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What to do if You Have Problems Connected with Health Care
http://www.abanet.org/publiced/practical/health/pr
Source: American Bar Association
General guidance on what people can do if they have problems with the care they receive under health plans. Topics covered include: what to do if the plan refuses to cover treatment; whether people have a claim if the plan does not live up to promises in a brochure; whether people can recover from a plan for a doctor's mistake; and whether people can recover from a plan for negligence. Also includes definitions to several terms which relate to claims against health plans, including respondent superior, apparent authority, and corporate negligence liability.
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Medicare and You
http://www.medicare.gov/publications/pubs/pdf/1005
Source: United States Department of Health and Human Services, Centers for Medicare and Medicaid Services
Comprehensive booklet on Medicare. Topics covered include: overview of the Medicare program and health plans, the Original Medicare Plan, Medicare + Choice Plans, Medicare rights, other insurance and ways to pay health care costs. Information regarding the rights of Medicare beneficiaries includes: the right to appeal decisions regarding coverage, payment, or services; the privacy and disclosure of health care information by Medicare; the right of Medicare beneficiaries to access health care information; the right to be free from discrimination by companies or providers dealing with Medicare; and preventing and reporting Medicare fraud. Also includes contact information for agencies that can answer questions about Medicare.
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Summary of Health Insurance Protections in Washington
http://www.healthinsuranceinfo.net/wa01.html
Source: Institute for Health Care Research and Policy, Georgetown University
Summary of how state and federal laws protect access to health insurance and health care in Washington. Includes a concise list of some of the most important rights and protections of Washington residents, and a separate list of limits on rights and protections.
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Medicare Appeals and Grievances
http://www.medicare.gov/publications/pubs/nonpdf/a
Source: United States Department of Health and Human Services, Centers for Medicare and Medicaid Services
Explains the appeal rights of Medicare beneficiaries under both the Original Medicare Plan and Medicare Managed Care Plans. Describes how to appeal such actions as failure to pay for an item or service or failing to provide an item or service the patient thinks should be covered or provided.
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Understanding How the Health Insurance Portability and Accountability Act May Affect You
http://www.cms.hhs.gov/HIPAAGenInfo/
Source: United States Department of Health and Human Services, Centers for Medicare and Medicaid Services
Topics covered include: types of health insurance to which HIPAA applies, who is eligible for HIPAA protections, what rights people have under HIPAA, how to maximize HIPAA protections, how preexisting conditions may affect coverage, and how COBRA continuation coverage or conversion coverage may affect a person's eligibility for HIPAA protections.
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