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Health Insurance

    Results: 7

  • Benefits Assistance (3)
    FT-1000

    Benefits Assistance

    FT-1000

    Programs that provide assistance for people who are having difficulty understanding and/or obtaining grants, payments, services or other benefits for which they are eligible. The programs may help people understand the eligibility criteria for benefits, the benefits provided by the program, the payment process and the rights of beneficiaries; provide consultation and advice; help them complete benefits application forms; negotiate on their behalf with benefits administration staff; and/or represent them in administrative processes or judicial litigation. Included are benefits counseling organizations that offer a range of advocacy services and legal aid programs that offer more formalized legal assistance.
  • Children's State/Local Health Insurance Programs (1)
    NL-5000.8000-150

    Children's State/Local Health Insurance Programs

    NL-5000.8000-150

    Programs that provide health insurance for children who do not qualify for Medicaid and who have no access to privately purchased health insurance or to insurance provided through a family member's employer. Services covered by these programs vary by state but generally include hospitalization, physician services, emergency room visits, family planning, immunizations, laboratory and x-ray services, outpatient surgery, chiropractic care, prescriptions, eye exams, eye glasses and dental care. Eligibility requirements also vary. Included are state and/or local government health insurance programs which may be administered by the state or at the local level and public/private partnerships between state and/or local government entities and health insurance companies or other private organizations. Health care is generally provided through participating managed care plans in the area. Also included are other programs that help people prepare and file Children's State/Local Health Insurance applications and/or are authorized to do eligibility determinations for the program.
  • Health Insurance Information/Counseling (5)
    LH-3500

    Health Insurance Information/Counseling

    LH-3500

    Programs that offer information and guidance for people who need assistance in selecting appropriate health insurance coverage and which may also answer questions about health insurance benefits and help people complete insurance forms.
  • Health Insurance Marketplaces (1)
    LH-3000.3050

    Health Insurance Marketplaces

    LH-3000.3050

    Organized marketplaces (also called "exchanges") for the purchase of health insurance that are established by states, the federal government (federally-facilitated marketplaces) or states and the federal government in partnership; and set up as a governmental or quasi-government entity. The marketplaces enable individuals and small employers to compare available private health insurance options on the basis of price, benefits and services, quality and other factors; and are required to provide for the operation of a toll-free call center and an Internet website as consumer assistance tools. They help enhance competition in the health insurance market, provide a range of affordable health insurance choices and give small businesses the same purchasing power as large businesses. They serve as a one-stop shop where individuals can get information about their options; be assessed for premium assistance subsidies (tax credits) which are determined on a sliding scale and cost sharing assistance subsidies; and be assessed for or enrolled in the plan of their choice. The marketplaces are not insurers, so they do not bear risk themselves, but determine the insurance companies that are allowed to participate in them. Health plans provided through the marketplaces are made available to qualified employers and their employees in the small group market through a small business health options program (SHOP).
  • Medicaid Applications (1)
    NL-5000.5000-520

    Medicaid Applications

    NL-5000.5000-520

    County or state offices that accept applications and determine eligibility for the Medicaid program; and reinstate individuals who have lost their Medicaid benefits due to incarceration, institutionalization, noncompliance or other reasons. Also included are other programs that help people prepare and file Medicaid applications and/or are authorized to do eligibility determinations for the program.
  • Medicare Information/Counseling (1)
    LH-3500.5000

    Medicare Information/Counseling

    LH-3500.5000

    Programs that offer information and guidance for older adults and people with disabilities regarding their health insurance options with the objective of empowering them to make informed choices. Included is information about benefits covered (and not covered); the payment process; the rights of beneficiaries; the process for eligibility determinations, coverage denials and appeals; consumer safeguards; and options for filling the gap in Medicare coverage (Medigap supplement insurance). Also available is information relating to an individual's eligibility for benefits and assistance with evaluating their options and enrolling in a Medicare plan (A, B, C, and/or D) that will best meet their needs. These programs also address coordination of benefits when beneficiaries have other types of health insurance in addition to Medicare (e.g. Medicaid, employer coverage or retiree insurance) and provide counseling and assistance regarding the subsidies that are available to low income beneficiaries enrolled in the Part D Prescription Drug Benefit (which help pay for Part D premiums and reduce the cost of prescriptions at the pharmacy) and the Medicare Savings Programs which help pay for Medicare out-of-pocket costs. They may also provide information about Medicaid and the linkages between the two programs, referrals to appropriate state and local agencies involved in the Medicaid program, information about other Medicare-related entities (such as peer review organizations, Medicare-approved prescription drug plans, Medicare administrative contractors), and assistance in completing related Medicare insurance forms.
  • Social Security Retirement Benefits (1)
    NS-7000.8000

    Social Security Retirement Benefits

    NS-7000.8000

    A program administered by the Social Security Administration that provides monthly cash payments (sometimes called old-age insurance benefits) for people age 62 and older who are fully insured. Workers may retire at age 62 and receive a reduced benefit or may wait until age 65 and receive a full benefit. Benefit amounts depend upon wages earned and the number of quarters of coverage credited to the individual's Social Security record.