Health Insurance

    Results: 10

  • Disability Benefits (2)
    NS-1800

    Disability Benefits

    NS-1800

    Public social insurance programs that replace income lost because of a physical or mental impairment severe enough to prevent a previously employed person from working. Monthly cash benefits are paid to the eligible individual with a disability and his or her eligible dependents throughout the period of disability.
  • Health Insurance/Dental Coverage (6)
    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.
  • Long Term Care Insurance (6)
    LH-3000.4500

    Long Term Care Insurance

    LH-3000.4500

    Private insurance companies, government programs and public/private partnership programs that issue individual and group insurance plans or policies which pay for nursing facility care, home health care, adult day health care, respite care, hospice care and/or home modifications to eliminate barriers for people who are chronically ill. Long-term care policies cover all levels of care including skilled, intermediate and custodial. Benefits may be triggered when an individual's doctor orders care, when s/he has some cognitive impairment or if s/he is unable to perform certain activities of daily living independently such as bathing, dressing, eating and toileting. A limited number of states participate in public/private partnerships which have provisions to protect participants from becoming impoverished in order to become eligible for Medicaid long-term care benefits.
  • 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.
  • Medicaid Applications (1)
    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 Appeals/Complaints (1)
    NS-8000.5000-520

    Medicare Appeals/Complaints

    NS-8000.5000-520

    Programs that are responsible for hearing appeals and resolving grievances that have been filed by people who have applied for or are receiving benefits through the Medicare program (including the Part D Prescription Drug Benefit and the subsidies that are available to low income beneficiaries enrolled in the Part D Benefit) and believe that an adverse action has been wrongly taken, including discrimination, violation of rights and/or failure to take an appropriate action.
  • Medicare Insurance Supplements (9)
    LH-3000.5000

    Medicare Insurance Supplements

    LH-3000.5000

    Organizations that offer insurance policies which pay for some health care costs that are not covered by Medicare. These generally include Medicare deductibles and co-payments, but not long-term care.
  • Medicare Savings Programs (1)
    NL-5000.5000-700

    Medicare Savings Programs

    NL-5000.5000-700

    Programs that pay all or a portion of Medicare costs for low income Medicare beneficiaries with limited resources/assets. The programs are administered by Medicaid medical assistance offices, pay all or a portion of Medicare premiums and may pay Medicare deductibles and co-insurance. Included are the Qualified Medicare Beneficiary (QMB) program that pays Medicare premiums, deductibles and co-payments for people with combined incomes that do not exceed 100 percent of the federal poverty level; the Specified Low-Income Beneficiary (SLMB) program that pays Medicare Part B premiums for people with combined incomes between 100 and 120 percent of the federal poverty level; the Qualifying Individuals (QI) program that pays Medicare Part B premiums for people with combined incomes 120 and 135 percent of the federal poverty level; and the Qualified Disabled and Working Individuals (QDWI) program that helps pay the Part A premium for individuals under age 65 who have a disability and are working, have lost their premium-free Part A when they returned to work, are not receiving medical assistance from their state and meet income and resource limits required by their state. The QI program is available on a first come, first served basis. Asset/resource limits are uniform for the QMB, SLMB and QI programs and are $7,160 for single individuals and $10,750 for married couples. Resource limits for the QDWI are $4000 in countable assets/resources for individuals and $6000 for married couples.
  • State/Local Health Insurance Programs (2)
    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.
  • Veteran/Military Health Insurance (1)
    NS-8000.9000

    Veteran/Military Health Insurance

    NS-8000.9000

    Programs administered by the Department of Defense (DoD) Health Affairs Office or the U.S. Department of Veterans Affairs that provide health benefits coverage for eligible military personnel, eligible veterans and eligible dependents.
 
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