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Insurance and 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 to which they are entitled by law. 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.
  • Health Insurance Claims Assistance for Beneficiaries (1)
    FT-3900.3300-300

    Health Insurance Claims Assistance for Beneficiaries

    FT-3900.3300-300

    Programs that provide a variety of supportive services for individuals who need assistance in completing, filing and/or appealing decisions with regard to their medical insurance claims.
  • Health Insurance Information/Counseling (1)
    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/Dental Coverage (5)
    LH-3000

    Health Insurance/Dental Coverage

    LH-3000

    Organizations that issue insurance policies which reimburse policy holders for all or a portion of the cost of hospital, medical or dental care or lost income arising from an illness or injury.
  • Home/Community Based Care Waiver Programs (1)
    NL-5000.5000-800.30

    Home/Community Based Care Waiver Programs

    NL-5000.5000-800.30

    State Medicaid programs operating under a waiver that permits them to utilize Medicaid funds, normally available only to pay for care in a skilled nursing, intermediate care or other long-term care facility, to provide case management and home care services for eligible individuals as a means of avoiding premature institutionalization. Individuals must be Medicaid eligible, must be certified or certifiable for long-term care, and must meet other criteria as specified in the state waiver, e.g., age and disability requirements. States are allowed to make waiver services available to people at risk of institutionalization, without being required to make waiver services available to the Medicaid population at large. States use this authority to target services to particular groups, such as elderly individuals, technology-dependent children, seriously emotionally disturbed children, or persons with intellectual disabilities or developmental disabilities; or on the basis of disease or condition, such as AIDS. Covered services depend on the population(s) covered in the waiver. Those for older adults and adults with disabilities, for example, include but are not limited to case/care management, homemaker services, home health aides, personal care, adult day health care, habilitation and respite care. Services for children may also include wraparound facilitation/community support, independent living/skill building services and parent support and training. Every state has its own set of waiver programs that are unique.
  • Medicaid Information/Counseling (1)
    LH-3500.4900

    Medicaid Information/Counseling

    LH-3500.4900

    Programs that offer information and guidance for people who may qualify for Medicaid including those who do not have access to insurance provided by an employer, cannot afford privately purchased health insurance or cannot afford the out-of-pocket costs associated with a health insurance plan they may have in place with the objective of empowering them to make informed choices. Included may be information about the eligibility requirements for Medicaid and how to apply; Medicaid Managed Care options including benefits covered (and not covered) by the program; the payment process for co-payments; Medicaid "spend-down" (the process of reducing the assets an individual possesses in order to qualify for Medicaid); and information about Medicare and the linkages between the two programs. The program may also answer questions about Medicaid services available to individuals with disabilities; and some programs may help people who qualify with enrollment and provide referrals to providers who accept State Medicaid health insurance.
  • Medical Expense Assistance (1)
    LH-5100

    Medical Expense Assistance

    LH-5100

    Programs that pay the health care expenses of people who are unable to obtain necessary care without assistance. Medical expense assistance programs may have age, income, disability, need or other eligibility requirements.
  • 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 the eligibility requirements for Medicare; selection and enrollment in a Medicare prescription drug plan; benefits covered (and not covered) by the program; the payment process; the rights of beneficiaries; the process for determinations, coverage denials and appeals; consumer safeguards; and options for filling the gap in Medicare coverage. These programs also provide counseling and assistance about the subsidies that are available to low income beneficiaries enrolled in the Part D Prescription Drug Benefit; and 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, fiscal intermediaries and carriers), and assistance in completing Medicare insurance forms.
  • Veteran Benefits Assistance (2)
    FT-1000.9000

    Veteran Benefits Assistance

    FT-1000.9000

    Programs that provide assistance for veterans who are having difficulty understanding and/or obtaining the full benefits and services to which they are entitled by law based on service to their country. The programs may help veterans 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 U.S. Department of Veterans Affairs staff; and/or represent them in administrative processes or judicial litigation. Included are veteran rights organizations that offer a range of advocacy services as well as legal aid programs that offer more formalized legal assistance.
 
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