CES Medicaid and CHIP Programs 2

Question 1

What is the Federal Medical Assistance Percentage (FMAP) used to determine?

Accepted Answer

The share of Medicaid costs the federal government reimburses to each state

Answer

FMAP is the formula-driven percentage of state Medicaid expenditures that the federal government matches, varying by state based on per capita income.

Question 2

Which of the following is a mandatory Medicaid service that all states must cover?

Accepted Answer

Inpatient hospital services

Answer

Inpatient hospital services are a mandatory Medicaid benefit all states must provide, while adult dental, vision, and chiropractic services are optional.

Question 3

What is 'presumptive eligibility' in the context of Medicaid and CHIP?

Accepted Answer

A qualified entity temporarily enrolls an applicant who appears eligible while the formal application is processed

Answer

Presumptive eligibility allows trained qualified entities to provide temporary Medicaid/CHIP coverage while the state agency completes the full eligibility determination.

Question 4

What is the Medicaid Estate Recovery Program (MERP) designed to do?

Accepted Answer

Recover Medicaid costs from the estates of deceased beneficiaries who were 55 or older

Answer

MERP requires states to seek repayment of Medicaid costs from the estates of deceased beneficiaries who were age 55 or older when they received services.

Question 5

Under Medicaid rules, retroactive coverage can go back up to how many months prior to the month of application?

Accepted Answer

3 months

Answer

Medicaid may cover eligible medical expenses incurred up to 3 months before the month an individual applies, provided they were eligible during those months.

CES - Certified Enrollment Specialist Practice Test

CES - Certified Enrollment Specialist Practice Test

CES Medicaid and CHIP Programs 2