Insurance and Benefits

Results: 8

• Benefits Assistance (2)
  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 (9)
  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.
• CHIP Programs (1)
  NL-5000.1500

  CHIP Programs

  NL-5000.1500
  
  Organizations that help families obtain health insurance for their children under the State Children's Health Insurance Program (SCHIP), a program that is jointly financed by the federal and state governments and administered by the states. In some states, CHIP is an expansion of the Medicaid program and allows children of parents with higher incomes than were allowable in the past to participate and receive health insurance through Medicaid. In other states, CHIP is a separate program from Medicaid and covers children whose parents have incomes that are higher than the state's Medicaid eligibility levels. Within broad Federal guidelines, each state determines the design of its program, eligibility groups, benefit packages, payment levels for coverage, and administrative and operating procedures. The insurance pays for doctor visits, immunizations, hospitalizations and emergency room visits, but additional services may be available depending on the benefits defined by the state. Depending on the family's income, insurance premiums and co-pays may apply.
• Health Insurance Premium Assistance (2)
  LH-5100.3000

  Health Insurance Premium Assistance

  LH-5100.3000
  
  Programs that make health insurance payments for individuals who are at risk for losing their health, dental and/or vision care coverage and who meet age, income, disability, need or other requirements. Some programs may also provide assistance with deductibles and co-pays.
• Medicaid (2)
  NL-5000.5000

  Medicaid

  NL-5000.5000
  
  A combined federal and state program administered by the state that provides medical benefits for individuals and families with limited incomes who fit into an eligibility group that is recognized by federal and state law. Each state sets its own guidelines regarding eligibility and services within parameters established at the federal level. Many people are covered by Medicaid, though within these groups, certain additional requirements must be met. Eligibility factors include people's age, whether they are pregnant, have a disability, are blind, or aged; their income and resources (like bank accounts, real property or other items that can be sold for cash); and whether they are U.S. citizens or lawfully admitted immigrants. Families who are receiving benefits through TANF and individuals who receive SSI as aged, blind and disabled are categorically eligible groups. The rules for counting a person's income and resources vary from state to state and from group to group. There are special rules for those who live in nursing homes, for people served under the Medicaid Waiver program, for people served by Program of All-Inclusive Care for the Elderly (PACE) programs and for children with disabilities living at home. Medicaid makes payments directly to a person's health care provider; and some recipients may be asked to pay a small part of the cost (co-payment) for some medical services. Most states have additional "state-only" programs to provide medical assistance for specified low-income persons who do not qualify for the Medicaid program.
• Medical Care Expense Assistance (1)
  LH-5100.5000

  Medical Care Expense Assistance

  LH-5100.5000
  
  Programs that pay the hospital bills, doctor bills, rehabilitation service bills, laboratory expenses or other health care expenses of people who are unable to obtain necessary health care without assistance. Also included are programs that provide vouchers which enable eligible individuals to obtain medical care. Medical bill payment assistance programs may have age, income, disability, need or other eligibility requirements.
• 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.
• WIC (10)
  NL-6000.9500

  WIC

  NL-6000.9500
  
  A public health nutrition program administered by the USDA Food and Nutrition Service that provides nutrition education, nutritious foods, breastfeeding support and health care referrals for income-eligible pregnant or postpartum women, infants and children up to age five. Foster parents, grandparents, guardians and single fathers who have custody of their children may also be eligible to receive food assistance for children up to age five if they meet income guidelines. WIC provides specific foods to supplement the dietary needs of participants to ensure good health and development. Food packages typically include iron-fortified infant cereal, milk, cheese, eggs, whole grains, peanut butter, beans, fruits, vegetables and juice. Families can shop for WIC foods at most grocery stores using a WIC electronic transfer benefit (EBT) card or vouchers.