Someone who can help you understand or apply for benefit programs when you become disabled or turn 65. Their goal is to help you avoid financial complications while developing a sustainable plan for the future.
C
Coinsurance
The portion of the payment for medical services that an individual is responsible for. For example, your health coverage may pay for 80% of the costs of a service, while you will have to pay the remaining 20%.
Community Work Incentives Coordinator (CWIC)
The federal government pays benefits planners in communities around the country to help people think ahead about work incentives and benefits issues. CWIC'S are benefits planners who are trained by the Social Security Administration to assist beneficiaries with programs including Supplemental Security Income (SSI), and Social Security Disability Insurance (SSDI) in addition to other related programs.
Copayment
A set amount an individual must pay upon receiving medical services. For example, you may have to pay $10 each time you visit the doctor.
D
Deductible
The amount an individual is responsible for paying for health care services before the insurer begins to pay.
F
Federal Adjusted Gross Income
Total taxable income. This includes money, goods, property, and services from all sources after any adjustments or deductions that are shown on a federal tax return.
Federal Poverty Level (FPL)
A table of income amounts used to determine financial eligibility for federal and state programs. Each year, the Department of Health and Human Services (HHS) issues the Federal Poverty Guidelines in the Federal Register. The Federal Poverty Level for one person is $10,400. For each additional person, add $3,480. For Medi-Cal programs, these figures go into effect in March or April of each year.
Formulary
A list of drugs that a health plan covers.
P
Payer of Last Resort
The insurer who pays medical claims last when an individual has multiple sources of health coverage.
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