Protect: Protect Our Universal Public Health Care System Making Evidence Based Decisions On Value And Quality To Sustain The System For Generations To Come
Our universal health care system belongs to the people of Ontario. Ontarians fund it and depend on it for their health and the health of their children. With an aging population that will have a growing need for health care services, maintaining a sustainable health care system means controlling costs and targeting funding on preventing illness and improving results for patients. Examples of upcoming improvements :
- A Patient Ombudsman will be appointed to help people who have an unresolved complaint about their care at a hospital, long-term care home or in home care services provided by Local Health Integration Networks.
- Ontario will now require more public reports on how the health system is performing and how patients are being treated, including mental health, wait times, public drug programs and public health.
- A health care system that puts patients first requires the input and participation of patients. We will continue to expand how patients are engaged throughout the health care system.
For more information on Ontario’s plan for changing and improving Ontario’s health system see the Patients First: Action Plan for Health Care.
Understanding Which Insurance Plan Pays First
Why would someone want to have more than one insurance plan? It depends on who you ask. You may want additional coverage to make sure you get all the healthcare services you need. Medicare and other insurers, on the other hand, have another vested interest. If you have more than one health plan, they may be able to shift the burden of payment onto the other party.
Don’t worry. Someone is going to foot the bill, and as long as everyone goes according to plan, it shouldn’t be you. You need to understand who is going to pay first and who, if anyone, is going to pay any costs that are left over. This is where Medicare Secondary Payer comes into play.
Health Plan Report Cards
People across Texas shared their thoughts about their health plan, and rated them, one to five stars, on the services their plan provided. You can compare plans using the overall ratings or by looking at the services that matter the most for you and your family.
You can view the report cards on the Managed Care Report Cards page. Click the program you are enrolled in and find your service area to see plans available to you.
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How To Choose A Health Plan
When picking a plan, think about the following:
- Are doctors you already use and like covered by the plan?
- How is the plan rated on issues that are important to you and your family?
- What value-added services are available through the plan?
We also provide tools to help you choose the best plan for you and your family.
Medicaid That Doesnt Count As Minimum Essential Coverage In Utah
If anyone in your household is covered by only the following programs, they do not have minimum essential coverage. This means they are eligible for premium tax credits and other savings on a Marketplace insurance plan, if they qualify based on their income and other criteria.
- Primary Care Network:
- Adults with income at or below 95% of the FPL who receive a limited primary and preventive care benefit package
- High-risk pregnant women who receive pregnancy-related services
What to do: You dont have to end Marketplace coverage for anyone whose only additional health coverage is provided by the plans above. They can keep their Marketplace plan with tax credits and other savings too. You dont have to take any action on the notice from the Marketplace.
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Medicaid That Counts As Minimum Essential Coverage In Maryland
If anyone in your household is covered by the following programs, they do have minimum essential coverage. This means they are not eligible for premium tax credits and other savings with a Marketplace plan.
- Full Medicaid coverage
- Medicaid for low-income pregnant women Programs that cover the costs of maternity and childbirth services for women who arent eligible for Medicaid otherwise.
- Medicaid for medically needy individuals if you qualify for comprehensive coverage without needing to deduct medical expenses from your income to meet the states medically needy income level .
What to do: If anyone in your household is covered by the programs above, IMMEDIATELY end their Marketplace coverage with premium tax credits. See how to end a Marketplace insurance plan.
They can enroll in a Marketplace plan, but only at full price.
Plan First Family Planning Benefit Program Now Available In New Jersey
Some New Jerseyans have a new option to get family planning services at no cost to them. This is a Medicaid benefit program called Plan First, which is managed by New Jerseys public health insurance program, NJ FamilyCare.
Under Plan First, you can get family planning services free of charge. Medicaid also offers free or low-cost family planning services, but Plan First expands New Jerseys Medicaid coverage for family planning only, allowing more New Jersey residents access to care by raising the income limit for Medicaid coverage of these services.
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Medicaid That Counts As Minimum Essential Coverage In North Dakota
If anyone in your household is covered by the following programs, they do have minimum essential coverage. This means they are not eligible for premium tax credits and other savings with a Marketplace plan.
- Full Medicaid coverage
- Medicaid for low-income pregnant women Programs that cover the costs of maternity and childbirth services for women who arent eligible for Medicaid otherwise.
- Medicaid for medically needy individuals if you qualify for comprehensive coverage without needing to deduct medical expenses from your income to meet the states medically needy income level .
What to do: If anyone in your household is covered by the programs above, IMMEDIATELY end their Marketplace coverage with premium tax credits. See how to end a Marketplace insurance plan.
They can enroll in a Marketplace plan, but only at full price.
Medicaid That Counts As Minimum Essential Coverage In Vermont
If anyone in your household is covered by the following programs, they do have minimum essential coverage. This means they are not eligible for premium tax credits and other savings with a Marketplace plan.
- Full Medicaid coverage
- Medicaid for low-income pregnant women Programs that cover the costs of maternity and childbirth services for women who arent eligible for Medicaid otherwise.
- Medicaid for medically needy individuals if you qualify for comprehensive coverage without needing to deduct medical expenses from your income to meet the states medically needy income level .
- Global Commitment to Health Comprehensive for mandatory and optional state plan populations
What to do: If anyone in your household is covered by the programs above, IMMEDIATELY end their Marketplace coverage with premium tax credits. See how to end a Marketplace insurance plan.
They can enroll in a Marketplace plan, but only at full price.
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What Does Plan First Cover
Plan First is not a full health insurance plan, so youll still need health insurance for seeing a primary care physician and any specialists. If you get pregnant while on Plan First, your family planning provider can help connect you with resources to enroll in Medicaid coverage for pregnant women, as well as refer you to prenatal services.
With Plan First, you can receive services to prevent unintended pregnancies. These services may include:
- Female and male birth control, including condoms, the pill, IUDs and more
- Pregnancy tests
- Sterilization
and more.
Medicaid That Counts As Minimum Essential Coverage In Oregon
If anyone in your household is covered by the following programs, they do have minimum essential coverage. This means they are not eligible for premium tax credits and other savings with a Marketplace plan.
- Full Medicaid coverage
- Medicaid for low-income pregnant women Programs that cover the costs of maternity and childbirth services for women who arent eligible for Medicaid otherwise.
- Oregon Health Plan
What to do: If anyone in your household is covered by the programs above, IMMEDIATELY end their Marketplace coverage with premium tax credits. See how to end a Marketplace insurance plan.
They can enroll in a Marketplace plan, but only at full price.
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Advantages Of Starting A Virtual
Bestsennyy outlined four primary benefits of a virtual-first health plan. Virtual-first health plans:
- Are more convenient
- Lead to higher quality of care
- Lead to better outcomes through better preventative care
- Reduce costs due to efficiency
Oleg Bestsennyy, Partner at McKinsey & Company
The convenience of leveraging virtual care as the first point of care can manifest in time saved on transportation, decreased barriers to access related to stigmas, and more.
The format also gives members more control over their healthcare management.
The opportunity just to start at least the full patient 360 view through a virtual platform is critical because it can be scheduled by that consumer directly, Maroney said.
We know that good preventative care, active management of chronic health conditions, that’s really pretty critical to improving our members health outcomes, Spanos said.
But we also know that a lot of our members aren’t accessing primary care regularly. There’s a shortage of primary care providers in the US. There’s also no guarantee that the time and place of those appointments will be convenient for our members.
As a result, many patients resort to high-cost care sites, such as emergency departments.
So now you start to create the downstream cost outcomes that we want to see, in addition to actually driving the member behavior that we want to see around adherence, Spanos shared.
Medicaid That Counts As Minimum Essential Coverage In Utah
If anyone in your household is covered by the following programs, they do have minimum essential coverage. This means they are not eligible for premium tax credits and other savings with a Marketplace plan.
- Full Medicaid coverage
- Medicaid for low-income pregnant women Programs that cover the costs of maternity and childbirth services for women who arent eligible for Medicaid otherwise.
- Primary Care Network:
- Adults eligible under section 1925 & 1931 and medically needy adults
- Adults with income at or below 200% of the FPL who receive premium assistance
- COBRA-eligible adults with income below 200% FPL who receive premium assistance
- CHIP children who receive premium assistance
What to do: If anyone in your household is covered by the programs above, IMMEDIATELY end their Marketplace coverage with premium tax credits. See how to end a Marketplace insurance plan.
They can enroll in a Marketplace plan, but only at full price.
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Healthy Families Safe Communities
Together, Keystone First and our providers are committed to advocating health and safety in the communities we serve. We designed Healthy Families, Safe Communities as a resource center for members and providers. Learn more about our initiatives for issues like gun safety, teen dating violence and food insecurity:
Medicaid That Counts As Minimum Essential Coverage In New Hampshire
If anyone in your household is covered by the following programs, they do have minimum essential coverage. This means they are not eligible for premium tax credits and other savings with a Marketplace plan.
- Full Medicaid coverage
- Medicaid for low-income pregnant women Programs that cover the costs of maternity and childbirth services for women who arent eligible for Medicaid otherwise.
- Medicaid for medically needy individuals if you qualify for comprehensive coverage without needing to deduct medical expenses from your income to meet the states medically needy income level .
What to do: If anyone in your household is covered by the programs above, IMMEDIATELY end their Marketplace coverage with premium tax credits. See how to end a Marketplace insurance plan.
They can enroll in a Marketplace plan, but only at full price.
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Find Out If Your Medicaid Program Counts As Minimum Essential Coverage
Most Medicaid programs are considered “minimum essential coverage” . This means they meet the requirement for having health coverage under the health care law.
- If your Medicaid program counts as minimum essential coverage: You are not eligible for a premium tax credit or other savings to enroll in a Marketplace insurance plan. You should immediately end Marketplace insurance for anyone in your household who is enrolled in these Medicaid programs and is also using premium tax credits with a Marketplace plan.
- If your Medicaid program DOESNT count as minimum essential coverage: You are eligible for premium tax credits and other savings on a Marketplace insurance plan, if you qualify based on your income and other criteria.
Select your state and well tell you if your Medicaid coverage counts as minimum essential coverage, and what action to take.
What Do I Need To Provide With My Application When Applying For The Fpbp
You will need to bring or send in documentation for each of the items listed below:
- Full legal name as it appears on your birth certificate
- Social Security Number
- Proof of your citizenship or immigration status. If you are a U.S.citizen and provide a valid Social Security Number , a match with Social Security Administration will verify your SSN, date of birth/age and U.S. citizenship. If SSA verifies this information, no further proof is needed. The SSA match cannot verify birth information for a naturalized citizen. You will need proof of naturalization or a U.S. passport)
- Proof of your age , like a birth certificate, or a passport
- Proof of earned income, like recent paycheck stubs , a letter from your employer or a profit and loss statement if you are selfemployed
- Proof of your unearned income, from sources like Social Security Benefits, NYS Disability Benefits, or Unemployment Benefits
- Proof of where you live, like a rent receipt, letter from your landlord, mortgage statement, or postmarked nonwindow envelope from mail you received recently
- Health Insurance benefit card or policy statements
- You do not need to bring or send in proof of your resources, such as bank statements, vehicles you own or insurance policies. Resources are not counted in determining eligibility for the FPBP.
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Medicaid That Doesnt Count As Minimum Essential Coverage In North Dakota
If anyone in your household is covered by only the following programs, they do not have minimum essential coverage. This means they are eligible for premium tax credits and other savings on a Marketplace insurance plan, if they qualify based on their income and other criteria.
- Medicaid for medically needy individuals if you qualify for comprehensive coverage only after incurring medical expenses to meet a spenddown amount.
- Limited coverage that pays only for:
- Family planning
- Tuberculosis services
- Outpatient hospital services
What to do: You dont have to end Marketplace coverage for anyone whose only additional health coverage is provided by the plans above. They can keep their Marketplace plan with tax credits and other savings too. You dont have to take any action on the notice from the Marketplace.
What Health Services Are Covered By The Fpbp
Family Planning Services include:
- Most FDA approved birth control methods, devices, and supplies
- Emergency contraception services and followup care
- Male and female sterilization
- Preconception counseling and preventive screening and family planning options before pregnancy
- Transportation to family planning visits
- Retroactive coverage
The following additional services are considered family planning only when provided within the context of a family planning visit and when the service provided is directly related to family planning:
- Pregnancy testing and counseling
- Comprehensive health history and physical examination, including breast exam and referrals to primary care providers as indicated .
- Screening and treatment for sexually transmitted infections
- Screening for cervical cancer and urinary tract or femalerelated infections
- Screening and related diagnostic laboratory testing for medical conditions that affect the choice of birth control, e.g. a history of diabetes, high blood pressure, smoking, blood clots, etc.
- HIV counseling and testing
- Counseling services related to pregnancy, informed consent, and STD/HIV risk counseling
- Bone density scan
- Ultrasound
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Medicaid That Counts As Minimum Essential Coverage In Arizona
If anyone in your household is covered by the following programs, they do have minimum essential coverage. This means they are not eligible for premium tax credits and other savings with a Marketplace plan.
- Full Medicaid coverage
- Medicaid for low-income pregnant women Programs that cover the costs of maternity and childbirth services for women who arent eligible for Medicaid otherwise.
- Arizona Health Care Cost Containment
What to do: If anyone in your household is covered by the programs above, IMMEDIATELY end their Marketplace coverage with premium tax credits. See how to end a Marketplace insurance plan.
They can enroll in a Marketplace plan, but only at full price.
How Do I Apply
First, go to Washington Healthplanfinder to see if you are eligible for Apple Health coverage or a subsidized Qualified Health Plan. If you’re eligible, sign up for one of those plans. They provide full health care coverage, which includes family planning.
If you’re a teen you may be eligible for Apple Health coverage on your own. Call Washington Healthplanfinder at 1-855-923-4633 to find out if you’re eligible. Read more information about health coverage for teens and young adults.
If you’re not eligible for Apple Health, make an informed choice to waive your right to apply for Apple Health, or you need confidential services, contact your Apple Health provider and apply for benefits over the phone or in-person with an eligible Apple Health provider.
You can also apply by fax , email , telephone with HCA or mail without provider assistance. In that case, you should securely transmit or mail the Application for Family Planning Only services. Family Planning Only programs services are available through any Apple Health provider.
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