Insurance Benefits

Results: 9

• Benefits Assistance (1)
  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.
• Long Term Care Options Counseling (2)
  LH-4600

  Long Term Care Options Counseling

  LH-4600
  
  Programs that offer an interactive decision support process that helps individuals in need of long term care and their families understand their strengths, needs, preferences and unique circumstances and weigh the pros and cons of available alternatives. The consultation includes a discussion of the factors to consider when making long term care decisions, information about the range of long term care support options available in their community (such as personal care, transportation and medication management) and resources that can help them pay for services. The program also provides decision support to help identify next steps in the process and help in connecting with services, if needed. The service is generally available to older adults and adults of any age who have a disability; can be of benefit to people using their own resources to pay for services; and may be provided over the telephone or in person (at home, at an agency, in a hospital, at a rehabilitation or nursing facility or in another setting of the person's choosing). The objective of the program is to allow people to live as independently as possible in the setting of their choice.
• Medicaid Appeals/Complaints (3)
  NL-5000.5000-500

  Medicaid Appeals/Complaints

  NL-5000.5000-500
  
  Programs that are responsible for hearing appeals and resolving complaints that have been filed by people who have applied for or who are receiving services through Medicaid and believe that they have been discriminated against, that their rights have been violated or that the state or county has failed to take appropriate action with respect to their application or benefits.
• Medicaid Applications (3)
  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 (2)
  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.
• Pension Benefits Assistance (1)
  FT-1000.6500

  Pension Benefits Assistance

  FT-1000.6500
  
  Programs that provide information, education, advocacy and/or other forms or legal assistance for people who are experiencing difficulties understanding or collecting their retirement benefits or who have other complaints about the terms or administration of their public or private pension plan or fund.
• Retirement Benefits (1)
  NS-7000

  Retirement Benefits

  NS-7000
  
  Public programs administered by retirement disbursement authorities that make monthly cash payments to eligible workers and their eligible dependents following retirement. The amount of the monthly check is based on the worker's earnings and the length of time contributions were made to the retirement program.
• State Medicaid Waiver Programs (1)
  NL-5000.5000-800

  State Medicaid Waiver Programs

  NL-5000.5000-800
  
  Medicaid programs offered by states that have been authorized by the Secretary of the U.S. Department of Health and Human Services (HHS) to waive certain Medicaid statutory requirements giving them more flexibility in Medicaid program operation. Included are home and community care based (HCBC) waiver programs operated under Section 1915(c) of the Social Security Act that allow long-term care services to be delivered in community settings; managed care/freedom of choice waiver programs operated under Section 1915(b) of the Social Security Act which allow states to implement managed care delivery systems or otherwise limit individuals' choice of provider under Medicaid; and research and demonstration project waiver programs operated under Section 1115 of the Social Security Act to projects that test policy innovations likely to further the objectives of the Medicaid program. Each of the states has developed waivers to meet their needs; and while every state's waiver programs have their own unique characteristics, there may also be common threads.
• State/Local Health Insurance Programs (1)
  NL-5000.8000

  State/Local Health Insurance Programs

  NL-5000.8000
  
  Programs that provide health insurance for people who do not qualify for Medicaid, do not have access to insurance provided by an employer or cannot afford privately purchased health insurance. 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. Other services may include alcohol and drug treatment, mental health services, medical and equipment and supplies and rehabilitative therapy. 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.