This quiz covers the 2018 FL Statewide Medicaid Managed Care Program, assessing knowledge on topics like fee-for-service, benefits, enrollment changes, and program components. It's designed for individuals involved in health administration or policy.
• Mandatory
• Voluntary
• Excluded
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• Prescriptions, Check Ups, Laboratory, X Rays
• Over the Counter Items, Circumcision, Adult Dental, Pet Therapy
• Surgery, Birthing Center Services, Hospice Services
• Emergency Services, Transportation, Podiatric Services
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• Department of Elder Affairs
• Social Security Administration
• The Agency for Health Care Administration
• Florida Legislature
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• have to start the enrollment process to be eligible for the LTC program all over.
• be responsible for paying the plan for services received during the temporary loss.
• continue receiving services from the LTC plan for up to 60 days and cannot change plans.
• have the option to change to a different LTC plan if they choose to.
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• establish Medicaid eligibility and verification of assets.
• recommend the least restrictive, safe, and most appropriate placement, identify the Level of Care, and long-term care needs.
• determine if the recipient will qualify for disability with the SSA or for worker’s compensation.
• identify if the recipient qualifies for services under the Agency for Persons with Disabilities.
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• Tell Susie it’s her choice and you cannot provide any information.
• Tell Susie she is eligible for a comprehensive plan. Inform her that she has the option to enroll into the same plan for both programs, but is not required to.
• Tell Susie she can go on the website to review her plan enrollment options.
• Tell Susie she can go to the senior center and someone will help her choose a plan.
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• DCF case worker who will meet with enrollees to perform an assessment, develop a plan of care, and assist the enrollee in obtaining appropriate care.
• care coordinator/case manager who will meet with enrollees to perform an assessment, develop a plan of care, and assist the enrollee in obtaining appropriate care.
• care coordinator/case manager who will provide long-term care services that are needed.
• DCF case worker who will provide information to enrollees or thier families to help them choose a direct service provider.
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• Become the Power of Attorney and make changes to the enrollee’s case.
• Develop a plan of care, assign direct services providers, and perform an assessment.
• Determine if the enrollee would qualify for food stamps and cash assistance.
• Perform a CARES assessment to determine the level of care.
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• no change
• open enrollment
• temporary loss
• lock-In
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• AHCA and The Florida Legislature
• DCF & SSA
• LTC & MMA
• LTC & CARES
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• KidCare Applicants
• DCF Applicants
• SSA Applicants
• WIC Applicants
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• Eligibility
• Recertification
• Express Enrollment
• Reinstatement
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True
False
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• Call, Mail, Text, In Person
• Call, Online, IVR, In person
• Mail, Online, Send a Fax
• Call, Text, Mail, Fax
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• AHCA
• The Plan
• DCF
• SSA
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• Changes during Open Enrollment and Reinstatements will be granted another 120 day change period.
• Changes during the initial 120 days and Good Cause plan changes will be granted another 120 day change period.
• Changes during the 60 day open enrollment will be granted another 120 day change period.
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• Agent states: "Yes, this long-term care plan will best meet all of your needs."
• Agent states: "My grandmother has that plan, you'd probably like it too."
• Agent states: " You'd get more services and better doctors with this plan."
• Agent states: "All MMA plans offer dental services. Contact the plan to find out more information about dental services."
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• DCF and SSA
• Elder Affairs and CARES
• HMO's and PSN's
• AHCA and DOEA
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• a company that has been approved to work for the LTC plan to provide long-term care services to enrollees.
• a company that has been approved to provide medical services to enrollees.
• a company that provides services to children with special medical needs.
• a company that has been approved to provide services for individuals that are 65 years old or older.
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• a small amount paid by the enrollee to the provider for each visit or treatment. Co-pays range from $1-$3.
• a small amount paid by the plan to the provider for each visit or treatment. Co-pays can be any amount.
• a set amount of money paid by AHCA to the plan for each visit or treatment. Co-pays are set by the plan.
• a percentage paid by the enrollee to the plan for each visit or treatment. Co-pays can vary in amount.
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• 60
• 90
• 120
• 180
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• Respite Care
• Adult Day Healthcare
• Home Delivered Meals
• Prescription Medication
• Assisted Living
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• Be at least 18 years old, File for financial eligibility and Meet the required Level of Care.
• Have filed for a disability check, food and medical assistance through SSA.
Be 65 or older, need someone to care for you and already be approved for Medicare.
• Need someone to take care of you while your family goes to work.
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• Tell the caller dental for adults is not covered.
• Tell the caller to call the Agency for Healthcare Administration.
• Tell the caller all dental is covered by Medicaid.
• Review the extra benefits on the brochure to see if it's listed, if not listed refer to the plan.
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• Receive services from doctors that accept straight Medicaid.
• See a primary care provider that will coordinate their overall care and will be referred to a specialist if needed.
• Call the AHCA Medicaid Helpline concerning their benefits and questions.
• See any primary care provider and specialists under any plan in their current region.
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• Continuity of Care
• Comprehensive Care Plan
• Coordination of Dual Eligibles
• CARES Assessment
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True
False
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• is the Thursday before the 2nd to the last Saturday of the month before 11:59pm.
• is the second to the last day of the month before 11:59pm.
• is the last day of the month before 11:59pm.
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• Tell Susie to call the care coordinator at the plan.
• Tell Susie to call DOEA.
• Tell Susie she cannot change direct service providers.
• Tell Susie she can change the provider during open enrollment.
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• Selective Medicaid Management Care
• Statewide Medicaid Managed Care
• Standard Managed Medical Complete
• Statewide Managed Medical Core
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• 180
• 90
• 120
• 30
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• Yes, the child would qualify for LTC, because children get all medically necessary services.
• No, the child must live in a nursing home in order to qualify for LTC.
• No, because they must be at least 18 years of age.
• Yes, people with disabilities may qualify for LTC.
• CMS case workers.
• trained nurses skilled to assist with children with special needs.
• trained nurses staffed to help AHS employees with their complex medical needs.
• trained nurses staffed to assist enrollees with complex medical needs.
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• "Since this is free medical care, once you enroll you cannot change it."
• "Don't worry, you have 60 days for open enrollment to change the plan for any reason, call us back if you want to change the plan."
• "Once you enroll, you will be in a no change period, and you will not be able to change the plan."
• "Don't worry, you have 120 days to change the plan for any reason. Call us back if you want to change the plan."
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• Enroll Susie into an LTC plan
• Refer Susie to SSA
• Refer Susie to DOEA to get screened for LTC
• Refer Susie to her Primary Care Doctor
• Pre-Paid Medicaid
• Straight Medicaid
• Medically Needy
• Basic Services
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• These recipients must stay on their current waiver to receive services until it runs out and then apply to receive services through a long-term care plan.
• These recipients can stay on their current waiver to receive services or can leave the waiver and receive services through fee-for-service Medicaid.
• These recipients can stay on their current waiver and also receive the same services through a long-term care plan.
• These recipients can stay on their current waiver to receive services or can leave the waiver and receive services through a long-term care plan.
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• when Medicaid is approved. The effective date can be any day of the month.
• when Medicaid is approved. The effective date is always on the first of the month.
• as soon as the applicant applies for Medicaid, even if the status is "Processing".
• the following month. The enrollee will have FFS for the first month.
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• Call DOEA to request an extension on their Medicaid eligibility.
• Call the LTC plan to find out about their Medicaid eligibility before the 60 days are over.
• Call the LTC plan to find out about their Medicaid eligibility before the 60 days are over. • Make plans to find another facility since they are losing Medicaid eligibility.
• Call DCF or SSA to find out about their Medicaid eligibility status before the 60 days are over.
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Quiz Review Timeline (Updated): Mar 21, 2023 +
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