The Service Tree lists all services in "branched" groups, starting with the very general and moving to the very specific. Click on the name of any group name to see the sub-groups available within it. Click on a service code to see its details and the providers who offer that service.
Health Insurance Information/Counseling
Affordable Care Act Insurance Information/Counseling
Organizations that provide consumer assistance for individuals and small businesses wanting to purchase private insurance through the marketplaces for themselves or, in the case of employers, for their employees. Their primary responsibility is to facilitate enrollment of consumers in health insurance plans offered through the marketplaces. The Affordable Care Act (ACA) requires the use of trained navigators to provide in-person education, and eligibility and enrollment assistance; and permits the use of trained in-person assisters and application counselors. The operator of the marketplace determines the process for establishing and managing the navigator program. Operations will vary depending on the model selected by the jurisdiction. Choices include a federally operated (or federally-facilitated) marketplace, a federal/state partnership or a state operated marketplace.
General Health Insurance Information/Counseling
Programs that help people in need of health insurance evaluate the full range of alternatives available to them and select the coverage that best meets their needs.
Medicare Information/Counseling
Programs that offer information and guidance for older adults and people with disabilities regarding their health insurance options with the objective of empowering them to make informed choices. Included is information about benefits covered (and not covered); the payment process; the rights of beneficiaries; the process for eligibility determinations, coverage denials and appeals; consumer safeguards; and options for filling the gap in Medicare coverage (Medigap supplement insurance). Also available is information relating to an individual's eligibility for benefits and assistance with evaluating their options and enrolling in a Medicare plan (A, B, C, and/or D) that will best meet their needs. These programs also address coordination of benefits when beneficiaries have other types of health insurance in addition to Medicare (e.g. Medicaid, employer coverage or retiree insurance) and provide counseling and assistance regarding the subsidies that are available to low income beneficiaries enrolled in the Part D Prescription Drug Benefit (which help pay for Part D premiums and reduce the cost of prescriptions at the pharmacy) and the Medicare Savings Programs which help pay for Medicare out-of-pocket costs. They may also provide information about Medicaid and the linkages between the two programs, referrals to appropriate state and local agencies involved in the Medicaid program, information about other Medicare-related entities (such as peer review organizations, Medicare-approved prescription drug plans, Medicare administrative contractors), and assistance in completing related Medicare insurance forms.
State/Local Health Insurance Information/Counseling
Programs that offer information and guidance for people who do not qualify for Medicaid, do not have access to insurance provided by an employer or cannot afford privately purchased health insurance regarding their state and/or local government health insurance options (including insurance programs administered by the state or at the local level and public/private partnerships between state and/or local government entities and health insurance companies or other private organizations) with the objective of empowering them to make informed choices. Some programs may also help people who qualify with enrollment.