Medicaid 101

Goal- For you to understand the Medicaid program at a high level including who is eligible, what services they can receive and who provides them.

Key Questions Included

1. What does it mean that Medicaid is an insurance program?
2. What does it mean that Medicaid is a partnership between the federal government and the states?
3. What do you mean there are 50 different Medicaid programs?
4. What are the federal laws and regulations that govern the Medicaid program?
5. What are the state laws and regulations that govern the Medicaid program?
6. What are the regulations used for each provider or service type in program operations?
7. Who can be a Medicaid provider?
8. How do you become a Medicaid provider?
9. What are some of the challenges of being a Medicaid provider?

Goal - For you to understand the key differences between the Medicare and Medicaid programs at a high level including who is eligible, what services are covered in each program and how the program is operated.

Key Questions Included

1. Who can be covered under Medicare?
2. Who can be covered under Medicaid?
3. Can anyone be covered under both Medicare and Medicaid?
4. What services does each program cover?
5. How are coverage decisions made in each program?
6. How big is each program? What are the major spending categories for each program?
7. What are the Medicare carriers?
8. How are Medicare regulations updated compared to Medicaid regulations?
9. What is the Medicare Part D program?

Goal- For you to have a detailed understand of required covered groups and groups states have options to cover.

Key Questions Included

1. What are the major eligibility groups?
2. What are the mandatory vs optional eligibility groups?
3. What is retro-active eligibility?
4. What is the Federal Poverty Level (FPL)?
5. How is FPL used in Medicaid programs?
6. Can states change the levels of FPL they use for eligibility in their programs?
7. What are the different FPL-based eligibility requirements across states for Medicaid?
8. How do waivers and state plan amendments allow different eligibility requirements across states?
9. What are the different approaches to eligibility application systems across states?