Show:
Role of IPA/Navigator
Medicaid 1
Medicaid 2
Medicaid 3
HH Composition
100
Name the ACA Requirements for Navigators/Assisters.
What are: Knowledgeable in eligibility, enrollment & program requirements, Fair and impartial, Facilitate QHP selection, Refer to consumer assistance or ombudsman, Protect confidentiality and privacy, Cultural, language and disability access.
100
Name the age group that previously was not eligible for a Medicaid program.
What is the new adult group between the ages of 19-65 years of age.
100
The individual who files the application on behalf of their household member is know as what?
What is the "Primary Applicant".
100
Name the new brand name for Medicaid.
What is Washington Apple Health.
100
Give the definition of what an "Assistance Unit" is.
What is a unit of those HH members who must be looked at todether due to income, age or tax-filing status in order to determine the HH size.
200
Name the steps one must complete to become and IPA/Navigator.
What are: Complete the required training, Certification exam, Background check, verification of language certification, Attestations - Code of Ethics, Privacy and Security.
200
Name two items from traditional Medicaid that have changed as a result of the MAGI Methodology being applied. Think all programs...
What are: No asset or resouce limits & 5% income disregard across all programs.
200
Name the 4 key components of creating an assistance unit.
What are: Tax Filing Status, Relationship, Age & Pregnancy.
200
Name the countable income for MAGI.
What is countable income for tax purposes will be countable income for MAGI Medicaid.
200
Bob and Suzie are married and file taxes jointly with their child in common, Tommy. Bob and Suzie Claim Tommy as their tax dependent. Name the assistance units for each individual in the household.
What are: Bob Suzie Tommy Suzie Bob Bob Tommy Tommy Suzie
300
Name the IPA/Navigator guiding principles.
What are: Duty to consumer, Community & Consumer trust, Promoting health equity, Knowledge and skills, Timeliness and Accuracy, Enduring Relationships, Seamlessness.
300
Name 3 impacts that the ACA had on Medicaid.
What are: Create a new Medicaid eligibility group for adults, Required use of new methodology known as MAGI & Created a simplified application process with automated data-matching and real time eligibility determinations.
300
Name the information that the Healthplanfinder collects about your household.
What is: Information on other HH members, Their current/future tax filing status, Relationship to Primary Applicant, If they live in the same home and Demographics.
300
How is self employment income counted.
What is by using the income and deductions claimed on the previous year's taxes. If individual employed less than a year, then SE is determined by averaging income earned within the amount of months that the business has been in operation within the last year.
300
Jon is an unmarried 20 year old residing in his parent's home. Parents claim Jon as a tax dependent. Name the HH composition for Jon's assistance unit.
Who are: Jon Dad Mom
400
Name the Code of Ethics key points.
What are Treat all people respectfully, Respect privacy and confidentiallity, do not engage in any relationship with a consumer that creates a risk of harm, Maintain knowledge and skills.
400
Name the the 4 groups that are included in the Simplified Application Process.
Who are Family, Children, Pregnant Women & New Adult Group.
400
Name the MAGI Assistance rules and exceptions to those rules to determine assistance units.
What are: Rule 1 - Does the individual expect to file taxes, Rule 2 - If they do not file taxes, do they expect to be claimed as a tax dependent by someone else, if so, does the individual meet any of the 4 exceptions. Rule 3 -If the individual answered no to rule 1&2 or yes to rule 2 but an exception applies then the client is considered a Non-Filer.
400
Name 6 of the Non-countable income under MAGI Methodology.
What are: Employment/training programs, Bona fide loans, Federal income tax returns, Earned income tax credit, child support payments, L&I, Foster Care payments, VA benefits, One time payments, money withheld to repay and overpayment, needs based assistance from other agencies.
400
Ann is a single parent & is not filing taxes Ann has two childre, Drew (12) and Annabellle (7) Drew's father claims him as a his tax dependent but Drew is currently living with his mother Ann. Name the who is included in each person's assistance unit.
Who are: Ann Drew Annabelle Drew Ann Ann Annabelle Annabelle Drew
500
Name the Key Points for Consumers to know about when looking for health care coverage through the Healthplanfinder.
What are: Individual Mandate & Penalties, Eligibility requirements, Medicaid Expansion, Qualified Health Plans and Tax Credits and cost sharing.
500
Name the 4 programs that do not follow the MAGI methodology.
What are Classic Medicaid programs that include ABD individuals, SSI Cash recipients, Foster Care children & Long Term Care and Waivered Services.
500
Scenario: *Ryan & Kari are married with a child in common, Austin, & Kari's child, Monica, from a previous Relationship. *Ryan & Kari file taxes jointly and claim their child, Austin, as their tax dependent. *Monica's Father (Non-custodial parent) Claims her as his tax dependent. State the assistance units for each member of the Household.
What are: Ryan Kari Austin Monica Kari Ryan Ryan Ryan Austin Austin Kari Kari Austin
500
Name the 2 step process for processing AEM Medicaid application.
What are: 1. An eligibility Determination 2. A medical determination of the emergent Condition.
500
Brad and Julie are married with child in common, Jesse (1) Brad and Julie File Taxes Separately. Brad claims child, Jesse, as his tax dependent. Name who is included in each person's assistance unit.
Who are: Brad Julie Jesse Julie Brad Brad Jesse Julie