Are you looking for information about how to find, choose, and use quality health coverage?
Click on a link below for specific resources that will address your concerns. (NOTE: Some of these links take you to commercial sites. Families USA does not endorse or vouch for the products or services offered on any of these sites.)
If you have had trouble finding or maintaining adequate health coverage, you may want to participate in our Consumer Story Bank. Stories about people's experiences help make often complex policy issues understandable to a broader group. If you would like to share your story, go to Story Bank.
New from Families USA:
State Guides to Finding Health Coverage: Millions of Americans have no health insurance, and finding health insurance can be difficult. If you are looking for coverage, this guide can help point the way. Whether you have recently lost your job, are an early retiree, or have a serious medical condition, this guide includes numerous resources that may help you find the coverage you need. (Updated 2009)
I already have health insurance, and
I am looking for a new health insurance plan, and
I want information regarding insurance for a specific group:
I already have health insurance, and
HealthCareCoach.com: This site offers information on how to use and retain insurance. The site provides information about how to choose services, file claims, and protect your service, all while keeping costs down.
HealthInsuranceInfo.net: This site provides online consumer guides for each state and the District of Columbia summarizing laws that protect people when they are trying to keep their health insurance. The guides include lists of relevant state agencies and glossaries of commonly used terms. The site also offers an online newsletter that contains consumer perspectives on how private coverage works for people in various circumstances.
How Private Insurance Works: A Primer: begins by defining private health coverage. It goes on to examine the structure and operation of private health insurance, including the types of organizations that provide it, how managed care is delivered, and how risk pools and underwriting work. It also describes how private health insurance coverage is regulated under federal and state laws, and it explains how the current nature of private insurance relates to key issues facing federal and state policymakers.
Fact Sheets on Managed Care: These five fact sheets, written for a general audience, together serve as an introductory course on how to be a savvy user of managed health care. Available in both English and Spanish, and including explanations of many terms that may not be widely understood, the fact sheets address the following: how the U.S. health care system and managed care plans work, understanding performance measures for quality of health care services, how to figure out which health plans meet one's needs, health plan report cards, and consumer surveys.
Center for Patient Advocacy: This site includes the following consumer information: guidelines to follow when an individual is in a dispute with a health plan or provider, a glossary of insurance and medical terms, advice on choosing the right physician, a list of state agencies that address senior citizen concerns, contact information for regional Medicare offices and Medicare-approved HMOs, and a description of states' long term care programs.
The Health Benefits Advisor is designed to help workers and their families better understand group health benefits provided by employers and by employee organizations (such as unions) and the laws that govern them, especially when they experience changes in their life and work situations. The Advisor may also assist employers in understanding their responsibilities under the applicable laws. The site provides guidance that is general in nature and does not address health benefits offered through federal, state, or local government plans or church plans. (2003)
The Official Site for People with Medicare: This government-produced site for people with Medicare coverage provides general information about Medicare, such as how to locate doctors who will accept Medicare patients and how to file Medicare claims. There is also a question-and-answer section.
The National Association of Insurance Commissioners: This site provides links to the Web site of each state's insurance department so consumers can find local information.
Healthcare Coverage Options Database: Assistance for Obtaining Health Coverage: This Web site provides information on health insurance options for low-income U.S. residents. The site includes comprehensive information on large-scale programs like Medicaid, the State Children's Health Insurance Program (SCHIP), and the federal Health Care Tax Credit Program, as well as hundreds of smaller state, federal, and private programs.
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I already have health insurance, and
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I need help with a specific problem
Consumer health assistance programs in a number of states provide expert assistance with health insurance problems. See our program locator to find out if there is such a program in your state.
Consumer Guide to Handling Disputes with Your Employer or Private Health Plan: This guide is geared towards helping consumers who are seeking ways to resolve disputes with their current health plans or to better understand their coverage. The guide helps individuals navigate their plan's internal review process as well as their state's external review process. It also provides consumers with state-specific guidelines and other practical information.
Center for Patient Advocacy: This site contains the following consumer information: guidelines to follow when an individual is in a dispute with a health plan or provider, a glossary of insurance and medical terms, advice on choosing the right physician, a list of state agencies that address senior citizen concerns, contact information for regional Medicare offices and Medicare-approved HMOs, and a description of states' long term care programs.
HealthCareCoach.com: This site provides an action center, which serves as a way for consumers to gain information about their rights and to make sure that their rights are protected. There are specific links to subjects such as Understanding Your Rights, Cutting Through the Red Tape, and When You Think That You Need Legal Advice or Counsel.
COBRA: This site acts as a clearinghouse for questions and answers regarding the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) that may be of interest to individuals and small businesses. The site explains an individual's rights under COBRA and also attempts to answer questions about problems that may arise regarding COBRA. It also offers private insurance rate quotes while focusing on temporary insurance needs.
HIPAA Online: This site offers an "interactive tool," provided by the U.S. Department of Health and Human Services, that is designed to help answer questions about health care and an individual's rights and protections under the Health Insurance Portability and Accountability Act (HIPAA). For instance, the site discusses issues such as retaining health coverage after losing or changing jobs, during pregnancy, after moving, or after divorce. Privacy issues are also covered. Employers can use this site to get information about health care for their employees.
Official Site for People with Medicare: This site explains how to file claims and appeals for people who are covered by Medicare. There is also a link to appeal forms that can be printed directly from the Web page.
Needymeds.com is a Web site that provides complete and accurate information on the patient assistance programs that are established by prescription drug manufacturers. These programs are designed to help those who can't afford their medicines obtain them at no cost or low cost. Unfortunately, many people, including doctors, nurses, social workers, and patients, don't know that these programs exist. The information on the Web site is obtained only through regularly contacting every drug company directly.
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I am looking for a new health insurance plan, and
HealthInsuranceInfo.net: This site provides online consumer guides for each state and the District of Columbia summarizing laws that protect people when they are trying to keep their health insurance. The guides include lists of relevant state agencies and glossaries of commonly used terms. The site also offers an online newsletter that contains consumer perspectives on how private coverage works for people in various circumstances.
What Consumers Need to Know about Buying Health Coverage from Associations -- From Families USA
What Consumers Need to Know about Health Savings Accounts -- From Families USA
What Consumers Need to Know about Purchasing Health Insurance as an Individual -- From Families USA
State Guides to Finding Health Coverage: Millions of Americans have no health insurance, and finding health insurance can be difficult. If you are looking for coverage, this guide can help point the way. Whether you have recently lost your job, are an early retiree, or have a serious medical condition, this guide includes numerous resources that may help you find the coverage you need. (Updated 2009)
Health Care Coach: This site provides a tool aimed at helping individuals navigate their way through the health care system independently and effectively. Under the health insurance tab, there are sections for getting health insurance, basic health insurance facts, using insurance, and protecting health coverage.
Actor's Fund of America, "Access to Health Insurance/Resources For Care": Provides state by state information and resources.
Consumer health assistance programs in a number of states provide expert assistance with health insurance problems. See our program locator to find out if there is such a program in your state.
Life-Line: This site is geared towards helping consumers become better informed as to what kind of health insurance options are available. The site suggests a strategy to help visitors choose the best health insurance plan to fit their needs. There are sections focusing on getting started, types of insurance, sources of insurance, individual coverage, and cost of care. The cost of care option provides information on the national average cost of different procedures.
The Ten Commandments for HMOs: This site provides a list of questions that consumers should ask when choosing an HMO. The list was compiled by a consumer who conducted research on the topic after having trouble getting straight answers from prospective HMOs.
The National Association of Insurance Commissioners: This site provides links to the Web site of each state's insurance department so consumers can find local information.
GovBenefits: This site is a guide to government benefits for which visitors may be eligible.
First Gov for Consumers: This is a government site for consumers. The site addresses a broad range of issues. There is information for the elderly and links to sources of help with choosing the correct health care plan. It provides information on health coverage and treatment options for common health problems and provides pointers for choosing the best health care.
COBRA: This site that acts as a clearinghouse for questions and answers regarding the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) that may be of interest to individuals and small businesses. The site explains an individual's rights under COBRA and also attempts to help answer questions about problems that may arise regarding COBRA. It also offers private insurance rate quotes and group rate quotes, all while focusing on temporary insurance needs.
Insure Kids Now: This site puts families in contact with health programs in their state. It has a section on frequently asked questions. It also offers a toll-free hotline for families to connect with local health programs. In addition, the site offers help to individuals with immigration concerns. (Information is also available in Spanish.)
Health Insurance Resource Center: This Web site is targeted at families, individuals, and the self-employed. It is designed to help consumers make decisions about the health insurance that they may be thinking about purchasing. It describes the steps that should be taken to purchase an insurance policy and what to do after a plan has been purchased. The site also offers free quotes, answers frequently asked questions, and provides a glossary of insurance terms.
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I am looking for a new health insurance plan, and
Several companies offer Web sites that allow you to search health insurance plans offered in your state and obtain quotes. When you shop for insurance over the Web, be sure you are using a "licensed insurance broker." You should be able to find information on the site listing the states in which the company is licensed to sell policies or provide information about policies. You can also call or visit an insurance broker or agent to get information about health insurance offered in your state. Again, make sure the broker is licensed. Another way to find health insurance is to go to a specific insurance carrier in your state and ask that insurance carrier for a quote. Your state insurance department should be able to tell you what health insurers are licensed to sell in your state, and some state insurance departments offer shoppers guides or other materials.
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I am looking for a new health insurance plan, and
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I am uninsured or underinsured and I need information about my rights to health care and how to find treatment
Legal Rights to Care: There are federal, state, and local laws and regulations existing to increase access to health care for individuals who may otherwise not be able to get needed medical attention due to an inability to pay for services. Health Assistance Partnership provides an overview and additional links to more information of the applicable laws which include Hill-Burton and EMTALA.
Finding Low and No-Cost Treatment: The lack of insurance coverage does not change an individual’s need for medical treatment. Uninsured and under-insured individuals may be able to get the treatment they need at facilities designed to treat those who can’t afford to pay for services. The use of these facilities can prevent visits to the emergency room which can result in unwanted medical debt.
Health Assistance Partnership’s Free Care Resource Manual
US Department of Health and Human Services, Health Resources and Services Administration
Pharmacy Programs and Resources, compiled by TennCare Advocacy Program
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I am looking for a new health insurance plan, and
Discounted Treatment in Hospitals: Unpaid hospital charges for low-income and uninsured patients has been a growing factor in medical debt with hospital billing departments asserting that they could not reduce fees or waive collections on the debt without violating Medicare laws. Contrary to this position, Secretary Tommy Thompson of the US Department of Health & Human Services issued a news release February 19, 2004 stating “To be sure that there will be no further confusion on this matter, at my direction, the Centers for Medicare & Medicaid Services and the Office of Inspector General have prepared summaries of our policy that hospitals can use to assist the uninsured and underinsured. This guidance shows that hospitals can provide discounts to uninsured and underinsured patients who cannot afford their hospital bills and to Medicare beneficiaries who cannot afford their Medicare cost-sharing obligations. Nothing in the Medicare program rules or regulations prohibit such discounts.”
Summaries of the agency’s policies are reflected in a Frequently Asked Questions document (search "uninsured").
Medical Debt and Debt Collection: Uninsured patients often can not afford to pay for treatment related to an emergency room visit or hospital stay which is a good reason for patients to only seek emergency room treatment for true emergencies. The inability for patients to pay their bills has not necessarily impeded strong debt collection tactics by providers and hospitals specifically. Some states are seeing hospitals and contracted debt collectors freeze patients’ bank accounts and even pursue arrest warrants (also referred to as “body attachments”) when patients fail to appear for court hearings. More on medical debt is found in an issue brief by The Commonwealth Fund, Unintended Consequences: How Federal Regulations and Hospital Policies Can Leave Patients in Debt, published June 2003 and updated June 2004. Also see the Access Project's studies.
Many hospitals have charity programs for patients who meet criteria. These programs are often times not publized and therefore patients do not know that they exist. If patients incur hospital bills that they are not able to pay, then they should inquire about the hospital's charity or indigent care program. A common criteria for eligibility is the patient has to apply for and be denied Medicaid and applications may even be accepted after an account has been sent to collections.
Consumers should always seek to resolve issues involving outstanding bills and try not to ignore medical debt as it may cause negative credit ratings or subject them to unwanted debt collection practices. Some resources for counseling consumers are under the heading "Helping Consumers Deal with Medical Debt", located here.
Related Conference Calls: "Good State Laws and Policies About Hospital Billing." This includes some model laws that may by of interest to advocates.
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I want information regarding insurance for a specific group:
www.medicare.gov: This site provides extensive information on the Medicare program. It is also the Web site of the new Prescription Drug Assistance Program that helps consumers get information on programs providing prescription drug assistance to individuals in need. Other online resources include a directory of physicians serving Medicare beneficiaries, a complete Spanish language version of the Medicare Health Plan Compare site, and enhancements to Nursing Home Compare.
Medicare at a Glance: This report provides a basic overview of the Medicare program, including how it is financed, who is eligible for coverage, and what benefits the program covers. It also describes sources of supplemental health coverage that fill the gaps in care that Medicare leaves, recent trends in the Medicare+Choice program, and current and future forecasts for Medicare spending.
First Gov for Consumers: This government site addresses a broad range of issues. There is information for the elderly and links to resources that can help consumers choose the correct health care plan. It provides information on health coverage and treatment options for common health problems, and it provides pointers on choosing the best health care.
BenefitsCheckUp: This service of the National Council on Aging is an on-line resource that identifies federal and state assistance programs for older Americans. To use the confidential service, the user spends a few minutes entering financial information into an on-line questionnaire. The program then explains what benefit programs he or she might be eligible for and how to apply for them. The program does not require the user to enter his or her name, address, Social Security number, or any other identifying information.
The Center for Medicare Advocacy, Inc. is a private, non-profit organization that provides education, advocacy, and legal assistance to help elders and people with disabilities obtain necessary health care. The organization is involved in education, training, and litigation activities of importance to Medicare beneficiaries nationwide. Advice, written materials, and legal services are free to Connecticut residents and for a fee to others.
The Medicare Rights Center (MRC) is a not-for-profit organization dedicated to ensuring that older adults and people with disabilities with Medicare get good, affordable health care. The Medicare Rights Center Web site offers helpful and reliable Medicare information for consumers and professionals and Medicare counseling by e-mail.
Needymeds.com is a Web site that provides complete and accurate information on the patient assistance programs that are established by prescription drug manufacturers. These programs are designed to help those who can't afford their medicines obtain them at no cost or low cost. Unfortunately, many people, including doctors, nurses, social workers, and patients, don't know that these programs exist. The information on the Web site is obtained only through regularly contacting every drug company directly.
Myziva: This is a free site for potential nursing home residents and their loved ones to find, compare, and evaluate nursing homes in their community. The site also provides information on what to look for when visiting a nursing home, how to pay for care at such a home, how to get admitted, and how to prepare for admission, as well as a helpful glossary of terms.
Health Assistance Partnership provides information about Medicare and links to SHIPs, which are state-counseling programs that assist people eligible for Medicare.
Talking with Your Parents about Medicare and Health Coverage, a consumer guide updated for 2003, helps seniors and their adult children sort through the basic facts about Medicare and the choices seniors make related to health coverage and paying for care. This guide answers questions on a range of issues, including Medicare coverage, supplemental insurance, Medicare managed care, and ways of paying for prescription drugs. It also includes state-by-state resources that can be used to obtain more specific help with questions.
Medicare Nursing Home Information: This site offers a section that provides individuals with information on Medicaid- and Medicare-certified nursing homes. There is also information on payment and patient rights and a strategy to evaluate nursing homes.
Careplanner: This is a long-term care decision support tool developed by CMS. The tool was designed for seniors, adults with disabilities, and those with chronic illnesses who need support services, as well as for seniors who wish to plan ahead. Social workers, case managers, health professionals, and government agencies can also use the tool to help individuals and families assess and select options and access available services.
Long Term Care Living: This site is geared towards helping those in need of long-term care (LTC). There is an emphasis on selecting a nursing home or other form of LTC service, paying for the service, and coping with the transition. The site also provides information for family members who are in the process of, or debating, putting a loved one into long-term care. There is also information for spouses and a guide to the myths and realities about nursing homes.
Long Term Insurance Group: This site provides information for people who feel that they may need long-term care in the future. It explains what long term care is, provides an explanation for who needs long term care insurance, provides quotes for services, and explains how to get a policy.
Private Long-Term Care Insurance: Who Should Buy It and What Should They Buy? explores the feasibility of long-term care insurance (LTCI) for working families and older adults. It looks at how many working-age families can afford LTCI and whether it is a sensible investment for people who are decades away from requiring long-term care. It also examines the affordability of LTCI for older people, what kind of policies make sense for seniors, and whether there are less costly products that might reach more buyers and still provide some meaningful protection. (March 2003)
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I want information regarding insurance for a specific group:
Insure Kids Now: This site puts families in contact with health programs in their state. It has a section on frequently asked questions. It also offers a toll-free hotline for families to connect with local health programs. In addition, the site offers help to individuals with immigration concerns. (Information is also available in Spanish.)
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I want information regarding insurance for a specific group:
Protect Your Family's Health...with Confidence: This bilingual booklet explains how parents can receive low-cost or free health coverage. It examines Medicaid and SCHIP (the State Children's Health Insurance Program) and answers questions regarding children's health coverage when a parent is not a U.S. citizen. The booklet also serves as a guide for families with concerns about immigration status.
Immigrants Eligibility for Medicaid and CHIP: Laws passed after welfare reform have restricted eligibility for legal immigrants who had formerly been eligible for Medicaid and SCHIP. This fact sheet discusses who is and who is not subject to the new restrictions.
Insure Kids Now: This site puts families in contact with health programs in their state. It has a section on frequently asked questions. It also offers a toll-free hotline for families to connect with local health programs. In addition, the site offers help to individuals with immigration concerns. (Information is also available in Spanish.)
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I want information regarding insurance for a specific group:
Health Insurance Resource Center: Risk Pools: This site provides general information about high-risk pools. Risk pools are not for everyone, and this site explains what kind of people should consider high-risk pools and who should not. The site also lists the states that have high-risk pools-only about 30 states have established this type of program. There are also links to other Web sites with more information on risk pools. High-risk pools vary across states, so it is important to be familiar with the differences among states before making a decision as to whether joining a risk pool is the best option.
National Association of State Comprehensive Health Insurance Plans: This site provides information for consumers about contacting and using their state's high-risk insurance pool. The site briefly explains the purpose of high-risk pools. It also lists the states that have risk pools and includes links to individual state information.
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I want information regarding insurance for a specific group:
COBRA: This site that acts as a clearinghouse for questions and answers regarding the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) that may be of interest to individuals and small businesses. The site explains an individual's rights under COBRA and also attempts to help answer questions about problems that may arise regarding COBRA. It also offers private insurance rate quotes and group rate quotes, all while focusing on temporary insurance needs.
Health Care Tax Credit Program: The Internal Revenue Service (IRS) offers basic information about the newly enacted tax credit for people who lost their jobs due to trade. Some of these people are eligible for a federal tax credit that will cover 65 percent of the costs of specified health coverage.
HealthInsuranceInfo.net: This site provides online consumer guides for each state and the District of Columbia summarizing laws that protect people when they have lost their health coverage and are trying to buy health insurance. The guides include lists of relevant state agencies and glossaries of commonly used terms. The site also offers an online newsletter that contains consumer perspectives on how private coverage works for people in various circumstances.
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I want information regarding insurance for a specific group:
Veteran Benefits and Service: This site focuses on veterans' health care. It has sections on eligibility, counseling, and other health care information relevant to veterans. There is also a section for homeless veterans where concerned people can learn how to help homeless veterans receive health care.
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