Does The Government Require Health Insurance

How To Find A Doctor Or Dentist

There are a few online platforms out there that will help you find family doctors, dentists, and other medical specialist in Hong Kong.

Primary Care Directory is a government website that lets you search for a medical practitioner in your area. When searching, you can choose between looking for dentists, family doctors, specialists, or professionals practicing Chinese medicine. You can also specify the preferred gender of your doctor and see the doctors availability.

The website provides:

• contact details of the doctors
• their qualifications
• their type of practice
• the hospitals they are affiliated with
• languages they speak
• prices of the consultations
• possible payment methods.

However, the search engine does not specify the field the doctors are working in, so you will need to look through their credentials to know their specialty.

Average Wait Time to See a Doctor in Hong Kong

Waiting for a scheduled surgery can take a long while in Hong Kong. Waiting for a joint replacement surgery might take you 4-10 years, according to the governments statistics, while the cataract surgery will make you wait from nine months to two years.

Hong Kongs Hospital Authority provides a list of accident and emergency care wait times in various hospitals around the territories.

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Federal Mandated Health Benefits

Federal law includes a number of insurance-related mandates:

ACA essential health benefits The Affordable Care Act was a landmark change in terms of mandated health benefits, creating a universal floor in terms of the essential health benefits that must be included on every new individual and small group health plan in every state.

The requirement to include EHBs applies to all individual and small group plans with effective dates of January 1, 2014, or later. The list of EHBs includes:

• Ambulatory services
• Pediatric services, including oral and vision care .

Within the parameters of those general EHB categories, each state defines its own benchmark plan, with insurers then modeling their individual and small group plans on the state’s EHB benchmark plan. So even though all new individual and small group plans have to cover all of the EHBs, the specifics of the coverage will vary from one state to another, and will depend on various coverage mandates that each state imposes.

With the exception of preventive care and hospitalization services, EHBs do not have to be covered by large group plans , or by self-insured plans of any size.

Large group plans do tend to be fairly robust, however. And some other mandates apply to the large group market.

COBRA continuation coverageCOBRA is a federal law that provides certain former employees and their dependents the right to continue coverage for a maximum of 18 to 36 months. .

Seniors And Ohip Coverage: Ontario Drug Benefit Program

Seniors who have a valid Ontario Health Card qualify for the Ontario Drug Benefit . When you reach the age of 65, the Government will send you a letter about three months before your 65th birthday telling you that you will automatically join the Ontario Drug Benefit program on the first day of the month after you turn 65 years old.

The ODB program covers most of the cost of 5,000+ prescription drug products. Prescriptions must be filled in an Ontario pharmacy to be covered. Along with prescription medication, the program also covers other services, including:

• pneumonia vaccination
• allergy shots and EPIPen
• one comprehensive eye exam every 12 months

In some cases, individuals may qualify before they reach the age of 65, for instance if they live in a:

• long-term care home

For more information, refer to the Ontario government website on the Ontario Drug Benefit program.

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Ohip+ Children And Youth Pharmacare Plan

Under Ontarios OHIP+ plan, anyone who is 24 years old and younger who is covered by OHIP and is not covered by a private insurance plan does not have to pay for prescriptions for more than 5,000 drug products currently available through the Ontario Drug Benefit plan. Individuals do not have to enrol in the program, as coverage is automatic and ends on the individuals 25th birthday.

Medications covered include:

• cancer drugs and drugs for rare diseases
• antibiotics for infections,
• attention deficit hyperactivity disorder drugs

For more information on OHIP+ and the drugs covered, visit ontario.ca.

What Medical Services Are Insured By Manitoba Health And Seniors Care

Manitoba Health and Seniors Care directly pays physicians services that are medically required for you or your dependants. If you are a Manitoba resident, and are physically present in the province for 183 days, you are eligible for insured medical services. Benefits include the following services:

• Patients who are billed for insured services by physicians who practice outside the plan are entitled to reimbursement from Manitoba Health and Seniors Care
• Physicians’ services
• X-ray and laboratory services in approved facilities when ordered by a physician

What other practitioners services am I insured for?

Optometrists Manitoba Health and Seniors Care provides coverage under the provincial health plan for one routine complete eye exam provided in a 2-year benefit period for patients under the age of 19 years and 65 years of age and over. All residents, regardless of age, are entitled to coverage of an eye exam when warranted by medical conditions as determined by the eye care provider. Unless the patient falls into one of these categories, eye exams are not insured. The provincial health plan also includes coverage for certain tests provided by optometrists including the Full Threshold Visual Fields Test, the Tonometry Test and the Dilated Fundus Examination.

Chiropractors Manitoba Health and Seniors Care will insure a maximum of 7 visits per Manitoba resident per calendar year. The adjustment of the spinal column, pelvis and extremities are insured chiropractic services.

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What If I Want To Enroll In Health Insurance Outside Of Open Enrollment

If you missed the Open Enrollment Period for the year but want to enroll in health insurance, there are generally two options available to you.

First, you might be able to enroll in health insurance coverage if you qualify for a Special Enrollment Period . You may qualify for an SEP if you had a change in your household. This includes marriage, divorce, giving birth to a baby, or adopting a child. You can also qualify for an SEP if you have a change in residence, like a move to a new zip code, new county, new state. Or if youre a student moving for school. If you lose your existing health insurance coverage, you might also be able to qualify for an SEP. You can learn how else you might qualify for a SEP and how to apply for one here.

Second, depending on your income level, you might be able to qualify for Medicaid. Medicaid is the federal insurance program that provides health insurance, and thus medical care, to low-income Americans. Another critical part of Obamacare was that it allowed states the option of expanding their Medicaid programs. They did this by upping the percentage of the federal poverty level a person must earn annually to qualify. If your income level lets you qualify for Medicaid, you can enroll outside of the Open Enrollment Period. And if you qualify, your coverage will start immediately and so will your access to health services.

Health Care Markets And Pricing

The US health insurance market is highly concentrated, as leading insurers have carried out over 400 mergers from the mid-1990s to the mid-2000s . In 2000, the two largest health insurers had total membership of 32 million. By 2006 the top two insurers, WellPoint ” rel=”nofollow”> Anthem) and UnitedHealth, had total membership of 67 million. The two companies together had more than 36% of the national market for commercial health insurance. The AMA has said that it “has long been concerned about the impact of consolidated markets on patient care.” A 2007 AMA study found that in 299 of the 313 markets surveyed, one health plan accounted for at least 30% of the combined health maintenance organization /preferred provider organization market. In 90% of markets, the largest insurer controls at least 30% of the market, and the largest insurer controls more than 50% of the market in 54% of metropolitan areas. The US Department of Justice has recognized this percentage of market control as conferring substantial monopsony power in the relations between insurer and physicians.

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How Is Healthcare Provided In The United States

The United States primarily has a third-party payer system of healthcare, which means that a health insurance plan reimburses doctors for the bulk of the cost of healthcare services provided to patients. The nation used a mixed system of public and private insurance. The two major public programs are Medicaid, for low-income people and individuals with disabilities, and Medicare, for people 65 or older or younger people with certain disabilities or kidney disease. Most Americans, 48 percent, are enrolled in private health insurance through their employer. The remainder of insured people either purchase private insurance through the individual market or receive insurance through a different publicly-funded program, like the military’s TRICARE.

How can healthcare be changed?

Health Care Rights Under The Us Constitution

The health care reform debate raises many complex issues including those of coverage, accessibility, cost, accountability, and quality of health care. Underlying these policy considerations are issues regarding the status of health or health care as a moral, legal, or constitutional right. It may be useful to distinguish between a right to health and a right to health care.1 An often cited definition of “health” from the World Health Organization describes health as “a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity.”2 “Health care” connotes the means for the achievement of health, as in the “care, services or supplies related to the health of an individual.”3 For purposes of this report, discussion will be limited to constitutional and legal issues pertaining to a right to health care.

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Q What Should I Do If I Move

It is important that ServiceOntario has your current address to ensure your coverage remains active and for any direct communication with you.

There are three ways to update your address:

For more information refer to , fact sheets .

Northern Health Travel Grant :

You may be eligible for a to help pay transportation costs if you live in northern Ontario and must travel long distances for specialty medical care.

Services in Other Canadian Provinces and Territories :

Most of your Ontario health coverage benefits can be used across Canada. The province or territory you are visiting will usually bill Ontario directly. If you have to pay for health services you receive in another part of Canada, you can submit your receipts to your local to be considered for reimbursement. Prescription drugs from pharmacies, home care services, ambulance services and long-term care services provided in other provinces and territories are not covered.

Services Outside Canada :

For people , the ministry pays a set rate for emergency health services. Emergency health services are those given in connection with an acute, unexpected condition, illness, disease or injury that arises outside Canada and requires immediate treatment. are not covered. Ontario residents are encouraged to purchase supplementary insurance when traveling outside Canada as many emergency health services provided outside the country cost much more than OHIP may pay.

Is Health Insurance Mandatory In 2020 Your State May Require It

Under President Obamas Affordable Care Act , the individual mandate required everyone to have health coverage. However, Trump changed all that, so starting in 2019, health insurance is no longer mandatory.

Find Affordable Health Insurance In Your Area!

Its 2020, and Americans are still confused about the health insurance laws in this country, and rightfully so. In 2010, President Obama passed one of the most comprehensive pieces of healthcare legislation in US history, which included an individual mandate requiring every citizen to enroll in health insurance or face a tax penalty.

However, as part of an effort to repeal the Affordable Care Act, President Trump vowed to eliminate the individual mandate. Some states are fighting back, which leads us to the question at hand. Are you required to have health insurance in 2020? Per usual, the answer is a bit more complicated than you may expect.

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Affordability Remains A Barrier To Coverage And Care

Although the ACA extended insurance coverage to 20 million Americans,26 affordability remains a barrier to obtaining and maintaining coverage. According to a 2020 poll by the Commonwealth Fund, one-third of uninsured adults who previously had nongroup coverage said they could not afford the cost of their health plan.27

Affordability problems also prevent some Americans from seeking care and ultimately have negative consequences on health. Prior to the pandemic, nearly 1 in 10 of adults reported not getting care due to cost during the past year. Throughout the pandemic, other factors such as canceled medical appointments, social distancing requirements, scarce appointment availability, and fear of health care settings contributed to about 30 percent to 40 percent of adults reporting that they delayed or forwent care sometime in the past four weeks.28 For example, a Centers for Disease Control and Prevention report documented a sharp drop in routine pediatric vaccinations.29 Concerningly, research by the Urban Institute found that people with chronic disease, Black Americans, and low-income children were among the populations more likely to have delayed or forgone care during the pandemic.30 Without policy interventions to address gaps in coverage, affordability, and care, these trends could widen existing disparities in care and health.

Why Are Californians Required By Law To Have Health Insurance

What you need to know about the individual mandate â and how it impacts you and your family.

Having health insurance isnât just a good idea â if you live in California, itâs the law. In fact, 2020 marks the first year that Californians are required by state law to have health insurance. This law is referred to as the individual mandate because it means that all individuals in California are mandated to be covered by health insurance. Hereâs what you need to know to understand the individual mandate and how this law can benefit you.

Understanding Health Care Reform

The Patient Protection and Affordable Care Act passed in 2010 with the mission of making health care more accessible nationwide. There were two key points of his act. First, people could no longer be denied or charged more for health insurance due to preexisting conditions. Second, a federal individual mandate was established, which meant that purchasing health insurance that meets specific conditions was a requirement under law. These two aspects worked hand in hand. By making sure everyone paid into the system â young and old, healthy and ill â the sickest members could receive care without premium costs going haywire for everyone. From 2014 on, when the law went into effect, those who chose to go uninsured faced a financial penalty at tax time.

The Individual Mandate Comes to California

More Financial Help for Californians

What Does This All Mean for Me?

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Physician And Lab Fees

Eligible expenses are the reasonable and customary charges for physicians services and laboratory services where such services are not eligible for reimbursement under the participants provincial or territorial health insurance plan, but where such services would be covered in one or more other provincial/territorial plans, with the following important notations:

• Where only one province/territory provides reimbursement for a particular service, and that province/territory discontinues the coverage, the issue shall be subject to review by the Partners Committee as to whether coverage will also be discontinued under the Plan. Claims for such services, following cessation of provincial/territorial coverage, shall be held by the Administrator pending the decision of the Partners Committee.
• Where a province/territory begins reimbursement for a particular service, claims for the service shall be held by the Administrator pending a review by the Partners Committee as to whether the service should be covered in the other provinces and territories.

Laboratory services include those services which, when ordered by and performed under the direction of a physician, provide information used in the diagnosis or treatment of disease or injury. Services include, but are not limited to, blood or other body fluid analysis, clinical pathology, radiological procedures, ultrasounds, etc.

Status Of The Uninsured

The uninsured proportion was stable at 14â15% from 1990 to 2008, then rose to a peak of 18% in Q3 2013 and rapidly fell to 11% in 2015. The proportion without insurance has stabilized at 9%.

A 2011 study found that there were 2.1 million hospital stays for uninsured patients, accounting for 4.4% of total aggregate inpatient hospital costs in the United States. The costs of treating the uninsured must often be absorbed by providers as charity care, passed on to the insured via cost-shifting and higher health insurance premiums, or paid by taxpayers through higher taxes.

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Mandated Insurance Benefits And The Cost Of Health Insurance

Most peoplewhether for or against mandatesagree that mandated health benefits increase health insurance premiums. Depending on the mandated benefit and how that benefit is defined, the increased cost of a monthly premium can increase from less than 1% to more than 5%.

Trying to figure out how a mandated benefit will impact an insurance premium is very complicated. The mandate laws differ from state to state and even for the same mandate, the rules and regulations may vary.

For example, most states mandate coverage for chiropractors, but the number of allowed visits may vary from state to state. One state may limit the number of chiropractor visits to four each year while another state may require insurers to cover up to 12 chiropractor visits each year. Since chiropractor services can be expensive, the impact on health insurance premiums may be greater in the state with a more generous benefit.

Another example is infertility coverage, which is not required under federal law but is required by several states. Across those states, there’s wide variation in terms of what has to be covered in terms of infertility treatment, which means that the impact on premiums differs significantly from state to state.