Health Coverage For People With Disabilities

If you have a disability, you have three options for health coverage through the government.

• Medicaid provides free or low-cost medical benefits to people with disabilities. Learn about eligibility and how to apply.

• Medicare provides medical health insurance to people under 65 with certain disabilities and any age with end-stage renal disease . Learn about eligibility, how to apply and coverage.

• Affordable Care Act Marketplace offers options to people who have a disability, dont qualify for disability benefits, and need health coverage. Learn about the .

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The Highlights

• You could ask general questions about what insurance benefits that employer grants.

If you need to learn how to find out if someone has health insurance, there are a few avenues to take. We will get into all of that in a step-by-step manner because we understand insurance is a complicated business.

For instance, you cannot just call up the American Medical Association and ask about John Qs specific policy. Get a good start by typing your ZIP code into our helpful tool above to find reasonable health insurance rates from the best insurance companies in your area.

• #7 How can I go to the doctor without insurance?

The Insurance Company Is Requiring That I Provide Them My Social Security Number In Order To Apply For Health Coverage Why Does The Insurance Company Need My Social Security Number

Federal regulations governing the Internal Revenue Service require that all health insurance carriers that provide minimum essential coverage to an individual during a calendar year must report to the IRS the name and Social Security number of each individual who is covered under the policy or program. Learn more about this requirement here: .

Your SSN should only be asked for by the company that you are buying insurance from when you are filling out the application for insurance. Never provide a SSN while shopping for insurance or comparing premiums.

Both state and federal law require that your personal information must be kept confidential and cannot be shared or misused. For more information on how Massachusetts law defines personally identifiable information and what steps businesses must take to protect that personal information, please visit .

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Check Your National Insurance Record

You can check your National Insurance record online to see:

• what youve paid, up to the start of the current tax year
• any National Insurance credits youve received
• if gaps in contributions or credits mean some years do not count towards your State Pension
• if you can pay voluntary contributions to fill any gaps and how much this will cost

Q How Do I Change My Name On My Health Card Upon Dissolution Of My Marriage

To change your name on your photo health card to reflect your birth name or a previous married name, you must visit a ServiceOntario centre, complete a Change of Information and present the original of one of the following:

• A divorce certificate which includes your previous name and the requested name
• A marriage certificate which includes your previous name and the requested name
• Birth certificate
• Change of name certificate

If you do not already have a photo health card, you must also provide three original documents to prove citizenship, Ontario residence and identity.

If you have any questions regarding your own specific situation, call the ServiceOntario, INFOline at 1-866-532-3161.

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What Is A Health Insurance Network Provider

Health insurance network providers are the medical service organizations. Your health plan has agreements with these groups to provide service to you. If your plan specifies a list of authorized network providers, then going “outside the network” could mean that have higher out-of-pocket costs. Your plan might also deny your claim, leaving you to pay the entire bill.

What Type Of Insurance Do I Need

Each insurance plan is different when it comes to what’s covered, what’s not, and how much things cost. Figuring out which one is right for you is a bit of a balancing act: You want to get the most benefits at the least cost.

Start by looking at all the parts of the plan, not just the price you pay. For example, a plan with a low monthly isn’t necessarily the cheapest your co-pay might be very high or you might pay more for your prescriptions. If you don’t have any health problems, that might be OK. But if you see a doctor a lot or take prescription medications regularly, a more expensive plan that covers more of the cost to see a doctor or get a prescription may actually turn out to be cheaper.

You’ll also have to look at whether your plan covers things that are important to you. For example, many plans don’t cover things like dental or vision care, counseling sessions, or alternative therapies like chiropractic or acupuncture.

The three major plans you’ll likely have to choose from are: indemnity plans, managed care plans, or consumer-driven health plans.

Indemnity Plans

Indemnity plans are also called fee-for-service or reimbursement plans. With this kind of plan you can see any doctor you want any time you want. You pay the doctor directly and then send your claim to your insurance company. The company pays you back for part of the total cost.

Managed Care Plans

The four basic types of managed care plans are:

Consumer-Driven Health Plan

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Other Options You Should Be Aware Of

There are some additional options that you should be aware of. First, you may be able to convince your doctor to accept your new health insurance. If it is your doctor that does not currently accept your health insurance instead of the other way around, then a simple request might allow you to keep both your insurance and your same doctor. You also may be able to switch to a similar insurance plan that will allow you to keep your doctor and give you nearly the same options that you had with your health plan. You should consider every possibility when it comes to getting the right healthcare planning getting the right doctor, because the wrong ones can make it more difficult for you to manage your healthcare.

Q My Baby Was Born In An Ontario Hospital But We Are Only Visiting Ontario For A Short Period Can We Use The Ontario Health Coverage Infant Registration Form To Register Our Baby For Ontario Health Coverage While We Are Here

No. Tourists, transients or visitors are not eligible for OHIP coverage. For a child born in Ontario to be eligible for Ontario health insurance coverage they must make their primary place of residence in Ontario, and be physically present in Ontario for at least 153 days in any 12-month period to retain OHIP coverage.

If you are visiting Ontario from another province or territory in Canada, contact your home province/territory regarding health insurance coverage for your baby and any insured services received while visiting Ontario.

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Contact Local Welfare Office

Another way to find out about your Medi-cal status is to contact the local welfare office. Dont forget that even though Medi-cal is a statewide program, local offices administer it. If you are not sure where your local welfare office is located, then dont worry. Just go to the website of the Department of Health Care Services and check the list of county welfare offices. You can also find out the location of your local welfare office in your local phone book. It will be mentioned under the category of Social Services or Health and Human Services.

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Compare Health Plan Networks

Costs are lower when you go to an in-network doctor because insurance companies contract lower rates with in-network providers. When you go out of network, those doctors dont have agreed-upon rates, and youre typically on the hook for a higher portion of the cost.

If you have preferred doctors and want to keep seeing them, make sure theyre in the provider directories for the plan youre considering. You can also directly ask your doctors if they take a particular health plan.

If you dont have a preferred doctor, look for a plan with a large network so you have more choices. A larger network is especially important if you live in a rural community, since youll be more likely to find a local doctor who takes your plan.

Eliminate any plans that dont have local in-network doctors, if possible, and those with very few provider options compared with other plans.

Speak With Case Manager

Your Case Manager is usually present at your local welfare office. When you contact the welfare office, tell them that you want to speak with your Case Manager. He will ask you to provide him with your Medi-cal identification number and your social security number. If you are wondering where you can find your Medi-cal identification number, then it is mentioned on your Beneficiary Insurance Card . In case you do not know who your Case Manager is, you can ask the local welfare office to provide you the required information. The local welfare office will also transfer your call to your Case Manager.

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Do You Need A Travel Insurance Policy

People do not always think about the type of health insurance they have when they are going to be out of state until it’s too late. Find out what type of plan you have and learn about its limitations. This will help you decide if you need a travel insurance policy.

You may need different types of coverage depending on how often you travel. A one-time trip may merit different choices than regular travel across state lines.

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What To Do If Youre Not Covered

In a perfect world, you always know if insurance covers you before you need medical care. But thats not how real life works out many times.

Its one thing to do your research and request your summary of benefits and coverage before theres a problem.

What are your options if you need medical care in the moment?

But you may not have time to do research when you need answers.

If you need to see a new doctor or schedule services not covered by insurance, you do have a few options.

Q How Do I Change My Name On My Health Card To My Married Name

To change your name on your health card to reflect your married name, you must visit a ServiceOntario centre , complete a Change of Information and present the original of one of the following:

• Certificate of Marriage
• Certified copy of Statement of Marriage
• Original marriage document issued outside of Ontario which contains the names of both spouses
• A record of marriage form
• Change of name certificate

If you are changing your name to reflect a ‘common-law’ marriage, you must visit a ServiceOntario centre, complete a Change of Information and present the original of one of the following:

• Change of Name certificate
• Certified copy of the court order for a change in surname
• Notarized affidavit of the facts supporting the use of the ‘common-law’ surname

If you do not already have a photo health card, you must switch to a photo health card in order to change your name. You will be required to provide three original documents to prove citizenship, Ontario residence and identity.

If you have any questions regarding your own specific situation, call the ServiceOntario INFOline at 1-866-532-3161.

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Q Am I Still Eligible For Ohip If I Temporarily Leave Ontario

You may be out of the province for up to 212 days in any 12-month period and still maintain your Ontario health insurance coverage provided that you continue to make Ontario your primary place of residence.

To maintain eligibility for OHIP coverage you must be an eligible resident of Ontario. This means that you must :

• have an OHIP-eligible citizenship/immigration status and
• be physically present in Ontario for 153 days in any 12-month period and
• be physically present in Ontario for at least 153 days of the first 183 days immediately after establishing residency in the province and
• make your primary place of residence in Ontario.

If you will be out of the province for more than 212 days in any 12-month period, please refer to the Longer Absences from Ontario fact sheet.

Q What Should I Do If I Need To Take My Baby To The Doctor But Haven’t Received His Or Her Health Card

The infant registration form contains a convenient tear-off record of your baby’s Ontario health number. Keep and present this record for any required medical services until you receive your child’s plastic Ontario health card.

If you do not have the tear-off record and you have paid for medical services for your child while awaiting his or her health card, your health care provider can reimburse you in full when you show the health card as proof of your child’s OHIP eligibility.

It usually takes 6 weeks from registration for ServiceOntario to process and mail your child’s health card.

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How Do I Find Out If A Doctor Is Covered By My Insurance

One of the common questions that people have about their health insurance is whether they can use a specific doctor. When signing up for health insurance for the first time, or the first time with a new plan, most people are mostly concerned about keeping the same doctor that they have always had either through a different insurance plan or on a cash basis. In this article, we will be covering how you can find out whether your doctor is covered on your new insurance plan and some steps that you can take if you find that your regular doctor is not part of your new health insurance network.

Can I Cancel My Own Health Insurance

It is not advisable to cancel your health insurance coverage unless you have alternative coverage lined up that meets minimum creditable coverage standards. You should also keep in mind that individuals can only enroll in a new health plan during the regular annual open enrollment period each fall or through a special enrollment process if you have experienced some type of qualifying event .

If you are enrolled in a health plan through MassHealth or the HealthConnector and need to cancel it because you are now eligible for employer-sponsored coverage, you should contact MassHealth or the HealthConnector directly to disenroll. You will want to keep in mind when your new coverage is expected to begin so that you do not overlap or go without coverage. If you are changing jobs, were laid off or terminated, or retiring, your employer will generally handle cancelling your health insurance coverage.

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Can The Doctor Find Alternatives

If you need a medication or procedure thats not covered, talk to your doctor.

• What are the alternatives?
• Can they prescribe a drug that your insurance does cover?
• Are there other options to treat your condition?

You can also ask your doctor to contact your insurance company.

Doctors can request exceptions for their patients. They need to show your provider why you need specific medication, treatment, or care.

While not ideal, you can pay for the medication your doctor prescribed yourself. This makes sense when the cost of the prescription is not much higher than the cost of your co-pays.