Health Insurance
Health Insurance Options
Making sense of the healthcare system – including insurance – is a necessary step in the brain tumor journey. To simplify things, we’ve collected some helpful resources.HIPAA (Health Insurance Portability and Accountability Act of 1996)
• Limits exclusions for pre-existing medical conditions in group health plans to a maximum of 12 months (18 months for late enrollees). • A pre-existing medical condition is one in
COBRA (Consolidated Omnibus Budget Reconcilliation Act of 1986)
• Group health plans with 20 or more employees are required to offer continuation of group health insurance coverage for individuals and their dependents. • Employees qualify for COBRA due
Federally-Funded Health Centers
• Provide health care/dental care to individuals of all ages. • Are available to those without health insurance. • Payment is based on income- you pay what you can afford.
Hill-Burton Facilities
• A small number of hospitals and health care facilities are required to provide low-cost or no-cost medical care to those in need. • Eligibility is determined by family size
Managed Care Plans
• Have agreements with certain physicians, hospitals and health care providers to provide a range of services. • Include PPOÕs, HMOÕs and POSÕs. PPOÕs have arrangements with physicians, hospitals and
Indemnity Plans
• Also known as fee-for-service or traditional health insurance. • Usually indemnity plans offer more flexibility in choosing doctors and hospitals. • Typically, there is a deductible, the amount of
Veteran’s Health Administration Programs
• Those eligible for veteranÕs health benefits include- Army, Navy, Air Force, Marines, Coast Guard, Reservists and National Guard members who were called to active duty. • Provides a Medical
Military Health System (MHS)
• The health program for active duty service members, their families, survivors, retirees and former spouses is called TRICARE. • To be eligible for benefits, you must be registered in
State Risk Pools
• Are created by state legislatures for individuals who have pre-existing medical conditions that make them “high-risk” or “medically uninsurable.” • Generally, there are no exclusions for coverage. • Costs
Social Security Disability Insurance (SSDI)
• SSDI pays monthly benefits to individuals who are totally disabled (and certain family members) that have worked long enough and have paid Social Security taxes. • After 24 months
Medicaid
• Medicaid is a joint federal/state program that pays for health care services. • Medicaid is available to certain low-income individuals and families who meet eligibility guidelines as determined by
