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Advocacy & Planning

    Results: 3

  • Case/Care Management (14)

    Case/Care Management


    Programs that develop plans for the evaluation, treatment and/or care of individuals who, because of age, illness, disability or other difficulties, need assistance in planning and arranging for services; which assess the individual's needs; coordinate the delivery of needed services; ensure that services are obtained in accordance with the case plan; and follow up and monitor progress to ensure that services are having a beneficial impact on the individual. Case management is a collaborative process characterized by communication, advocacy and resource management to promote high quality, cost-effective interventions and outcomes.
  • Individual Advocacy (2)

    Individual Advocacy


    Programs that intercede on behalf of individuals to help them establish eligibility for or obtain needed services when they have been denied benefits or services for which they are eligible, when they need assistance to communicate their needs to a service provider or to otherwise effectively represent themselves, or when they have a complaint about a service. Individual advocacy attempts to reach equitable settlements without resorting to litigation and seeks to meet individual needs without attempting to change social institutions.
  • Medicare Information/Counseling (2)

    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 the eligibility requirements for Medicare; selection and enrollment in a Medicare prescription drug plan; benefits covered (and not covered) by the program; the payment process; the rights of beneficiaries; the process for determinations, coverage denials and appeals; consumer safeguards; and options for filling the gap in Medicare coverage. These programs also provide counseling and assistance about the subsidies that are available to low income beneficiaries enrolled in the Part D Prescription Drug Benefit; and 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, fiscal intermediaries and carriers), and assistance in completing Medicare insurance forms.

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