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Insurance & Benefits

    Results: 11

  • Benefits Assistance (12)
    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.
  • 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 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 (4)
    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.
  • Medicaid (1)
    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.
  • Medicare (1)
    NS-8000.5000

    Medicare

    NS-8000.5000

    A federally funded health insurance program administered by the Centers for Medicare & Medicaid Services (CMS) under the U.S. Department of Health and Human Services for people age 65 and older; for individuals with disabilities younger than age 65 who have received or been determined eligible for Social Security Disability benefits for at least 24 consecutive months; and for insured workers and their dependents who have end stage renal disease and need dialysis or a kidney transplant. As with ESRD, the 24-month waiting period is waived for disability beneficiaries diagnosed with Amyotrophic Lateral Sclerosis (ALS, also called Lou Gehrig's disease). Premiums, deductibles and co-payments or out-of-pocket costs apply to Medicare coverage for most people. Special programs that assist with paying some or all of these costs are available for low income individuals who qualify. Medicare has four parts, but not every Medicare beneficiary has every part. Medicare Part A (Hospital Insurance) covers inpatient hospital stays, care in a skilled nursing facility, hospice care and home health care that meets the program eligibility criteria. Medicare Part B (Medical Insurance) covers services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, preventive services and more. Together, Medicare Part A and Part B are called Original Medicare. Medicare Part C enables private insurance companies to offer Medicare Advantage (MA) Plans under contract with CMS that provide all Part A and Part B benefits to plan enrollees. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans and Medicare Medical Savings Account Plans. Some plans offer extra benefits and services that aren't covered by Original Medicare, sometimes for an extra cost; and most (but not all) include Medicare prescription drug coverage. Medicare Part D (Medicare prescription drug coverage) is an optional benefit that helps beneficiaries cover the cost of prescription drugs. The plans are offered by insurance companies and other private companies approved by Medicare and add prescription drug coverage to Original Medicare, some Medicare Private-Fee-for-Service Plans and Medicare Medical Savings Account Plans.
  • Medicare Information/Counseling (3)
    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.
  • State Medicaid Waiver Programs (2)
    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.
  • Veteran Benefits Assistance (46)
    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 Services Officers (VSOs) who are trained and accredited by the Veteran's Administration (VA) and can be found in offices specific to each state, the county courthouse, the local VA office and local veteran's rights organizations; as well as legal aid programs that offer more formalized legal assistance.
  • Veteran Burial Benefits (3)
    NS-1000.9000

    Veteran Burial Benefits

    NS-1000.9000

    A program of the U.S. Department of Veteran Affairs that provides a variety of burial benefits for eligible deceased veterans of peacetime or wartime service who have been discharged under conditions other than dishonorable and, in the case of some benefits, for their dependents. Included are burial in a national cemetery (opening and closing the grave, headstones and markers and perpetual care); headstones and markers for graves of veterans that are located anywhere in the world as well as niche markers for urns; headstones or markers for memorial plots in situations where the veteran's remains are not available for burial; Presidential Memorial Certificates; and burial flags which drape the veteran's coffin and are given to the next of kin or close associate following the funeral. Burial and funeral allowances are also available to certain veterans under specified conditions.
  • Veteran Education Benefits (4)
    HL-8000.1800-900

    Veteran Education Benefits

    HL-8000.1800-900

    Programs administered by the U.S. Department of Veterans Affairs or other organizations that provide educational financial assistance for veterans and service personnel and their eligible dependents. Veterans and service personnel who served on active duty between January 31, 1955 and January 1, 1977 for specified periods of time are eligible for a variety of education benefits under the GI Bill including a stipend for tuition assistance at approved educational institutions. Veterans and service personnel who entered active duty after January 1, 1977 may participate in a voluntary contributory plan in which the individual's savings for a future education are administered and augmented by the government. Partial educational assistance is also available to the survivors of deceased or disabled veterans whose death or permanent and total disability was service-connected; and to the spouses and children of servicemen and women who have been listed for more than 90 days as missing in action, captured in the line of duty or forcibly detained by a foreign power.