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Calhoun Health Insurance

Facts and Figures

  • Insurance
    Carriers
    5
  • Number of
    General Doctors
    35
  • Number of
    Hospitals
    1

State Government Insurance Programs Offered

Mississippi Comprehensive Health Insurance Risk Pool Association (MCHIRPA)


www.mississippihealthpool.org Includes Hospital services, Physician care, Limited mental health care, Prescription drugs, and other services. Benefits for nervous and mental conditions, Alcohol and drug services (and certain other treatment and services) are provided with substantial limitations. Prescription coverage does not begin until you have been enrolled in MCHIRPA for 6 months. Lifetime maximum benefit of $1,000,000. Must be a legal Mississippi resident under age 65 years old. Must have been turned down for coverage by an insurance company in the last 12 months or diagnosed with a health condition that causes insurance companies to automatically reject you; or you were offered coverage by an insurance company, but the policy contained a material underwriting restriction (such as an elimination rider); or offered coverage costing more than an MCHIRPA policy and cannot be eligible for or have other, similar coverage from a private or government health plan (including Medicare and Medicaid) in order to get MCHIRPA coverage. May be eligible for MCHIRPA with HIPAA.

Pre- existing Condition Insurance Plan (PCIP) Run by the U.S. Department of Health and Human Services


www.PCIP.gov Covers broad range of benefits, including primary and specialty care, hospital care, and prescription drugs. Must have been uninsured for at least 6 months prior to applying. Must prove being a U.S. citizen or legal U.S. resident, a Mississippi resident, and having problems getting insurance due to a pre-existing condition.

Medicaid


Health screenings (including vision and hearing exams); Preventive health care such as immunizations; Inpatient and outpatient hospital care; Doctor's or clinic visits for well-child check ups and sick-child care; Lab services; Prescription medications; Eyeglasses and hearing aids; Dental care; and Mental health services. Pre-Existing Health Conditions Covered Must be a Mississippi resident and a U.S. citizen or eligible immigrant. Must be children up to age 19, uninsured, ineligible for Medicaid, with family incomes up to 200% FPL. Proof of most recent full month's family income, (such as a paycheck stub) must accompany the application. Each adult or child applying must provide his or her Social Security number on the application.

Mississippi CHIP Children’s Health Insurance Plan


www.medicaid.ms.gov/Chip. aspx Health screenings (including vision and hearing exams); Preventive health care such as immunizations; Inpatient and outpatient hospital care; Doctor's or clinic visits for well-child check ups and sick-child care; Lab services; Prescription medications; Eyeglasses and hearing aids; Dental care; and Mental health services. Pre-Existing Health Conditions Covered Must be a Mississippi resident and a U.S. citizen or eligible immigrant. Must be children up to age 19, uninsured, ineligible for Medicaid, with family incomes up to 200% FPL. Proof of most recent full month's family income, (such as a paycheck stub) must accompany the application. Each adult or child applying must provide his or her Social Security number on the application.

First Steps


www.msdh.state.ms.us (Search: First Steps) Provides family training and counseling, nursing care, Nutritional counseling and planning, Psychological services in behavior management, Learning and mental health, Physical therapy to help teach body movement, crawling, walking, Occupational therapy to help teach self-help, playing and eating skills, Speech pathologist services to help develop language skills, Transportation assistance to and from appointments. Must be a resident of Mississippi and a child 0-3 years old who has a 25% or greater developmental delay in any one developmental area

Women-Infant-Children (WIC)


www.msdh.state.ms.us (Search: WIC) Nutrition education and services; breastfeeding promotion and education; monthly food prescription of nutritious foods; access to maternal, prenatal and pediatric health care services. Must live in Mississippi, have a nutritional need, and be child 0-5 years old, a new mom, or a pregnant or breastfeeding woman. Income must be at or below 185% FPL.

Breast and Cervical Cancer Prevention


www.msdh.state.ms.us (Search: Breast & Cervical Cancer) Screening and/or diagnostic mammograms annually for women 50 years of age and older, ultrasound, fine needle aspiration of the breast and breast biopsy, colonoscopy and biopsy, if indicated. Follow-up and referral for abnormal Pap exams and/or mammograms. Must be Mississippi women who do not have Medicaid, Medicare or other insurance or method of reimbursement Services available depending on age: Ages 40–49: Mammograms while funds are available and only if patients have abnormal clinical breast exams. Ages 40–64: Pap exams. Ages 50–64: Mammograms. Ages 19–39: May be specially approved for enrollment in the BCCP at the discretion of the program director if patient meets all other program criteria other than the age category, has an abnormality of the breast and/or cervix.

Medicare www.medicare.gov


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. Mississippi Seniorxms.org offers assistance and advice to seniors in need. Pre-Existing Health Conditions Covered Must be U.S. citizen or permanent U.S. resident, and: 1) If 65 years or older, you or your spouse worked for at least 10 years in Medicare-covered employment, or 2) You have a disability or end-stage renal disease (permanent kidney failure requiring dialysis or transplant) at any age.

VA Medical Benefits Package


www.va.gov Comprehensive preventive and primary care, outpatient and inpatient services. Pre-Existing Health Conditions Covered ”Veteran status” = active duty in the U.S. military, naval, or air service and a discharge or release from active military service under other than dishonorable conditions. Certain veterans must have completed 24 continuous months of service.

Heath Care Reform

Small business tax credits.  34,700 small businesses in Mississippi 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 40,700 Medicare beneficiaries in Mississippi 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 Mississippi 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 32,400 people from Mississippi 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 1.3 million Mississippi 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 124,000 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 Mississippi peace of mind.

Insurance plans’ use of annual limits will be tightly regulated to ensure access to needed care.  This will protect the 1.2 million residents of Mississippi with health insurance from their employer, along with anyone who signs up with a new insurance plan in Mississippi.

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 14,300 individuals in Mississippi 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. $47.2 million federal dollars are available to Mississippi 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 178 Community Health Centers in Mississippi 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 32% of Mississippi’s population who live in an underserved area.

New Medicaid options for states. For the first time, Mississippi 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.nyhealthinsurer.com Tel (888)215-4045 Email [email protected]