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Health Insurance & Benefits

    Results: 6

  • Health Care Discrimination Assistance (10)
    FT-1800.2900

    Health Care Discrimination Assistance

    FT-1800.2900

    Programs that provide assistance for people who believe that they have been treated unfairly, denied health or mental health care services or benefits or have experienced delays in service provision based on their age, gender, family composition, race or ethnic origin, nationality, religion, disability, sexual orientation or marital status.
  • Health Insurance Information/Counseling (10)
    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).
  • Medicare (4)
    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.
  • Social Security Disability Insurance (23)
    NS-1800.8000

    Social Security Disability Insurance

    NS-1800.8000

    A federal program administered by the Social Security Administration that provides monthly cash benefits for disabled workers who are fully insured under the program, who are not capable of substantial gainful work and who have completed a five month waiting period.
  • State/Local Health Insurance Programs (3)
    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.