Monday, April 15, 2024

What Is Government Health Insurance

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Rashtriya Swasthya Bima Yojana:

More people than ever qualify for health care during government open enrollment

This scheme is directed towards people working in the unorganized sector. Often, they are not covered under any insurance policy. And in such a scenario, if they fall ill which happens frequently their savings get exhausted. Thus, they are never able to ensure they have savings in the bank. This is where health insurance can prove helpful to them.

Rashtriya Swasthya Bima Yojana is initiated by the Indian Governments Ministry of Labour and Employment. Individuals workers in the unorganized sector and below the poverty line are covered under this scheme. The cover also extends to their family .

Awaz Health Insurance Scheme:

This is a health insurance cover for migrant workers and is initiated by the Government of Kerala. It also offers insurance for death by accident for labourers. The scheme was launched in the year 2017 and targeted 5 lakh inter-state migrant labourers working in Kerala. The health insurance coverage offered under Awaz Health Insurance is Rs.15000, while the cover for death is Rs.2 lakh.

This policy can be obtained by labourers falling in the age group of 18 to 60. They shall be provided with an Awaz Health Insurance card, post submitting and processing of enrolment details pertaining to biometric information and other work-related documents.

About Government Health Care Programs For Parents And Children

If you live under the poverty line and require health care services, you may be eligible to receive benefits through the Medicaid program.

Individuals who may qualify for Medicaid include the following:

However, to enroll in Medicaid and receive long-term health care through the program, you must meet specific requirements stipulated by the federal government.

In addition, private sector health care providers will often work in accordance with the Medicaid program to ensure equal coverage to individuals who are receiving health care through this government-sponsored program.

Low-income individuals who are younger than 18 years of age and do not have a primary source of insurance may qualify to receive health care through the Childrens Health Insurance Program .

For instance, if your total household income exceeds the maximum eligibility stipulated by Medicaid, you may enroll your children in CHIP in order to ensure that they will receive the health coverage that they need.

Furthermore, if you have previously qualified for Medicaid benefits, you can combine the benefits provided by CHIP alongside your existing health care plan.

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The Aca Helped Stem Coverage Losses During The Pandemic

Medicaid, CHIP, and the health insurance marketplaces provide coverage options for those who have lost job-based coverage or experienced income changes over the past year. Medicaid and CHIP enrollment rose by 9.4 percent from February to September 2020, an increase of more than 6.6 million people. Under the ACA, Medicaid eligibility is based on monthly incomerather than annual income or assetswhich enables people experiencing sudden loss of income to access free and low-cost coverage.

Initial data for the ACA marketplaces suggest that enrollment in those programs is also above pre-pandemic levels. At the end of the most recent open enrollment period, a total of 8.25 million people had enrolled through the federal platform, essentially the same as the total from a year prior even though two states switched to state-based enrollment platforms and others had recently expanded Medicaid, two factors that would be expected to drive total federal enrollment lower for 2021.

The increases in Medicaid, CHIP, and marketplace coverage are a major reason why insurance loss during the pandemic was not as great as during the Great Recession. They also offer mechanisms to effectively restore coverage lost during the COVID-19 pandemic and expand health coverage and affordability.

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Obamacare. What is a Government Health Insurance Subsidy?

Most provincial plans offer basic coverage for a handful of medical expenses. Additional treatments are either covered in part or not at all. If you need a treatment that is not covered under your provincial plan, you will be required to pay the full cost unless you have additional insurance. Individual health insurance plans help defray your out-of-pocket costs by paying for products and services not covered by your provincial plan, which include

  • Eye exams, eyeglasses, contact lenses
  • Dental care

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Whats Covered By A Provincial Or Territorial Health And Dental Plan

Provincial and territorial plans pay for your basic healthcare and dental services and needs, and whats covered will vary depending on where you live. Generally speaking, these plans will cover things such as visits to the hospital or doctor, but may not cover other healthcare or paramedical services.

The Cons Of A Public Health Insurance Option

The cons of a public option health insurance all relate to the professionals involved in healthcare. However, what affects the professionals eventually trickles down to affect patients, too.

Private health insurers believe that a public option would put them out of business because it would cost much less and would have massive negotiating power. They would not be able to financially sustain their levels of service or keep paying their investors. Further, they fear that eventually so many people would flock to the public option, and the U.S. would end up with a single-payer system.

Providers are also concerned they believe massive negotiating power would force lower patient costs, but much of those lower costs would be borne by providers. Doctors fear they would be reimbursed at even lower rates than they are now.

Conservative healthcare reform watchdogs tell us that those lower reimbursements would mean more doctors and providers would reject patients who used any of the public option payers, including Medicare, Medicaid, TriCare, the VA, and the Children’s Health Insurance Program.

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How To Get Health Coverage

You can get health care coverage through:

  • A group coverage plan at your job or your spouse or partner’s job
  • Your parents’ insurance plan, if you are under age 26
  • A plan you purchase on your own directly from a health insurance company or through the Health Insurance Marketplace
  • Government programs such as
  • The Veterans Health Administration or TRICARE for military personnel
  • Your state, if it provides a health insurance plan
  • Continuing employer coverage from your former employer, on a temporary basis under the Consolidated Omnibus Budget Reconciliation Act
  • Myths And Policy Making

    Poll: Most Americans Want The Government To Pay For Health Care

    Popular confusion about the facts of health insurance coverage and its importance can hamper effective policy making, as can policy makers’ uncertainty about the interpretation of coverage trends and consequences. This report and those that will follow aim to provide reliable information, useful to both the public and policy leaderslegislators, employers, program managersas they meet the ongoing challenges of financing health care.

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    What The Government Health Plan Covers

    The BC provincial government health plan covers core health services including:

    • medically required services provided by a physician
    • diagnostic services,
    • basic hospital ward accommodation.

    In addition to these core services, the government health plan may provide limited coverage for other services in some cases, however most other health expenses are not covered.

    The following is a summary of the coverage limitations under the BC government health plan. These expenses may be eligible for coverage under your Blue Cross plan. Seeyour Member Profile for your plan’s coverage details.

    As well, most physicians in other Canadian provinces and territories will bill their own provincial health plan for services if you present your valid BC CareCard. The provinces recover the funding between each other. When travelling in Quebec you will likely be required to pay for your medical services and seek reimbursement later from the government health plan.

    The government strongly advises BC residents to purchase travel insurance when travelling outside of Canada and to other Canadian provinces to cover the cost of services not included in the reciprocal agreement between provinces.

    Million Uninsured Americans In 2009

    In mid-2009, Congress worked to reform U.S. healthcare insurance coverage, which at that time left more than 50 million men, women, and children uninsured and without access to adequate medical and health services.

    This deficit was due to the fact that healthcare coverage for all people, except for some low-income children and those covered by Medicare, was provided only by insurance companies and other private-sector corporations. This made it inaccessible for many Americans.

    Private company insurers proved ineffective at controlling costs and providing inclusive care, some actively working to exclude as many people from healthcare coverage as possible.

    Explained Ezra Klein for The Washington Post: “The private insurance market is a mess. It’s supposed to cover the sick and instead competes to insure the well. It employs platoons of adjusters whose sole job is to get out of paying for needed health care services that members thought were covered,” .

    In fact, multi-million bonuses were even awarded annually to top healthcare executives as an incentive to deny coverage to policyholders.

    In 2007, Slate reported, “The current system is increasingly inaccessible to many poor and lower-middle-class people … those lucky enough to have coverage are paying steadily more and/or receiving steadily fewer benefits,” .

    This widespread issue led to a reform campaign begun by the Democratic party and supported by the president.

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    Choosing A Health Insurance Plan

    Reading the fine print is important when choosing health care plans. These questions may help:

    • Can I go to any doctor, hospital, clinic, or pharmacy I choose?
    • Are specialists, such as eye doctors and dentists covered?
    • Does the plan cover special conditions or treatments such as pregnancy, psychiatric care, and physical therapy?
    • Does the plan cover home care or nursing home care?
    • Will the plan cover all medications my physician may prescribe?
    • What are the deductibles? This is the amount you must pay each year before your insurance company will begin paying claims.
    • Are there any co-payments? This is the amount of money you pay each time you receive medical services or a prescription.
    • If there is a dispute about a bill or service, how is it handled?

    Cigna Smart Support Program


    The Cigna Smart Support® program provides specialized customer service for public sector employers and their employees.

    Our dedicated multi-disciplinary team is behind you every step of the way. We are committed to helping solve your organizations specific health benefits challenges to help you achieve your goals.

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    Pros Of Government Healthcare

    Iconic American consumer advocate Ralph Nader summed up the positives of government-funded healthcare from the patient’s perspective:

    • Free choice of doctor and hospital
    • No bills, no co-pays, no deductibles
    • No exclusions for pre-existing conditions you are insured from the day you are born
    • No bankruptcies due to medical bills
    • No deaths due to lack of health insurance
    • Cheaper. Simpler. More affordable
    • Save taxpayers billions a year in bloated corporate administrative and executive compensation costs, .

    Other important positives of government-funded healthcare include:

    • 47 millions Americans lacked healthcare insurance coverage as of the 2008 presidential campaign season. Soaring unemployment since then caused the ranks of the uninsured to swell past 50 million in mid-2009. Mercifully, government-funded healthcare provided access to medical services for all uninsured, and lower costs of government healthcare caused insurance coverage to be significantly more accessible to millions of individuals and businesses.
    • Doctors and other medical professionals can now focus on patient care and no longer need to spend hundreds of wasted hours annually dealing with insurance companies. Patients, too, no longer need to fritter inordinate amounts of time haggling with insurance companies.

    Why Would The Cost Be So Much Lower With A Public Option

    • First, the government is a non-profit organization. Since their goal is to cover their costs, but not profit by the service, they don’t have to build the profit into their premium costs.
    • Second, administrative costs would be lower. Administrative costs are a substantial part of healthcare spending in the U.S., but are significantly less for public payer programs versus private insurers.
    • Third, a very large entity has better bargaining power. Better bargaining power would bring down pricing for all aspects of healthcare. Further, because private insurers would be in competition with the public option, the private insurers would have to lower their premiums and bargain more intensely, too.

    There is also a question of tax liability. A public option would be tax-exempt because, of course, it does not earn a profit. Private insurers exist only to make a profit for themselves and their investors. Their profits would incur tax liability a cost they would have to bear and include in their premium costs.

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    What Benefits Can You Get When You Retire

    Through the Coverage for Seniors program, the government offers Albertans aged 65 years and older premium-free coverage for prescriptions drugs and other health-related services not covered under the AHCIP. If youre looking to retire early, the Government of Alberta Non-Group Coverage program provides supplementary health benefits, for an economical monthly premium, to AHCIP-registered Albertans under 65 and their dependents for a variety of health-related services not covered by the AHCIP.

    While ACHIP manages eligibility and registration for government health benefits, Alberta Blue Cross® administers a variety of programs on behalf of the Government of Alberta including the Coverage for Seniors and Non-Group Coverage programs.

    The Coverage for Seniors and Non-Group Coverage programs dont provide travel insurance. If youre planning to travel outside the province or country, its recommended you purchase travel insurance to cover any emergency hospital or medical expenses.

    Yeshasvini Health Insurance Scheme:

    Real People Real Stories on | Health Insurance Marketplace Open Enrollment 2022

    The Yeshasvini Health Insurance Scheme is promoted by the Karnataka State Government. It is meant for farmers and peasants associated with a co-operative society. More than 800 procedures are covered as per this insurance policy.

    Co-operative societies help the peasants and farmers to get enrolled in the Yeshasvini Health Insurance Scheme. The beneficiaries can avail health care through network hospitals. The scheme extends its benefits to the family members of the main beneficiary as well.

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    How Would The Public Option Be Run

    A public option health insurance program would be run by the government but could be implemented just like private health insurance.

    • Self-sustaining: One option is to require a public health insurance to be self-sustaining that is, paid for only by the premiums paid by those who “belong” to that program.
    • Tax Subsidized: Another option would be for the premium costs to be subsidized through government taxes.
    • Federal or State Administered: Another approach is that the public option might not be handled solely by the federal government instead, it could be administered by individual states, which would set their own requirements.

    The public option was not a part of the healthcare reform, to begin with, but if private insurers do not manage to keep pricing fair, and do not keep those with pre-existing conditions covered, it could trigger the implementation of a public option.

    Employees State Insurance Scheme:

    A huge number of people worked in factories post-independence in India. The working conditions were such that there were injuries and deaths as well. This is where the concept of insurance proved beneficial. Employees State Insurance Scheme was launched in the year 1952 to offer a financial cover in case of illness, disability or death faced by insured workers/employees.

    Initially, only Kanpur and Delhi were considered, but the scope of the scheme expanded with time. This policy got an upgrade in the year 2015. Now, more than 7 lakh factories are a part of this scheme.

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    How To Enroll And Get Answers To Your Questions

    You can learn more about and apply for ACA health care coverage in several ways.

    • Visit to apply for benefits through the ACA Health Insurance Marketplace or you’ll be directed to your state’s health insurance marketplace website. vary by state.

    • Find a local center to apply or ask questions in person.

    • Download an application form to apply by mail

    Find the answers to common ACA questions about submitting documents, getting and changing coverage, your total costs for health care, tax options, and more.

    Want To Supplement Your Coverage


    Depending on your individual needs and your age of retirement, you may want to consider supplementing your provincial coverage with a retirement benefits plan to cover expenses for drugs, dental, travel or paramedical services. We have flexible plan options that provide you and your family with the coverage you need. For example, our retiree plan is available to those 50 to 75 years old or for those under 64, theres our Blue Choice® plan and our Blue Assured® plan is available for all ages.

    Member plans

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    How Do I Do A Change Of Address With Ohip

    If you are moving/or have moved, by law, you are required to inform the Ministry of Health and long-term care of your change of address. In order to keep your OHIP coverage active, it is important that you make sure your address is up-to-date. Keeping your address up-to-date will also ensure that you receive any communications from the ministry about your OHIP coverage.

    To update or change your address with OHIP, may use one of the following options:

    • Send a letter or visit your local ServiceOntario centre. You must include your name, health number, telephone number, current address and new address including postal code.
    • In-person: Visit the centre nearest you
    • Online: To update or change your address online, visit:

    Dr Ysr Aarogyasri Health Care Trust Andhra Pradesh State Government:

    The Andhra Pradesh Government along with the Dr YSR Aarogyasri Trust, which works for health care, has come up with four beneficial welfare schemes. These schemes cater to different people and assist them in time of need.

    Here are the four schemes:

  • Dr YSR Aarogyasri This scheme is dedicated to the welfare of the poor.

  • Aarogya Raksha This scheme is designed to benefit people Above Poverty Line .

  • Working Journalist Health Scheme This scheme is for journalists and it offers cashless treatment in case of listed procedures.

  • Employee Health Scheme This scheme is for the benefit of state government employees.

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