this from most insurance companies by calling your insurance company or by downloading it from their website. AKA: Summary of Benefits, Summary of Plan 2) Income information (Federal Tax form 1040) if applicable: The first page of your federal tax form is only needed if you are asking the regional center for deductible and/or copay/coinsurance funding or reimbursement. It is critical that you provide information as soon as possible to limit your costs. This document declares the number of dependents as well as the gross annual income, which is used to determine whether you meet eligible criteria. There may be circumstances when additional information is required. 3) Family Letter: Only needed if your family’s income is over 400% of FPL and you feel that you meet one of the three exceptions in law. There is no financial hardship policy. There are only three exceptions in statute, when the regional center may pay for copays, coinsurance and deductibles. What if I don’t want to submit my health insurance documentation? Your health insurance information is required. Regional center may fund for early intervention services (OT, PT and/or Speech) to offer your family the opportunity to provide the required information and access health services. A Notice of Action (NOA) will be sent within 30 days of service end date if family chooses to not pursue insurance coverage. What is the difference between an Explanation of Coverage (EOC) and Explanation of Benefits (EOB)? Explanation of Coverage (EOC) is a summary of all the benefits that are covered by your insurance company. It documents the deductible amounts, copay/coinsurance, categories of coverage, and what is not covered and it will show you the limits of coverage. This summary document will also show you what the family vs. individual deductible is (you only need to meet the individual deductible for the early start eligible child). This is not related to an actual visit to a doctor. Explanation of Benefit (EOB) is a summary of the charges that have occurred from a visit to a doctor/health care provider. It states the cost of the visit and the patient responsibility for the visit. A copy is mailed to you and a copy to your doctor/health care provider. It may also be referred to as a Schedule of Benefits under some health plans.
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