Contents -- Preface -- 1. Health Insurance: Managed Care and Indemnity Plans -- Historical Overview -- What Is a Fee-for-Service or Indemnity Plan? -- What Is Managed Care? -- Managed Care Plans -- Managed Care Definitions, Terms, and Features -- Managed Care versus Traditional Indemnity Health Insurance: Significant Differences -- Managed Care: Advantages and Disadvantages -- Defined-Contribution/High-Deductible Plans -- Health Savings Accounts -- Health Insurance Policy Checklist -- Health Insurance Tips -- Potential Sources of Insurance -- 2. Medicare -- Parts A, B, C and D -- Financial Assistance for Medicare Program Costs -- Medigap -- 3. Medicaid -- Eligibility -- Service Coverage -- Medicaid and Managed Care -- Employment and Medicaid -- Ticket to Work and Work Incentives Improvement Act -- 4. Social Security Disability Insurance -- Application -- Appeals -- Attorney Fees -- Waiting Period -- Medicare Eligibility -- Trial Work Period -- 5. Supplemental Security Income -- Financial Eligibility -- Application -- Disability Determination -- Appeal -- Medicaid Coverage -- Attorney Fees -- 6. SSDI and SSI: The Application Process -- Step 1: Description of Disability -- Step 2: Work History -- Step 3: Physician Contacts -- Step 4: Filing Application -- Determination -- 7. Employee Retirement Income Security Act -- ERISA Preemption -- Court Decisions -- Legislative Activity -- Regulatory Activity -- 8. Grievances and Appeals -- ERISA Plans -- Fully Insured Plans -- Challenging an Adverse Decision -- Sample Claim/Appeal Letter -- State External Review -- 9. Health Insurance Portability and Accountability Act -- HIPAA's Anti-Discrimination Protections -- Preexisting Conditions -- Creditable Coverage -- HIPAA Provisions for Individual Insurance -- Long-term Care Insurance -- Health Care Fraud -- Privacy -- Summary.

10. Consolidated Omnibus Budget Reconciliation Act of 1985 -- Qualifying Events -- Covered Benefits -- Notice and Election Procedures -- Cost of Coverage -- Certificate of Coverage -- 11. State "Mini-COBRA" Laws -- Mini-COBRA or Continuation of Coverage Laws Currently in Effect in 40 States -- 12. Ticket to Work and Work Incentives -- Medicare -- Medicaid -- 13. Comprehensive State Health Insurance for High-Risk Individuals -- Appendix 1: Insurance Directory: State Telephone Numbers (2007) -- Appendix 2: Useful Web Sites -- Appendix 3: Definitions of Key Acronyms -- Appendix 4: State Pharmaceutical Assistance Programs -- Appendix 5: State Children's Health Insurance Program -- Index -- A -- B -- C -- D -- E -- F -- G -- H -- I -- K -- L -- M -- N -- O -- P -- Q -- R -- S -- T -- U -- V -- W.