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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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The Health Insurance Portability and Accountability Act (HIPAA)
http://cms.hhs.gov/hipaa/hipaa1/content/more.asp
Source: United States Department of Health and Human Services, Centers for Medicare and Medicaid Services
Overview of the Health Insurance Portability and Accountability Act ("HIPAA"). Describes, in general, how HIPAA may help people obtain or keep health insurance. Includes a link to the Act itself.
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Workers' Rights to Health Plan Information
http://www.dol.gov/dol/topic/health-plans/planinfo
Source: Pension and Welfare Benefits Administration, United States Department of Labor
Describes the information which employers are required to give to employees about health plans, including plan descriptions and explanations of the procedures for appealing denial of benefits.
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Protections When Buying Individual Health Insurance in Washington
http://www.healthinsuranceinfo.net/wa03.html
Source: Institute for Health Care Research and Policy, Georgetown University
Comprehensive description of health insurance options for, and rights of, people who can not obtain, or are loosing, coverage through en employer or other group plan. Topics covered include individual health insurance sold by private insurers, COBRA continuation coverage and Washington continuation coverage, conversion policies, and the Washington State Health Insurance Pool (WSHIP).
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Eligibility for Medical Programs in Washington
http://fortress.wa.gov/dshs/maa/Eligibility/Index.
Source: Medical Assistance Administration, Washington Department of Social and Health Services
Includes links to Web pages which describe Washington's Medicaid and other medical assistance programs, including programs for children living in Washington, health insurance at a reduced rate for individuals and families who are Washington residents (Basic Health), emergency medical coverage for hospital services (Medically Indigent Program), coverage for people with disabilities who are working (Healthcare for Workers with Disabilities Program), medical coverage for families with children (Family Medical), programs to help Medicare recipients pay premiums (Medicare Savings Programs), emergency medical coverage for people who do not meet citizenship requirements of other medical programs (Alien Emergency Medical Program), medical coverage for pregnant women (Pregnancy Medical Program), medical coverage for aged, blind or disabled people (Aged, Blind and Disabled Medical Program).
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Your Employer's Bankruptcy: How Will it Affect Your Employment Benefits (Including Health Insurance)
http://www.dol.gov/ebsa/newsroom/fsbankruptcy.html
Source: Pension and Welfare Benefits Administration, United States Department of Labor
Describes what employees should do about their health plans when their employers are in bankruptcy. Topics covered include: how to get documents from, and what questions to ask, a health plan administrator; situations in which COBRA continuation coverage may or may not be available; how the Health Insurance Portability and Accountability Act ("HIPAA") may protect workers of bankrupt employees, and where to go for help or more information. This resource describes rights under federal laws.
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Pension and Health Care Coverage - Questions and Answers for Dislocated Workers
http://www.dol.gov/ebsa/publications/dislocated_wo
Source: Pension and Welfare Benefits Administration, United States Department of Labor
Describes how business closings, downsizings and reductions in hours may affect benefits under an employer's health plan. Topics covered include: whether COBRA continuation coverage may be available; rights under COBRA; and rights under the Health Insurance Portability and Accountability Act ("HIPAA") including the act's limitations on preexisting condition exclusions. This resource describes rights under federal laws.
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Limited Help with COBRA Premiums
http://www.medicareadvocacy.org/MedicaidandRT_Help
Source: Center for Medicare Advocacy, Inc.
Describes a tax credit which may be available under Trade Act of 2002 for COBRA premiums paid by workers displaced by "import competition or shifts of production to other countries."
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The State of Health Privacy - Washington
http://www.healthprivacy.org/usr_doc/WA_2002.pdf
Source: Institute for Health Care Research and Policy, Georgetown University
Comprehensive summary of Washington laws concerning health care information. Topics covered include patient access to health care information; restrictions on disclosure of information; privilege for communications between patients and certain health care providers; and requirements regarding information about specific conditions including cancer, HIV / AIDS and sexually transmitted diseases, mental health, and substance abuse.
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Correcting Information in Your Health Care File
http://www.washingtonlawhelp.org/link.cfm?207
Source: Northwest Justice Project
Explains how to request corrections to medical records, what health care providers are required to do when asked to correct medical records, and what people should do when their right to correct medical records is denied.
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Medicare Appeals Forms
http://www.medicare.gov/basics/forms/default.asp
Source: United States Department of Health and Human Services, Centers for Medicare and Medicaid Services
Links to online forms people can use in Medicare-related appeals. Forms include: Appointment of Representative, Request for Review of Part B Medicare Claim, Request for Hearing - Part B Medicare Claim, Request for Reconsideration of Part A Health Insurance Benefits, Request for Part A Medicare Hearing by an Administrative Law Judge, and Request for Part B Medicare Hearing by an Administrative Law Judge. Some forms are available in Spanish. Special tools are also provided to permit access to the forms by persons with visual disabilities.
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Representing Yourself at a Hearing Regarding DSHS Public Assistance (Including Medical Assistance)
http://www.washingtonlawhelp.org/link.cfm?286
Source: Northwest Justice Project
Describes how people can exercise their right to appeal any written or verbal decision of Washington's Department of Social and Health Services (DSHS). Topics covered include: how to request an interpreter, the deadline for requesting a hearing, how to request a hearing, how to prepare for the hearing, what to bring to the hearing, what will happen at the hearing, when the judge will make a decision, and how to further appeal the judge's decision. Also available in Russian and Spanish.
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