Question

Directions

Research managed care plans in your state. Try the Medicaid site to help you.

Create an outline of your research and include the types of plans offered, services offered, premiums, co-payments, appeal process, and other characteristics of the plan. If you cannot find a managed care plan in your state, research plans in another state.
Needs to be in a Word document.

SCORING GUIDE ( 40 POINTS )

Rating Scale
10-9	Work meets or exceeds criterion at a high level of competence.
8	Work reflects an understanding of criterion with minor misunderstandings/misconceptions.
7	Criterion partially met, but one or more important concepts/skills are missing or flawed.
6	Work reflects an attempt to meet criterion, but significant misunderstandings/misconceptions are apparent.
5-0	Criterion not met or work is absent.

Criteria
1.	Create an outline of your research and include the types of plans offered.
2.	Create an outline of your research and include the types of services offered and premiums offered.
3.	Create an outline of your research and include the types of co-payments and the appeal process.
4.	Create an outline of your research and include the types of other characteristics of the plan.

Answer 1

Medicaid is a public health insurance programme for the poor Medicaid is a programme to provide care for qualified low-income persons, although funded largely by federal grants-in-aid.

It is a state-administered program and is run entirely by the state governments and all 50 states participate in the program, but each the state has its own plan that sets eligibility criteria and benefits

Presently Texas poverty rate is about 16.4%.

Texas is one of the 19 states that did not expand the Medicaid.

Services provided through the Medicaid:

Inpatient and outpatient hospital care, physician services.laboratory and x-ray, nursing facility care, EPSDT.

No coverage for routine physicals, preventive care, dental care, eyeglasses, hearing aids

It does not cover nursing home care also

* Supplemental Nutrition Assistance Program (SNAP), food stamps

*Woman, Infants, and Children Program (WIC)

*Temporary Assistance for Needy Families (TANF)

Texas had the highest percentage of uninsured people of all 50 states, at roughly 19% of the state's population.

15.7% of Texas population was in enrolled in Medicaid compared to a national average of 18.3%

# Medicare beneficiaries who newly enroll pay the standard monthly premium of $134 per month.

Low-income beneficiaries who are eligible for both Medicare and Medicaid generally have their premiums paid by the state Medicaid agencies.

Medicaid pays the standard premium on behalf of the qualifying beneficiary.

States can impose co-payments, co-insurance, deductibles, and other similar charges on most Medic-aid covered benefits.

Both the inpatient and outpatient services that can be charged vary with income.

All of this out of pocket charges are based on the individual state's payment for that service

Out of pocket costs cannot be imposed for emergency services, family planning services, pregnancy-related services, preventive services for children

The maximum nominal deductible and managed care co-payment amounts are:

*Deductible :$ 2.65

*Managed care Co-payment :$ 4.00

The maximum co-payment that Medicaid may charge is based on what the state pays for that service.

These amounts are u[dated annually to account for increasing medical care costs.