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RN Nursing · Health Care Delivery Systems · Practice question

A 32-year-old pregnant client with low income is seeking health coverage options. After reviewing her financial status and medical needs, which government program should the nurse prioritize to assist her with health care coverage?

Answer & explanation

Correct: Medicaid

Medicaid is the correct program to prioritize for a 32-year-old pregnant client with low income. Medicaid is a joint federal and state program designed specifically to provide health coverage for low-income individuals and families, including pregnant women, who meet income eligibility thresholds. Pregnancy itself expands Medicaid eligibility in most states, and the program covers prenatal care, labor and delivery, and postpartum services. The Children's Health Insurance Program (CHIP) provides coverage for children up to age 19 in families whose income is too high for Medicaid but too low for private insurance; it is not the primary program for adult pregnant women. TRICARE is a healthcare program exclusively for active-duty military personnel, veterans, and their dependents; a civilian patient with no stated military affiliation would not qualify. Medicare is a federal program primarily serving adults 65 years and older, or those with certain disabilities such as end-stage renal disease; a 32-year-old without a qualifying disability does not meet Medicare eligibility criteria. Because the client is pregnant, low-income, and does not have identified military or age-related qualifications for the other programs, Medicaid is the most appropriate and immediately accessible coverage option the nurse should prioritize.

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