New Jersey Family Care: what is it?
... health insurance for New Jersey’s
not a welfare program
for working families who cannot
afford to buy health insurance
... Source: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-State/wyoming.html
3) Medicaid Expansion? No
4) What kind of coverage is available for mental health/substance abuse treatment through
... Aged, blind, disabled—low income higher
than poverty level
Children meeting TANF limits
Pregnant women not meeting other federal
qualifications, but who meet state income
Be Protected (Connexus)
... Intellectual disability for members over age 18
Massage or massage therapy
Obesity (all services and supplies except those
required under the Affordable Care Act)
Optional services or supplies, including those for
comfort, convenience, environmental control or
education, and treatment not medically ...
... requirements (BMI, presence of co-morbidity, failed attempts at weight
management through diet and exercise)
– Incentive Programs, e.g. reduction in cost-sharing as reward for maintaining a
specified health status factor, such as BMI or smoking cessation
The Affordable Care Act and the Criminal Justice System
... substance use disorder (SUD) and mental health (MH) services
Under the ACA, SUD and MH services are essential health
benefits which must be covered at parity (Mental Health Parity
and Addiction Equity Act) with other covered medical benefits
Requirements apply to most Medicaid and private insura ...
Health Care Reform - ADAP Advocacy Association
... What does Reform really do?
• People with very low income will be eligible
for Medicaid (<133% of Poverty level)
• People with some income will be eligible for
Insurance Exchanges (a bare bones, no frills
kind of insurance coverage)
• People with Private Insurance will get more
... q Proof of custody/guardianship must be presented at the time of admission.
Our referring community includes: clinicians, managed care organizations, schools, employers, employee assistance program personnel, clergy, family members, community agencies, and self-referrals. Four Winds maintains regula ...
When Medicaid for children was created in 1967, President Lyndon
... (3) DENTAL SERVICES (A) which are provided (i) at intervals which meet reasonable standards of dental practice, as determined
by the state after consultation with recognized dental organizations involved in
child health care, and
(ii) at such other intervals, indicated AS MEDICALLY NECESSARY, to det ...
Agency for Health Care Administration Assisted Living Facilities
... A & B, and meet additional clinical impairment criteria
• Services – Case management, and 20 other home and
community-based services including assisted living services,
11 acute care services, Medicare co-payments and coinsurance, and unlimited nursing facility care in enrolled
• Service ...
... Amends ERISA, PHSA, IRC
Financial requirements and treatment limits on
MH/SUD benefits must be no more restrictive than
those applicable to medical/surgical benefits
Group plans only (not small e’or or individual)
CMS, IRS, DOL announced Final Rule in Nov. 2013,
effective Jan. 2014
TITLE32pt/39pt - Gatton College of Business and Economics
... • Competitive markets can provide low cost coverage for
most, reducing the need for public assistance. Impediments
include: over-regulation of health insurance and
healthcare providers; tax treatment of individual policies.
• Health insurance vouchers to those remaining in true need.
-E.g., “Cash an ...
... (known as Essential Health Benefits) as well as current limits on consumers’ annual out-ofpocket spending. These changes could allow insurance companies to sell less comprehensive,
potentially even skimpy, coverage and/or require consumers to pay higher deductibles,
coinsurance and copayments. The r ...
Tuberculosis (TB) Related Medicaid Option
... Title XIX of the Social Security Act
Provides medical assistance for certain
individuals and families who have low incomes
Largest program providing medical and health
related services to America’s poorest people
Introduction to Medicare, Medicaid and Community Services
... • Terminally ill with a prognosis < 6 months.
• Patient choose to receive care from a
• Essentially all costs of terminal illness are
covered including medications,
transportation, home aids (20 hrs/week),
inpatient respite care, bereavement services
... bill cuts nearly $59 billion over 10 years from the Hospital Insurance trust fund by repealing a
0.9 percent payroll tax on higher-income workers. This would hasten Medicare’s insolvency and
diminish the program’s ability to pay for services in the future. The bill would also increase
Medicare premi ...
DSHS Presentation - Washington State Hospital Association
... – 24‐hour access to professional services by
providing a nurse‐triage line in project
– Improve the ability of community health clinics
(CHCs) to be effective Medical Homes and
alternate emergency care providers, and
– Create a case management system that is
integrated with the nurse‐tr ...
Los Angeles County Commission on HIV Health Services
... with income over 133% FPL to purchase insurance
More affordable and better coverage options for
individuals without group coverage
Federal premium and cost-sharing subsidies for
individuals with incomes133% - 400% FPL
o Around $19,000 to $57,616/per year for an
individual based on current standa ...
cmisp - Department of Human Assistance
... The purpose of the County Medically Indigent Services Program (CMISP) is to
provide medically necessary care to eligible indigents who are residents of
Sacramento County. It is a program of “last resort”. CMISP is available to residents
who have no other resources for health care, not eligible for a ...
Early and Periodic Screening, Diagnostic and Treatment (EPSDT) is the child health component of Medicaid. Federal statutes and regulations state that children under age 21 who are enrolled in Medicaid are entitled to EPSDT benefits and that States must cover a broad array of preventive and treatment services. Unlike private insurance, EPSDT is designed to address problems early, ameliorate conditions, and intervene as early as possible. For the 25 million children enrolled in Medicaid and entitled to EPSDT in 2012, the program is a vital source of coverage and a means to improve the health and well-being of beneficiaries.While a small number of cases and anecdotes regarding high EPSDT costs have garnered public attention, spending per child is low compared with worker-age adults and seniors covered by Medicaid. This is true despite the breadth of coverage provided to children through EPSDT. Children account for approximately half of Medicaid beneficiaries but only roughly 20-25 percent of the costs of the program overall. With Medicaid and EPSDT, however, poor children's access to health care is similar to that of non-poor, privately insured children and child Medicaid beneficiaries use care in approximately the same pattern as their privately insured counterparts. On average, Medicaid costs per child are less than private insurance.