Insurance Benefits

Results: 5

• 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.
• Medicaid Appeals/Complaints (1)
  NL-5000.5000-500

  Medicaid Appeals/Complaints

  NL-5000.5000-500
  
  Programs that are responsible for hearing appeals and resolving complaints that have been filed by people who have applied for or who are receiving services through Medicaid and believe that they have been discriminated against, that their rights have been violated or that the state or county has failed to take appropriate action with respect to their application or benefits.
• 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.
• Medicaid Information/Counseling (1)
  LH-3500.4900

  Medicaid Information/Counseling

  LH-3500.4900
  
  Programs that offer information and guidance for people who may qualify for Medicaid with the objective of empowering them to make informed choices. Included may be information about the eligibility requirements for Medicaid and how to apply; Medicaid Managed Care options, benefits covered (and not covered) by the program including long-term care and home and community-based services; the payment process for co-payments; Medicaid "spend-down" (the process of reducing income and/or assets an individual possesses in order to qualify for Medicaid); and information about Medicare and the linkages between the two programs. The program may also answer questions about Medicaid services available to individuals with disabilities; and some programs may help people who qualify with enrollment and provide referrals to providers who accept State Medicaid health insurance.
• State Medicaid Waiver Programs (1)
  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.