Practice Quiz

Managed Care Nursing

Category - Overview

Start a Study Session Sign up for Question of the Day
A 6-year-old female with severe disabilities and developmental delay is insured with an HMO plan. She lives with her biological father and two other siblings. Recently, the child became ill and her need for care increased to a hospital level. The patient’s father is unable to fully meet the needs of the 6-year-old and wants to know if there are any other viable resources to help him properly care for his daughter.

Which of the following would be the most appropriate resource?
  1. MA
  2. Medicaid with SSI option
  3. SSI and TEFRA
  4. Medicaid with TEFRA option
Explanation
Answer: D - The most appropriate resource for the 6-year-old with severe disabilities and developmental delays insured under a HMO plan would be Medicaid with TEFRA option.

Based on the scenario she meets four of the five required criteria for which this federal law was established. The fifth criteria is related to the child’s income which we do not know; however, this is based on FPG and if necessary the child could “spin down” to meet the criteria.
Was this helpful? Upvote!
Login to contribute your own answer or details
Start a Study Session Sign up for Question of the Day

Top questions

Related questions

Most popular on PracticeQuiz