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Doniphan Health Insurance

Facts and Figures

  • Insurance
    Carriers
    10
  • Number of
    General Doctors
  • Number of
    Hospitals

Insurance Carriers

State Government Insurance Programs Offered

Kansas Health Insurance Association (KHIA)


: Prevention services, Inpatient hospital care, Therapies (physical, speech, occupational), oral surgery, Spinal manipulation, Maternity, Emergency room and ambulatory services, Durable medical equipment, Mental health and substance abuse, Nursing, Home health, and Prescription drugs. If prior health coverage had a lapse of 31 days or more, there will be a 90-day pre-existing condition exclusion in KHIA coverage

Medicaid


Medicaid: Office visits, Checkups, Immunizations, Inpatient and outpatient hospital services, Lab and x-ray, Prescription drugs, Eye doctor exams and glasses, Hearing services and speech, Physical and occupational therapy, Dental services for children (checkups, cleanings, sealants, x-rays and fillings), Inpatient and outpatient mental health services, and substance abuse services, Medical transportation.

HealthWave


All applications will be screened for Medicaid- eligibility first. Services include Office visits, Checkups, Immunizations, Inpatient and outpatient hospital services, Lab and x-ray, Prescription drugs, Eye doctor exams and glasses, Hearing services and speech, Physical and occupational therapy, Dental services for children (checkups, cleanings, sealants, x-rays and fillings), Inpatient and outpatient mental health and substance abuse services, and Medical transportation. Must be a U.S. citizen or qualifying resident and live in Kansas. Must be children ages 0–18 living at or below 241% FPL. Must not already be covered by comprehensive and reasonably accessible health insurance, or be eligible for Medicaid. Children whose parents have access to the State group health insurance plan are not eligible.

Children and Youth with Special Health Care Needs (CYSHCN)


Helps those at risk for disabilities or chronic disease. Diagnostic services limited to one-time evaluation to determine if medically eligible, with no income requirement, for youth under 22 years old. Services also include Outpatient medical specialty care, Hospitalizations, Surgery, Durable medical equipment and medications, Limited therapy (physical and occupational), Case management that develops health care plan for each patient. Outreach clinics do specialty diagnosis, consultation, and follow-along care as close to the child's home as possible. Services cover hearing loss, orthopedic conditions, neurological impairment, cardiac diseases, and genetic diseases, counseling and planning.

Medicare


Medicare offers Part A, inpatient care in hospitals and rehabilitative centers; Part B, doctor and some preventive services and outpatient care; Part C allows Medicare benefits through private insurance (Medicare Advantage); Part C includes Parts A, B, and C not covered by Medicare. Part D covers prescription drugs.

MediKan


Limited benefits to adults whose applications for federal disability are being reviewed by the Social Security Administration. Average monthly benefit from General Assistance is $100. The program is time-limited to 24 months per person; however, assistance is continued for those who have an ongoing pending application for Social Security benefits (including the appeal process). The scope of MediKan’s services is similar to that of Medicaid’s, but some restrictions and limitations apply. Health benefits include medical care in acute situations and during catastrophic illness.

Heath Care Reform

Small business tax credits.  50,600 small businesses in Kansas could be helped by a new small business tax credit that makes it easier for businesses to provide coverage to their workers and makes premiums more affordable.1  Small businesses pay, on average, 18 percent more than large businesses for the same coverage, and health insurance premiums have gone up three times faster than wages in the past 10 years.  This tax credit is just the first step towards bringing those costs down and making coverage affordable for small businesses.

Closing the Medicare Part D donut hole. Last year, roughly 35,500 Medicare beneficiaries in Kansas hit the donut hole, or gap in Medicare Part D drug coverage, and received no extra help to defray the cost of their prescription drugs.2 Medicare beneficiaries in Kansas who hit the gap this year will automatically be mailed a one-time $250 rebate check. These checks will begin to be mailed to beneficiaries in mid-June and will be mailed monthly throughout the year as new beneficiaries hit the donut hole. The new law continues to provide additional discounts for seniors on Medicare in the years ahead and completely closes the donut hole by 2020. 

Support for health coverage for early retirees. An estimated 30,300 people from Kansas retired before they were eligible for Medicare and have health coverage through their former employers. Unfortunately, the number of firms that provide health coverage to their retirees has decreased over time.3  Beginning June 1, 2010, a $5 billion temporary early retiree reinsurance program will help stabilize early retiree coverage and help ensure that firms continue to provide health coverage to their early retirees. Companies, unions, and state and local governments are eligible for these benefits.

New consumer protections in the insurance market beginning on or after September 23, 2010.

Insurance companies will no longer be able to place lifetime limits on the coverage they provide, ensuring that the 1.7 million Kansas residents with private insurance coverage never have to worry about their coverage running out and facing catastrophic out-of-pocket costs.

Insurance companies will be banned from dropping people from coverage when they get sick, protecting the 183,000 individuals who purchase insurance in the individual market from dishonest insurance practices.

Insurance companies will not be able to exclude children from coverage because of a pre-existing condition, giving parents across Kansas peace of mind.

Insurance plans’ use of annual limits will be tightly regulated to ensure access to needed care.  This will protect the 1.5 million residents of Kansas with health insurance from their employer, along with anyone who signs up with a new insurance plan in Kansas.

Health insurers offering new plans will have to develop an appeals process to make it easy for enrollees to dispute the denial of a medical claim.

Patients’ choice of doctors will be protected by allowing plan members in new plans to pick any participating primary care provider, prohibiting insurers from requiring prior authorization before a woman sees an ob-gyn, and ensuring access to emergency care.

Extending coverage to young adults. Beginning on or after September 23, 2010, plans and issuers that offer coverage to children on their parents’ policy must allow children to remain on their parents’ policy until they turn 26, unless the adult child has another offer of job-based coverage in some cases. This provision will bring relief to roughly 16,800 individuals in Kansas who could now have quality affordable coverage through their parents.4  Some employers and the vast majority of insurers have agreed to cover adult children immediately.

Affordable insurance for uninsured with pre-existing conditions. $36.5 million federal dollars are available to Kansas starting July 1 to provide coverage for uninsured residents with pre-existing medical conditions through a new transitional high-risk pool program, funded entirely by the Federal government. The program is a bridge to 2014 when Americans will have access to affordable coverage options in the new health insurance exchanges and insurance companies will be prohibited from denying coverage to Americans with pre-existing conditions. If states choose not to run the program, the Federal government will administer the program for those residents.

Strengthening community health centers. Beginning October 1, 2010, increased funding for Community Health Centers will help nearly double the number of patients seen by the centers over the next five years. The funding could not only help the 36 Community Health Centers in Kansas but also support the construction of new centers.

More doctors where people need them. Beginning October 1, 2010, the Act will provide funding for the National Health Service Corps ($1.5 billion over five years) for scholarships and loan repayments for doctors, nurses and other health care providers who work in areas with a shortage of health professionals. This will help the 12% of Kansas’s population who live in an underserved area.

New Medicaid options for states. For the first time, Kansas has the option of Federal Medicaid funding for coverage for all low-income populations, irrespective of age, disability, or family status. 

"Vista Health Solutions" www.forhealthinsurance.com Tel (888)215-4045 Email [email protected]