Medikids Program Information Quiz

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The correct answer is 1-4. This means that MediKids is for children aged 1 to 4 years old.

The Department of Children and Families screens Kidcare applications for Medicaid. Medicaid is a government program that provides healthcare coverage to low-income individuals and families. Kidcare is a program within Medicaid that specifically focuses on providing healthcare coverage for children. Therefore, it makes sense that the Department of Children and Families would screen Kidcare applications for eligibility for Medicaid coverage.

MediKids, a program mentioned in the question, is administered by the Agency for Healthcare Administration. This means that the agency is responsible for overseeing and managing the MediKids program. The Florida Legislature and Florida Governor may have other roles and responsibilities in the healthcare system, but in this specific case, it is the Agency for Healthcare Administration that administers MediKids.

Healthy Kids is a program specifically designed for children aged 5-18. This program is not intended for children aged 1-4 or 0-5. It focuses on promoting health and wellness among older children and teenagers.

A reinstatement is created when an enrollee loses MediKids eligibility. This suggests that the individual was previously enrolled in the MediKids program but is no longer eligible for it. As a result, they need to be reinstated into a different plan or program that they are eligible for.

If a caller requests Children's Medical Services, you will refer them to KidCare Customer Service. This implies that Children's Medical Services is a separate entity or department that is not directly responsible for handling the caller's request. Instead, KidCare Customer Service is the appropriate point of contact for the caller's needs.

HMO stands for Health Maintenance Organization. This term refers to a type of healthcare plan that provides comprehensive medical services to its members for a fixed annual fee. HMOs focus on preventive care and require members to choose a primary care physician who coordinates their healthcare. This healthcare model aims to keep costs down by emphasizing preventive measures and managing the overall health of patients.

PSN stands for Provider Service Network. This is the correct answer because PSN refers to a network of providers who offer services to patients. This network typically includes hospitals, clinics, and other healthcare facilities. By being part of a Provider Service Network, healthcare providers can collaborate and coordinate care for their patients, ensuring that they receive the necessary services and treatments.

If a child is eligible for MediKids but the health plan has not started yet, then the child is covered by Fee for Service Medicaid. This means that the child will receive healthcare services on a fee-for-service basis, where healthcare providers are paid for each service provided. This coverage ensures that the child can still receive necessary medical care while waiting for their health plan to begin.

The primary care provider plays a crucial role in coordinating and managing a patient's healthcare. If the enrollee requires specialized medical care that is beyond the scope of the primary care provider's expertise, they will refer the patient to a specialist. This ensures that the enrollee receives the appropriate and specialized care they need to address their specific health condition or concern.

The statement "Coverage starts when the applicant makes a provider choice" is false. Coverage typically starts once the applicant's enrollment is approved and the first premium payment is made, not when the provider is chosen. The applicant may have the option to select a provider within the approved coverage, but this does not determine when the coverage begins.

The correct answer is the MediKids ID card. This card is specifically for out of state emergencies and would be the appropriate card for the enrollee to use in such situations. The Medicaid ID card is not specified for out of state emergencies, and the state ID card and health plan card are not mentioned as options.

Enrollees cannot have both MediKids and Medicaid at the same time. These are two separate healthcare programs, and individuals are typically eligible for one or the other based on their age and income level. MediKids is specifically for children, while Medicaid is for low-income individuals and families. Therefore, it is not possible for someone to have both at the same time.

Enrollees will call the MediKids Helpline to request another MediKids ID Card. The MediKids Helpline is specifically designed to assist enrollees with any inquiries or requests related to their MediKids ID Card. The AHCA and Florida KidCare Customer Service may be able to provide general assistance, but the MediKids Helpline is the most appropriate option for requesting a new ID Card.

If an enrollee wants to change their Primary Care Provider (PCP), they should call the health plan. The health plan is responsible for managing the enrollee's healthcare benefits and network of providers. They have the necessary information and resources to assist the enrollee in making the necessary changes to their PCP. The Department of Children Families may not have the authority or access to the enrollee's specific health plan details, and Enhanced Benefits is not a relevant entity for this purpose.

The correct answer is "exceed the income requirements." This means that the applicants who have a higher income than what is required are eligible for the full pay premium. In other words, they meet the financial criteria necessary to receive the maximum level of insurance coverage.

The correct answer is "No, the member can make a choice but doesn't have coverage yet." This means that the member does not currently have active MediKids coverage and has the option to choose coverage, but has not yet done so.

The correct answer is "Yes, because she's the parent." This is because parents are typically authorized to access information about their child's coverage. The fact that Jane Member is Sophie's mom indicates that she has a legitimate relationship and is therefore authorized to inquire about Sophie's MediKids coverage. The other options provided do not provide a valid reason for authorization.

The effective date of the enrollment request is determined by when the payment is received. Once the payment is received, the health plan will become effective.

If a health plan choice is not made, the member will have coverage under First Coast Advantage for 5/1/2014.

It is possible to complete a temporary address update for MediKids.

MediKids members do not have to wait until open enrollment to change their health plan. They can make changes outside of the open enrollment period if they experience a qualifying life event, such as getting married or having a baby. Therefore, the statement is false.

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During the month of March, the member is covered under FFS/Straight Medicaid. This means that they have coverage through the Fee-for-Service (FFS) Medicaid program, which provides payment for healthcare services on a per-service basis. This is different from managed care plans like Molina HealthCare and Sunshine State, which have a network of providers and may require prior authorization for certain services. The option "Doesn't have any coverage" is incorrect as the member is indeed covered under FFS/Straight Medicaid.

The correct answer is Florida KidCare Customer Service. This is because the question is asking about payment and eligibility questions, and Florida KidCare Customer Service is the most appropriate contact for these types of inquiries. AHCA may not specifically handle payment and eligibility questions, and Enhanced Benefits and MediKids Helpline may not be the appropriate contacts for Florida KidCare-related inquiries.

MediKids will have a $0 co-pay in order to receive services. This means that they will not have to pay any additional fees or out-of-pocket expenses when accessing the services provided by MediKids.

If any of the mentioned conditions occur, a disenrollment will take place. If the enrollee fails to make the payment, they will be disenrolled. Similarly, if the family income exceeds the program limits, the enrollee will be disenrolled. Lastly, if the child obtains private insurance, they will also be disenrolled. Therefore, all of the given options can lead to disenrollment.

A provider choice can be made even if the member has active Medicaid. This means that even if a person is currently enrolled in Medicaid, they still have the ability to choose their healthcare provider. Medicaid provides healthcare coverage for low-income individuals, but it does not restrict the individual's ability to choose their preferred healthcare provider. Therefore, the statement is true.

To be approved for MediKids, the applicant must have completed a payment and have a provider choice. This means that in order to qualify for MediKids, the applicant must have made a payment and also have the option to choose a healthcare provider. Both of these conditions must be met for approval.