Jones_M_HI215_Unit4_Template.docx

1 tricare prime 2tricare standard and extra 3tricare

This preview shows page 2 - 5 out of 6 pages.

1. TRICARE Prime 2.TRICARE Standard and Extra 3.TRICARE for Life 4. TRICARE Reserve Select 5. TRICARE Retired Reserve 6. TRICARE Young Adult Benefits and plans vary depending on your relationship to the initial person covered. CHIP Low income children whose parents do not meet qualifications for Medicaid. 3 State programs: 1. Medicaid expansion program-same package as Medicaid, includes Early and Periodic Screening, Diagnostic and Treatment Services (EPSDT). 2. Separate CHIP- states can choose to provide benchmark coverage, benchmark-equivalent coverage, or Secretary- approved coverage. States have the right to design their own program according to federal rules. Benefits may vary by state. The state may choose from one of the 3 programs or a combination.
Image of page 2

Subscribe to view the full document.

Government Sponsored Plan Table 3. Mandatory CHIP- well- baby and well-child care, dental coverage, behavioral health care, and vaccines. PACE Elderly adults 55 and older that meet nursing home facility level of care. Services include: 1. Location of service provision 2. Coverage of over-the- counter medications 3. Provision of hospice care 4. Provision of mental health services 5. Composition of interdisciplinary team 6. Employment status of interdisciplinary team members 7. Frequency of interdisciplinary team meetings Monthly reimbursement rate from Medicare uses two formulas; (1) the county rate book multiplied by a uniform PACE frailty adjuster and (2) a risk adjusted payment methodology. Monthly reimbursement rate from Medicaid is negotiated between the PACE provider and the State Medicaid Agency. TANF Families living at or below poverty, especially with children. Is a block grant from the federal government that provides cash assistance for the following: pay rent and utilities, personal care items, and copayments for medication. When created in 1996, 68 out of every 100 families in poverty received TANF. This has declined dramatically. In 1997 only 23 out of every 100 families received assistance. CHAMPVA Department of Veterans Affairs (VA) shares the cost of certain health care services and supplies with the Primary Family Caregiver, who is not entitled to care or services under a health plan contract, including a health insurance plan, TRICARE, Medicare or Medicaid. [ CITATION Fac19 \l 1033 ] Services include: 1. Mental health care: 23 outpatient visits per year before preauthorization is needed. 2. Prescriptions. 3. Doctor’s office visits. 4. Hospital services, in both inpatient and outpatient settings, including emergency room visits. 5. Lab and radiology. 6. Durable medical equipment. Only the approved primary family caregiver without insurance is eligible. Family members are not covered. Workers Comp People who suffer from work-related injuries and Pays 100% of medical costs. Pays cash for lost First established by the federal government for
Image of page 3
Government Sponsored Plan Table illnesses. Survivors of people who have died from work related injuries.
Image of page 4

Subscribe to view the full document.

Image of page 5
  • Fall '18
  • Monique Johnson

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern