Front Cover DISABILITY RIGHTS ADVOCATES A non profit corporation Disability Rights Advocates 2001 Center Street, Third Floor Berkeley, California 94704-1204 510-665-8644 510-665-8511 (FAX) 510-665-8716 (TTY) www.dralegal.org KNOW YOUR RIGHTS A pocket guide to health care & insurance for people with disabilities Page 2 HEALTH CARE, INSURANCE & PUBLIC HEALTH BENEFITS: Know your rights and the laws that protect you People with disabilities need quality affordable health care. But getting health services and insurance can be hard when you have a disability. Physical barriers can make it difficult for you to use medical equipment and health care facilities. Other barriers can affect communication — without a sign language interpreter or Braille, you may not be able to give and receive information about your health. Page 3 Health care providers may not understand your disability and its relationship to your overall health. Or they may not give you the respect you deserve. Adding to the challenge are high health care costs and problems with insurance. People with disabilities are: Twice as likely to delay needed health care because of cost; Three times more likely to go without needed health care; Less likely to receive certain health services that screen for cancer; Four times more likely to have special needs not covered by health insurance. You have rights. The more you know, the better you can protect yourself and your family. Some of your rights and the laws that ensure them are listed below. Page 4 As a person with a disability, YOU HAVE THE RIGHT TO: .Equal access to health services, free from discrimination. Americans with Disabilities Act (ADA), 42 U.S.C. §§ 12132, 12182 • Section 504 of the Rehabilitation Act. 29 U.S.C. § 794(a) • Cal Civil Code $§51, 54 • Cal. Government Code §11135 .Removal of most physical barriers that make it hard for you to use a health care facility. ADA. 42 U.S.C. § 12182(b)(2)(A)(iv) • ADA Accessibility Guidelines 28 C.F.R. Part 36, Appendix A • Cal. Civil Code §§ 51, 54 • Cal. Code of Regulations. Title 24 .A sign language interpreter, free-of- charge, if you need one for effective communication with your health care provider. ADA. 42 U.S.C. §§ 12132. 12182(b)(2)(iii) • 29 U.S.C. § 794(a) • 28 C.F.R §§ 36.301(c), 36.303 Page 5 .Health information in formats that work for people who are blind or have low vision. ADA, 42 U.S.C §§ 12132, 12182(b)(2)(A)(iii) • 29 U.S.C §794(a)•28 C.F.R. §36.303 .Useable medical equipment—like lower examination tables, wheelchair scales, and accessible mammography machines and eye examination equipment. ADA. 42 U.S.C. §§ 12132, 12182 • 29 U.S.C.§ 794(a) • 28 C.F.R. §36.303 .Be accompanied by your service animal when you visit a health care facility. ADA, 42 U.S.C §§ 12132, 12182(b)(2)(A)(iii) • 28 C.F.R. §36.302©(1) • Cal. Civil Code §54.2 .Receive emergency room treatment to stabilize emergency medical con- ditions, regardless of ability to pay. 42 U.S.C. § 1395dd • 42 C.F.R. § 489.24 • Cal Health & Safety Code § 1317 et seq. .Not have health care denied, delayed, or limited just because you have a disability. ADA. 42 U.S.C. §§ 12132, 12182 • 29 U.S.C.§ 794(a) • Cal Health & Safety Code § 1348.6 Page 6 .Not be shut out of or charged a higher premium for your employer's group health plan based on your disability. Health Insurance Portability and Accountability Act (HIPAA), 26 U.S.C. §9802, 42 U.S.C. § 300gg-1 • Cal. Health & Safety Code § 1357.52 • Cal. Insurance Code § 10198.9 . Not have your application for individual health, disability, or life insurance be denied on the basis of disability, unless the insurer has evidence justifying the denial. Cal. Insurance Code § 10144 • Cal. Health & Safety Code §1367.8 • Cal. Civil Code § 51 .Limits on how long your health plan can refuse to cover care for health problems you had before you enrolled in the plan. HIPAA. 26 U.S.C. § 9801. 42 U.S.C. § 300gg • Cal. Health & Safety Code §§ 1357.08. 1357.51 • Cal. Insurance Code § 10198.7 .Have certain benefits included in your health plan. Cal. Health & Safety and Insurance Codes • Newborn's and Mother's Health Protection Act. 29 U.S.C. §1185 • Women's Health and Cancer Rights Act. 29 U.S.C. § 1185b Page 7 .Pick your primary care doctor and not have to wait too long for an appointment. Cal. Health & Safety Code §§1367, 1373.3 .See specialists and get second opin ions when it is right for your health. Cal. Health & Safety Code §§ 1374.16. 138315 • Cal. Insurance Code § 10123.68 .Appeal if your health plan refuses to pay for the care you need. ERISA, 29 U.S.C. §§ 1132(a)(1)(B) 1133(2) • Cal. Health & Safety Code § 1368 et seq. .Access to an Independent Medical Review if your health plan refuses to pay for a covered health benefit. Cal. Health & Safety Code§§ 1374.30 et seq. • Cal. Insurance Code §§ 10169 et seq. .Continue group health plan coverage for 18-36 months after a job loss, divorce, or a child's loss of dependent status under the plan. Coverage may be extended further if a dependent child is disabled. COBRA. 29 U.S.C. §§1161 et seq. • Cal-COBRA. Cal. Health & Safety Code §§ 1366.20 et seq. & Cal. Insurance Code §§ 10128.50 et seq. • Cal. Health & Safety Code §1373(d) Page 8 More about your rights Learn about your rights from THROUGH THE MAZE: A GUIDE To HEALTH CARE AND INSURANCE RIGHTS FOR PEOPLE WITH DISABILITIES. This free handbook introduces you to health access rights for people with disabilities, insurance protections, helpful resources, and free and low-cost health care and insurance programs, including: Medicare, Medi- Cal. In-Home Supportive Services, AIDS Drug Assistance Program, Healthy Families, California Children Services, Child Health and Disability Prevention Program, and more! THROUGH THE MAZE is available in English, Spanish, and alternative formats from Disability Rights Advocates (DRA), a nonprofit legal center dedicated to protecting the civil rights of people with disabilities. Page 9 Rights & Advocacy Training DRA trains groups of people with disabilities and service providers throughout California. These practical workshops help explain your health care and insurance rights and give you the tips and tools you need to stand up for your rights. To order a free handbook or schedule a training, call 510- 665-8644, 510-665-8716 (TTY) or email us at healthaccess@dralegal.org. Page 10 DISABILITY WATCH, VOLUME 2: THE STATUS OF PEOPLE WITH DISABILITIES IN THE UNITED STATES This statistical report has helpful facts about health care and insurance, employment, hidden disabilities, and technology. For trainings in your area, disability-related resources, and updates on current cases, visit us online: www.dralegal.org DISABILITY BIGHTS ADVOCATES A non-profit corporation Disability Rights Advocates 2001 Center Street, Third Floor Berkeley, California 94704-1204 510-665-8644 510-665-8511 (FAX) 510-665-8716 (TTY) This publication was made possible with a generous grant from The California Endowment. Photos by Pat Kirkpatrick except mammogram photo courtesy of BHAWD/ Breast Health Access for Women with Disabilities. Special thanks to those friends and clients whose photos appear in this guide. Please note that the information provided in this guide is not a substitute for legal advice. Consult a lawyer if you have a problem.