicare
Medicaid
CHIP
Medicare → Elderly and certain disabled individuals
Medicaid → Low-income individuals and families
CHIP → Children in low-income families
A 70-year-old patient needs a dental extraction prior to receiving a kidney transplant. Will traditional Medicare likely cover this dental service? Why or why not?
Yes, Medicare may cover it only if the dental extraction is medically necessary as part of the preparation for a covered medical procedure (like the kidney transplant). In this case, the dental work is considered integral to a covered treatment.
Which of the following best describes Medicaid's coverage of dental care for adults?
A) Medicaid provides full dental coverage for all adults nationwide.
B) Medicaid dental coverage for adults is mandatory in all states.
C) Medicaid provides dental care for adults, but coverage varies by state.
D) Medicaid covers dental care for adults only if they are under the age of 21.
Individuals with disabilities
C) Medicaid provides dental care for adults, but coverage varies by state.
Which of the following is NOT a group that CHIP covers?
A) Children in families with incomes too high for Medicaid but too low for private insurance
B) Pregnant women
C) Children under 19 years of age
D) Children in families who are ineligible for Medicaid
B) Pregnant women
The Federal Poverty Level (FPL) for a family of four in the year 2023 is $30,000 annually. Calculate the following:
What is 150% of the FPL for a family of four?
If a family of four has an annual income of $45,000, are they eligible for Medicaid based on the FPL guidelines in a state that provides coverage for families with incomes at or below 150% of the FPL?
Calculate 150% of the FPL for a family of four:
150% of FPL=150%×30,000=1.5×30,000=45,000150\% \text{ of FPL} = 150\% \times 30,000 = 1.5 \times 30,000 = 45,000150% of FPL=150%×30,000=1.5×30,000=45,000Answer: 150% of the FPL for a family of four is $45,000.
Determine if the family is eligible for Medicaid based on the FPL:
The family has an annual income of $45,000, which is exactly 150% of the FPL for a family of four.
Since the state offers Medicaid to families with incomes at or below 150% of the FPL, this family would be eligible for Medicaid.