Final answer:
To avoid potential conflicts with state provided assistance programs, it is necessary to ask if a customer is enrolled in a state Medicaid program before enrolling them in a PFFS plan. Medicaid serves low-income people, while Medicare serves those over 65 and certain disabled individuals.
Step-by-step explanation:
Before enrolling any customer into a PFFS (Private Fee-For-Service) plan, it is important to ask if they are enrolled in a state Medicaid program. Medicaid is a government-funded program designed to provide health services to people with very low incomes who meet other eligibility requirements. This question arises due to how different health care plans can interact with one another, and the importance of understanding a beneficiary's coverage to avoid issues such as moral hazard and adverse selection.
Medicare, another government-funded healthcare program, provides health services to people over 65 years old as well as to people with certain disabilities. It is distinct from Medicaid, and individuals may be eligible for both, depending on their circumstances. Fee-for-service models like PFFS plans are one option under Medicare Advantage, also known as Part C of Medicare, which allows private health insurers to provide Medicare benefits. Following the enactment of the Patient Protection and Affordable Care Act (ACA or Obamacare), health insurance providers cannot deny coverage based on pre-existing conditions, which helps in mitigating issues related to high-risk pools and provides more universal access to health care services.