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Insurance Benefits

    Results: 7

  • 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.
  • Long Term Care Options Counseling (1)
    LH-4600

    Long Term Care Options Counseling

    LH-4600

    Programs that offer an interactive decision support process that helps individuals in need of long term care and their families understand their strengths, needs, preferences and unique circumstances and weigh the pros and cons of available alternatives. The consultation includes a discussion of the factors to consider when making long term care decisions, information about the range of long term care support options available in their community (such as personal care, transportation and medication management) and resources that can help them pay for services. The program also provides decision support to help identify next steps in the process and help in connecting with services, if needed. The service is generally available to older adults and adults of any age who have a disability; can be of benefit to people using their own resources to pay for services; and may be provided over the telephone or in person (at home, at an agency, in a hospital, at a rehabilitation or nursing facility or in another setting of the person's choosing). The objective of the program is to allow people to live as independently as possible in the setting of their choice.
  • 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 (7)
    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.
  • Retirement Benefits (2)
    NS-7000

    Retirement Benefits

    NS-7000

    Public programs administered by retirement disbursement authorities that make monthly cash payments to eligible workers and their eligible dependents following retirement. The amount of the monthly check is based on the worker's earnings and the length of time contributions were made to the retirement program.
  • SSI (1)
    NL-1000.8100

    SSI

    NL-1000.8100

    A federal income maintenance program administered by the Social Security Administration that provides basic financial assistance in the form of monthly checks for people who are age 65 and older, blind or have a disability and who have little or no income and resources. Some states supplement SSI checks for certain categories of recipients. If the state's supplemental payment is federally administered, individuals are automatically assessed for SSP eligibility when they apply for SSI and the supplemental payment is included in their SSI check. If a state administers its own supplemental payments, individuals must apply separately at the state agency.
  • Survivors Insurance (2)
    NS-8200

    Survivors Insurance

    NS-8200

    Public social insurance programs that replace income lost to dependents because of a worker's death. Monthly cash benefits are paid to the eligible dependents of deceased workers.