Today, the Medicaid program serves one in five Americans — or 72 million individuals — across all 50 states and 5 U.S. territories. And the federal government and states combined spend more than $600 billion on the program each year to provide health care coverage for children, pregnant women, adults in families with dependent children, individuals with disabilities and the elderly. With this level of impact, knowing how the program works is essential for innovating within the program so that it can be even more beneficial for the individuals it serves.
But who is currently eligible for the program? And in what ways is Medicaid different than Medicare? This educational video, featuring several of our leaders, gives a high-level overview of what Medicaid is, who it serves and how the program is managed.
Already watched the video? Test what you’ve learned with this quick quiz.
Test yourself! Take the Medicaid knowledge quiz.
What is the federal agency that oversees Medicaid?
Correct!
By law, states must designate a single state agency to administer their Medicaid program and submit a plan to CMS that demonstrates their understanding of and how they will adhere to federal Medicaid rules and regulations.
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By law, states must designate a single state agency to administer their Medicaid program and submit a plan to CMS that demonstrates their understanding of and how they will adhere to federal Medicaid rules and regulations.
What is the name of the companion program created with Medicaid?
Correct!
Medicare is administered by the federal government, whereas Medicaid is a federal-state partnership administered by the states. Medicare provides health care coverage for those 65 and over, or those under 65 with a disability — regardless of income.
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Medicare is administered by the federal government, whereas Medicaid is a federal-state partnership administered by the states. Medicare provides health care coverage for those 65 and over, or those under 65 with a disability — regardless of income.
The Affordable Care Act allows the optional coverage of childless adults under age 65?
Correct!
States were granted the option to extend coverage to parents or caretakers of dependent children with incomes below 133% of the federal poverty level under the Affordable Care Act. Collectively, this population is known as the Medicaid Expansion population.
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States were granted the option to extend coverage to parents or caretakers of dependent children with incomes below 133% of the federal poverty level under the Affordable Care Act. Collectively, this population is known as the Medicaid Expansion population.
What are two waivers used by states to accomplish certain goals in their Medicaid program?
Correct!
States use waivers to waive certain Medicaid program requirements, allowing the state to provide care for people who might not otherwise be eligible under Medicaid & personalize their Medicaid programs to meet their state’s unique needs. For example, waivers may be used to cap the number of individuals covered or to expand home and community-based services.
Sorry, that wasn't right.
States use waivers to waive certain Medicaid program requirements, allowing the state to provide care for people who might not otherwise be eligible under Medicaid & personalize their Medicaid programs to meet their state’s unique needs. For example, waivers may be used to cap the number of individuals covered or to expand home and community-based services.
All individuals must meet financial and non-financial requirements — which vary by state — to be eligible for Medicaid.
Correct!
All individuals must meet financial and non-financial requirements — which vary by state — to be eligible for Medicaid.
Sorry, that wasn't right.
All individuals must meet financial and non-financial requirements — which vary by state — to be eligible for Medicaid.
What percentage of children in the US are covered by Medicaid?
Correct!
The Medicaid program serves 50% of America’s children or approximately 37 million kids age 0-18.
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The Medicaid program serves 50% of America’s children or approximately 37 million kids age 0-18.
What advantages does managed care provide to states?
Correct!
States can authorize the use of managed care organizations (MCOs) to provide services to their Medicaid population. This helps states manage risk to taxpayers, control costs, make costs more predictable and improve care for those served by the program. The most common type of managed care structure is a comprehensive risk-based managed care arrangement, where a state contracts with an MCO, paying them a fixed dollar amount per member. 2/3 of Americans enrolled in Medicaid are served by Medicaid managed care.
Sorry, that wasn't right.
States can authorize the use of managed care organizations (MCOs) to provide services to their Medicaid population. This helps states manage risk to taxpayers, control costs, make costs more predictable and improve care for those served by the program. The most common type of managed care structure is a comprehensive risk-based managed care arrangement, where a state contracts with an MCO, paying them a fixed dollar amount per member. 2/3 of Americans enrolled in Medicaid are served by Medicaid managed care.
