Nga aputa o te kapinga hauora ohorere, 90-ra Medicaid, me nga piriti COBRA¶

Ko te mamae i tetahi ohotata hauora nui, te whakaurunga ki te hohipera, me te pokanga ohorere ranei i te waahi i waenga i nga mahere inihua hauora, i te kitenga ranei kua ngaro koe i to 60-ra Affordable Care Act (ACA) Waa Whakauru Motuhake (SEP) te wa kati, kua ngaro ranei to utu COBRA mo te kore utu, ka taea e koe te noho ki te tekau mano taara o nga pire hōhipera kore inihua. Ko te nuinga o nga turoro e kii ana ka pahemo te ra kati whakaurunga, ka tae mai ranei he urunga ruuma whawhati tata me te kore he kaari inihua kaha, karekau he huarahi ture ki te tiki mahere inihua hei utu mo nga tiaki hauora kua oti kee.

Ko te tikanga, ko te ture a te kawanatanga i te United States e hanga ana i roto e toru nga momo mahi whakaora hauora hou ** kua hangaia mo te whakakore i nga pire hauora kore inihua i roto i te waahi: (1) **Mandatory 90-Day Retroactive Medicaid Coverage (42 U.S.C. § 1396a(a)(34) me te 42 C.F.R.id. kia tae atu nga tari ki te 3 marama maramataka katoa i mua i te marama ka tono koe me te utu mo nga pire hōhipera i puta i roto i te marama i heke ai to moni whiwhi; (2) Te Rautaki Piriti Retroactive COBRA 105-Ra (29 U.S.C. § 1165 me § 1162(2)(C)), e taea ai e koe te "maanu" mo te 60 ra ki te kowhiri i te COBRA me etahi atu 45 ra hei utu i te moni tuatahi i te wa e pupuri ana koe i te 100 o to mahi whakamuri i te ra; me te (3) Maakete ACA "Nga Tikanga Motuhake" Retroactive Retroactive Special Enrollment Appeals (45 C.F.R. § 155.420(d)(9)), e tuku ana i te kapinga whakamuri i te wa i mauria ai koe i te hohipera, i te ngoikoretanga, i te hapa o te kaituku mahi/inihua kua ngaro koe i to matapihi whakaurunga 60 ra.

Mahia tenei inaianei¶

1. Kaua rawa e whakaroa te tiaki hauora whawhati tata no te mea kei roto koe i te waahi kapi: I raro i te ture a te federal Emergency Medical Treatment and Labor Act (EMTALA, 42 U.S.C. § 1395dd), ko nga tari whawhati tata o nga hohipera i uru ki te Hauora Hauora i te United States e kii ana i raro i te ture ki te whakarato i te tirotiro tirotiro hauora me te maimoatanga whakapumautanga katoa (tae atu ki te pokanga ohorere, te tiaki i te ICU, me te utu mo to tuunga ohotata, te tiaki ICU) me nga karaka rehita o te hohipera kaore e taea te whakaroa i te rongoa ki te patai mo te inihua, ki te tono moni putea ranei, ahakoa 1 kiromita (0.6 maero), 50 kiromita (31 maero) te tawhiti o te hohipera. Mena kei te mamae koe, i tetahi hoa aroha ranei kei te mamae o te uma, nga tohu whiu, te toto nui, te uaua ki te manawa, me etahi atu mate ohorere ranei, waea atu ki to nama whawhati tata (911 i te US me Kanata, 112 i te EU, 999 i te UK) tirohia to maatau tau ohorere whaiaronga tonu.
2. ** Tonoa mo Medicaid i mua i te ra whakamutunga o te marama ki te maukati i te 3-Marama Retroactive Lookback (42 C.F.R. § 435.915):** Kaore i rite ki nga mahere ACA Marketplace (ka whai mana anake i te tuatahi o te marama e whai ake nei), Ko te whakaurunga Medicaid kei te tatauhia i runga i nga moni whiwhinga-a-tau-a-tau-a- Kapi**. Mena i mate koe i te hohipera ohorere kore inihua i te marama o Hurae ka ngaro to mahi, kua tata ki te kore utu ranei i te marama o Hurae, ko te tono mo Medicaid i mua atu ranei Oketopa 31 ka akiakihia te kaupapa Medicaid a te kawanatanga (i nga whenua kaore he waahanga whaiti Wāhanga 1115) ki te whakahoki mai i nga pire hauora o Hurae, Akuhata, Mahuru ki te 1 o Hurae.
3. Whakamahia te Pooti COBRA 60-Ra + Matapihi Tuatahi Tuatahi 45-Ra ki te hipoki i tetahi ohorere i te wa o te whakawhiti mahi: Mena ka wehe koe i to mahi i roto i nga ra 60 kua hipa ka whai waahi koe i mua i te tiimata o te mahere hauora a to kaituku mahi hou (i mua ranei i te mana o to mahere ACA Marketplace), Kaua e utu mo te utu COBRA ki mua mena ka hiahia koe ki te tiaki hauora utu nui. I raro i te ERISA (29 U.S.C. § 1165), kei a koe 60 nga ra maramataka mai i te mutunga o te ra i mutu ai to kaunihera kaituku mahi, i te ra ranei i tukuna atu ai te Panui Pooti COBRA ki a koe ki te whiriwhiri COBRA, me etahi atu 45 ra maramataka i muri i te ra i kowhiria e koe COBRA ki te utu i nga utu whakamuri o to mahi, ka taea e koe te whakamarumarutanga o te utu whakamuri ki te **105 ra o to mahi morearea ki muri **105 ra mo to mahi. mate.
4. Kaua rawa e tuku noa COBRA i waenganui o te tau ki te whakaaro ka taea e koe te huri ki te Mahere ACA Marketplace: Koinei te mahanga inihua hauora tino mate i te United States. I raro i 45 C.F.R. § 155.420(e), ka mutu moata to rohenga COBRA (me te tuku ranei i to COBRA kia whakakorea na te mea ka mutu to utu i te pire o ia marama) EHARA he Takahanga Ora Tohu a Kaore e whakaohooho i te 60-ra te Waa Whakauru Motuhake i te HealthCare.gov. Ina kowhiria e koe me te utu mo COBRA, kua kore koe e huri ki te Mahere ACA Marketplace kua utua kia tae ra ano ki te tau Wai Whakauru Tuwhera (Noema 1), mena ka pau katoa to wa COBRA 18-marama ka mutu ranei te utu putea COBRA kaituku mahi.
5. Kia mohio ko te ngaro o te Kaimahi Moni COBRA ka puta he 60-ra ACA mo te whakaurunga motuhake: I te tukunga o te COBRA i waenganui-tau kaore e uru ki te SEP, ko nga ture a te kawanatanga (45 C.F.R. § 155.420(d)(15)) ka utua katoatia e to kaituku mahi (15)**). hei wāhanga o te mōkihi whakaweto, ko te paunga o taua kaituku mahi COBRA he Takahanga Ora Tohu e hoatu ana ki a koe 60 ra maramataka i mua atu i muri ranei i te ra whakamutunga o te tahua a te kaituku mahi ki te whakakore i te COBRA me te whakauru ki tetahi mahere ACA Marketplace kua utua.
6. ** Tukuna he Piira "Nga Tikanga Motuhake" SEP i raro i te 45 C.F.R. § 155.420(d)(9) ki te ngaro koe i to matapihi ACA 60-ra:** Ki te ngaro koe i to 60-ra Waa Whakauru Motuhake i muri i te ngaronga o te kapinga-mahi (tirohia to maatau ngaro o te aratohu inihua hauora) na te mea i mau koe i te hohipera, i te ngoikoretanga o te hauora, i pangia e tetahi aituā taiao FEMA, i tukuna ranei e to kaituku mahi, i te he ranei nga pepa i tukuna e to kaituku mahi, insurer ranei, waea atu ki te Marketplace Call Center (1-800-318-2596) tonu ki te tono i tetahi Waihanga Motuhake mo te whakaurunga motuhake me te ra whai hua o te Retroactive.

Rakau Whakatau: Te whakaora i te pire hauora karekau he inihua, he waahi kapi ranei¶

Whakamahia tenei tūtohi whakamatautau hei tautuhi ko tehea kupenga haumaru a-ture ka taea te whakakore i tetahi ohotata hauora kore inihua, te whakatuwhera ano ranei i te matapihi whakaurunga kati.

flowchart TD
    A["Ohotata Hauora Kore Inihua, I Ngaro ranei te Matapihi Whakauru Inihua Hauora"] --> B{"E hia nga ra mai i te mutunga o te kapi i runga i te mahi?"}
    B -->|"I roto i nga ra 60 o te ngaro o te kapi (me te whiwhi panui COBRA ranei)"| C["I Roto Matapihi 60-Ra Hohe: Whakatauritehia te Pooti Whakamuri COBRA ki te ACA SEP"]
    C -->|"Kua He Pire ER/Hospital Nui I Te Aputa"| D["Tohua Tonu COBRA (Whakahoki ki te Ra 1) + Whakamahia te Matapihi Utu Tuatahi 45-Ra"]
    C -->|"Kare ano he Pire Nui & Me Mahere Haere tonu"| E["Whakauruhia ki te Mahere Maakete ACA ma te 60-Ra SEP + Whakamahia COBRA hei Purua Ohotata 60-Ra Koreutu"]
    B -->|"60 Ra kua hipa, COBRA Kua Pahemo"| F{"Tirohia 4 Nga Raina Ora Whakamuri Ohotata"}
    F -->|"Whiwhi Marama Inaianei kei raro i te Tepe Medicaid State (hei tauira, 138% FPL / -$1,732/mo Kotahi)"| G["Tonoa mo Medicaid Inamata + Tonoa 90-Day Retroactive Coverage (42 C.F.R. 435.915)"]
    F -->|"Ka mutu te Moni Moni COBRA mo te Kaimahi"| H["Tonoa 60-Ra COBRA Moni Moni Whakamutunga SEP i raro i te 45 C.F.R. 155.420(d)(15) i runga HealthCare.gov"]
    F -->|"I ngaro 60-Ra SEP Na te Hapa Hohipera, Whakatupato, Hapa Kaimahi ranei"| I["Kōnae Tikanga Motuhake SEP Piira i raro i te 45 C.F.R. 155.420(d)(9) mo te Uwhi Whakamuri"]
    F -->|"Ko te COBRA kua ngaro i roto i nga ra 30 kua hipa mo te kore utu"| J["Whakaorangia te COBRA i roto i te 30-ra o te Waa Atawhai (29 U.S.C. 1162(2)(C)) ranei te Ture Popoto Iti"]

Rautaki 1: Te Piriti Retroactive COBRA 105-Ra (Me pehea te whiwhi whakamarumaru kore utu)¶

Ina wehe koe i tetahi mahi i te Maehe 31 me te inihua hauora a to kaituku mahi hou kaore e timata ki te 1 o Mei, ki te 1 o Hune ranei, ka pa ki a koe tetahi waahi whakamataku 30-ki-60-ra kaore he inihua. Ko te utu i te $900 ki te $2,400 ia marama ki mua mo COBRA (e utu ana i te 102% o te utu o te roopu roopu) hei kapi noa i te 45 ra i te wa e ora ana koe ka pau te moni mo te reti. Engari, whakamahia te COBRA Retroactive Bridge i raro i te ERISA §§ 602 me 605 (29 U.S.C. §§ 1162, 1165) me 26 C.F.R. § 54.4980B-6:

Me pehea te mahi a te karaka ture 60-Ra + 45-Ra¶

1. Te Matapihi Pooti 60-Ra (29 U.S.C. § 1165(a)(1)): I muri i te mutunga o te kapinga o to roopu kaituku mahi, kei a koe te iti rawa o nga 60 ra maramataka mai i te muri o (a) te ra i mutu ai to kapinga hohe, (b) te ra i tukuna e te kaiwhakahaere mahere to puka mana COBRA Pooti Pootitanga, ki te haina me te panui Pootitanga**
2. Kapi Whakamuri Hoki ki te Ra 1: Kaore i rite ki nga mahere hauora takitahi kei runga i te maakete, mena ka hainatia e koe to Puka Pooti COBRA i te Ra 59, me whakahau te ture a te kawanatanga ki te mahere ki te whakahoki ano i to inihua hauora ** hoki mai ano ki te Ra 1** (te meneti tika i mutu to kapinga mahi-mahi), me te kore mokowhiti i roto i te kapinga.
3. Te Matapihi Utu Moni Tuatahi 45-Ra (29 U.S.C. § 1162(2)(C)): Kua rahuitia koe kia tukuna mai he moni me to Puka Pooti COBRA. I raro i te ture a te kawanatanga, ina tae koe ki te pooti, ​​me homai e te mahere 45 ra maramataka i muri i te ra o to pooti COBRA hei utu i nga utu whakamuri tuatahi.
4. Me pehea te whakahaere i te "COBRA Float" ma te haumaru:
5. Whakakiia to Puka Pooti COBRA i te Ra 1, hainatia, ka maka ki roto i te envelopu hiri kua tohua ki te kaiwhakahaere COBRA i runga i to tepu kihini (me waiho he kape ki to hoa rangatira, hoapaki ohorere ranei).
6. Mena ka eke koe i roto i to waahi whakawhiti 30-ki-60-ra ki te mahere hauora a to kaituku mahi hou (me to mahere ACA Marketplace hou ranei) me te kore e whati he wheua, ka haere ranei ki te hohipera, me kaore koe e tuku reta i te puka COBRA, a ka utua e koe $0 mo nga ra 60 mo te whakamarumaru kino.
7. Mena ka pangia koe e te mate appendicitis, te tukinga motoka ranei i te Ra 42 (he pire $18,000 ER) i a koe e utu ana i te moni COBRA \(1,400, me tuku e koe to Puka Pooti COBRA kua hainatia ma te Mēra Whaimana i mua i te Ra 60, utua nga marama e rua o nga utu COBRA whakamuri (\)2,800) i roto i te 45 ra, me utu te kamupene inihua $0, i roto i te 45 ra.

Rautaki 2: Mandatory 90-Day Retroactive Medicaid & Presumptive Hospital Eligibility¶

Ki te kore koe e inihua i te wa e pa mai ana he ohorere hauora, kaua e whakaaro he nui rawa te moni ka whiwhi koe mo Medicaid i runga i nga mea i riro ia koe i mua i te tau maramataka.

He aha te hunga utu nui kua ngaro i a raatau mahi ka uru ki te Medicaid tonu¶

I raro i te Modified Adjusted Gross Income (MAGI) ture tatau Medicaid (42 C.F.R. § 435.603(h)) a te Affordable Care Act's, i te wa e titiro ana nga moni awhi ACA Marketplace ki to matapae ** whiwhinga tau-tau-tau**, Ko te whakaurunga Medicaid ka whakatauhia e to moni whiwhinga utu o mua atu i te marama-marama ranei etahi painga kore taake). Ahakoa i whiwhi koe i te $85,000 i waenganui o Hanuere me Hurae, mena kua whakataka koe i te 31 o Hurae, a ko to moni whiwhinga ia marama i te marama o Akuhata he \(0 (kei raro ranei i te 138% o te Federal Poverty Level i roto i te 40+ Medicaid Expansion states, tata **\)1,732/marama mo te pakeke kotahi**, $3,588 ranei mo te whanau kotahi mo te wha o te marama), Medicaid i Akuhata.

Te Whakamana i te Ture Medicaid Retroactive 3-Marama (42 U.S.C. § 1396a(a)(34))¶

I raro i te ture Medicaid a te kawanatanga (42 U.S.C. § 1396a(a)(34) me 42 C.F.R. § 435.915), me tuku e nga tari Medicaid a te kawanatanga he awhina hauora mo te tiaki me nga ratonga ka tukuna i muri ranei i te marama tuatoru i mua i te marama e tono ai te tangata, mena ka tutuki nga tikanga e rua:

1. I whiwhi koe i nga ratonga hauora i roto i tera marama o mua (pēnei i te haerenga ER, te noho hōhipera, te pokanga, te kawe waka tūroro, te whakahaunga ranei), ahakoa kua utua e koe te pire, kaore ranei; ME
2. Kua tika koe mo Medicaid i te wa i tukuna ai nga ratonga mena kua tono koe i tera wa (te tikanga ko to moni whiwhinga ia marama i tera marama o mua kei roto i te rohe Medicaid, ka nui ake ranei o pire rongoa kino i to moni whiwhinga i raro i te kawanatanga Medically Needy Spend-Down / Share of Cost programme).

Mahinga Mahi i te Moenga o te Hohipera (Hospital Presumptive Eligibility, 42 C.F.R. § 435.1110): I a koe e uru tonu ana ki te hohipera, tono ki te korero ki te Medicaid Financial Counselor or Patient Advocate ** me te tono Hospital Presumptive Eligibility (HPE)-More (HPE)- and a Hospital Presumptive Eligibility (HPE)-More (HPE) and a ** Tāpiri). I raro i te 42 C.F.R. § 435.1110, ka taea e nga hohipera whai mana te tuku kapinga Medicaid i runga i te waahi i te ra kotahi i runga i to moni whiwhinga o naianei kia taea ai e koe te whakakii i nga whakahaunga i te wa e tukuna ana koe i te wa e tukatukahia ana to tono whakamuri mo te 90 ra.

Te whakataurite o nga piriti kapinga ohorere me nga ture whakamuri¶

Te whakaora i tetahi kaupapa here COBRA kua ngaro: Ko te 30-ra te wa aroha me te ture "Poro iti"¶

Mena ka tukuna atu e to kaiwhakahaere COBRA he panui whakamutu e kii ana kua whakakorehia to kapinga COBRA na te mea he tomuri te utu utu mo ia marama, he poto ranei mo etahi taara, tirohia enei parepare ture e toru i naianei tonu:

1. Te 30-Day Marama Tohu Tohu Marama (29 U.S.C. § 1162(2)(C) me te 26 C.F.R. § 54.4980B-8, U&A-5): Mo ia utu COBRA ia marama i muri i to utunga 45-ra tuatahi, ka whakahauhia e te ture a-ture mo te iti rawa o nga ra **30-maramataka. Ahakoa e kii ana to pire COBRA "Ka tika i te tuatahi o te Marama," ko te utu kua tohua (ka tukuna ma te hikohiko ranei) i mua atu ranei i te 30 o nga ra i muri i te ra tika e tika ana i te wa tika, a me whakahoki ano e te Kaiinihua te kapinga ki te tuatahi o te marama.
2. Ko te Ture "Poto iti" a IRS (26 C.F.R. § 54.4980B-8, Q&A-5(d)): He maha nga wa ka whakakorehia e nga kaiwhakahaere COBRA nga kaupapa here ina huri te pikinga reiti a-tau i to moni marama mai i te $812 ki te $845 ka tukuna e to utu-aunoa te $812. I raro i te Ture Putea § 54.4980B-8, Q&A-5(d), ki te utu koe i te moni COBRA i te wa e poto ana e te "te moni iti", kua tautuhia e te whanga haumaru a te tari hei iti ake i te $50, 10 paiheneti ranei o te utu e hiahiatia ana, karekau te mahere ki te whakakore i to COBR** i te tuatahi ka tukuna he panui ki a koe. taapiri 30 ra maramataka mai i taua panui ki te utu i te rerekee ngaro.
3. ** Panui Pooti COBRA he hapa, ngaro ranei (ERISA § 502©(1), 29 U.S.C. § 1132©(1)):** I raro i te 29 U.S.C. § 1166, ko to kaituku mahi me te kaiwhakahaere mahere he wa kati ture (te tikanga tae atu ki te 44 nga ra kua honoa) ki te mērahia to Panui Pooti COBRA ki to wahitau kua mohiotia (tae atu ki nga panui whakawhirinaki motuhake mena ka hiahiatia). Ki te kore ratou e tuku mēra i te Panui Pooti COBRA i te wa tika, kaore to karaka pooti e 60 ra i timata ki te whakahaere i te ture**, a ka whiua e te Kaiwhakahaere Mahere ki runga ki te $110+ ia ra me te taunahatanga mo o kereme hauora hurahia.

Tārua-whakapiri tauira: Retroactive Coverage Tono & COBRA / SEP Piira¶

Whakamahia te Wāhanga 1 ki te tono i te ACA Exceptional Circumstances Retroactive SEP, Wāhanga 2 ki te tono mo 90-Day Retroactive Medicaid, Wāhanga 3 rānei hei whakataka i te COBRA Whakamutua.

SECTION 1: REQUEST FOR ACA MARKETPLACE "EXCEPTIONAL CIRCUMSTANCES" RETROACTIVE SEP
(PURSUANT TO 45 C.F.R. § 155.420(d)(9), § 155.420(d)(4), AND § 155.420(b)(2)(iii))

Date: [Insert Date]
TO: Health Insurance Marketplace Appeals Center / State-Based Exchange Appeals Unit
    [Mail to: Health Insurance Marketplace, Attn: Appeals, 465 Industrial Blvd, London, KY 40750-0061]
RE: Marketplace Application ID: [Insert ID] | Applicant: [Your Full Name & DOB]

Dear Marketplace Eligibility & Appeals Specialist:

I hereby request an immediate Special Enrollment Period (SEP) with a RETROACTIVE EFFECTIVE DATE of [Insert Date Coverage Should Have Started] pursuant to 45 C.F.R. § 155.420(d)(9) (Exceptional Circumstances) and/or 45 C.F.R. § 155.420(d)(4) (Misconduct or Error of Non-Exchange Entity / Employer / Issuer).

1. QUALIFYING LIFE EVENT & REASON FOR DELAY:
   My prior Minimum Minimum Coverage terminated on [Date]. I was prevented from completing my Marketplace plan selection within the standard 60-day window due to:
   [ ] Serious medical incapacitation / emergency hospitalization from [Date] to [Date] (hospital admission records attached).
   [ ] Failure of my former employer / health plan administrator to provide timely written notice of my coverage termination date or COBRA subsidy expiration until [Date] (late notice attached).
   [ ] A technical error / misrepresentation by the Marketplace, insurance carrier, or enrollment assister on [Date].

2. DEMAND FOR RETROACTIVE EFFECTIVE DATE:
   Pursuant to 45 C.F.R. § 155.420(b)(2)(iii), I request that my Marketplace coverage be made retroactively effective to [Insert Date] upon my payment of the corresponding binder premiums so that emergency medical claims incurred during the involuntary gap are covered.

--------------------------------------------------------------------------------
SECTION 2: NOTICE TO COBRA ADMINISTRATOR OF UNLAWFUL TERMINATION / INSIGNIFICANT SHORTFALL

TO: [Name of COBRA Third-Party Administrator & Employer Plan Administrator]
RE: Participant: [Your Full Name] | COBRA Account No.: [Insert Number]

PLEASE TAKE NOTICE that your purported termination of my COBRA continuation coverage effective [Date] violates ERISA §§ 602 and 605 (29 U.S.C. §§ 1162, 1165) and Treasury Regulation 26 C.F.R. § 54.4980B-8:
[ ] My premium payment was postmarked / transmitted on [Date], within the mandatory 45-day initial payment window or 30-day monthly grace period under 29 U.S.C. § 1162(2)(C) and 26 C.F.R. § 54.4980B-8, Q&A-5.
[ ] Any alleged underpayment of $[Amount] was less than the lesser of $50 or 10% of the required premium, triggering the mandatory 30-day written cure notice requirement under 26 C.F.R. § 54.4980B-8, Q&A-5(d). Enclosed is immediate payment of $[Amount].

Demand is hereby made for immediate reinstatement of my COBRA coverage with zero gap.

Sincerely,

____________________________________
[Your Signature, Printed Name, Address, Phone, and Email]

Te kapinga hauora ohorere o te ao me nga piriti utu whakahaunga¶

Mena ka ngaro koe i to mahere taapiri rongoa/hauora ki to waahi mahi, ka pa ranei koe ki tetahi pire hauora i te wa e whakawhiti ana koe i waho o te United States, whakahohehia enei kaupapa a-iwi i raro i te ture:

• Kanata (Provincial Public Pharmacare & Trillium / Fair PharmaCare Income Assessment): Ahakoa kei te kapi katoa nga ratonga o te hohipera me nga taote i raro i te inihua hauora porowini (OHIP, MSP, AHCIP, RAMQ), ka ngaro to mahi ka whakakorea te **Mahere Hauora me te Whakanuia o to Kaimahi . Mena ka tupono koe ki nga rongoa motuhake utu nui (pēnei i te insulin, te koiora, te rongoa ngakau ranei), tono tonu mo te kaupapa rongoa mo te mate kino a te iwi i to kawanatanga, penei i te Ontario Trillium Drug Program (e kapo ana i to utu whakahaunga kei waho o te pute ki te 4% o to moni whiwhinga whare), BC Fair PharmaCare, roupepaage rai. Mahinga Tino:** Tonoa te hotaka mo tetahiromatawai Moni Moni / Arotake Taaketan na ktatauhia to tangohanga i runga i to whakaiti i muri i te mahi-menga moni, kaua ko te whakahoki taake o tera tau. Kia mahara ano kei a koe 60 ra mai i te ngaronga o to mahere roopu kaituku mahi ki te huri ki tetahi mahere hauora "FollowMe / Assured Access" me te karekau he tiwhikete hauora.
• United Kingdom (NHS Low Income Scheme, HC1 Form & 3-Month Retroactive HC5 Refund): Ahakoa he kore utu te maimoatanga whawhati tata o te hōhipera NHS i te waahi e whakamahia ana mo nga kainoho o Ingarangi, ka ngaro to moni whiwhi ka kore e taea e koe te utu mo ** nga whakahaunga NHS ** (i Ingarangi), te maimoatanga niho, te tiaki kanohi ranei. Mena kare ano koe kia whiwhi i te Tiwhikete Universal, tuku mai he tono mo te kaupapa here moni whiwhi iti a NHS (Puka HC1) i runga ipurangi, ma te panui ranei kia whiwhi i tetahi HC2 Tiwhikete (100% utu whakahaunga me te tiaki niho) ranei HC3 Tiwhikete (awhina iti). Ture Whakahoki Whakahoki: Mena me utu koe mo te whakahaunga, tiaki niho whawhati tata ranei a te NHS i tenei ra i te wa e tatari ana kia whakamanahia to HC1 me to Whiwhinga Ao, patai ki te kai rongoa mo te Puka Rihiti NHS FP57 i te wa tika ka utua e koe (kaore e taea e koe te tiki FP57 a muri ake nei) ka tuku Puka Kereme Whakahoki HC5 kia riro mai i roto i te 3 marama ** te moni whakahoki moni.
• Ahitereiria (Medicare Safety Net, Kaari Tiaki Hauora Whakawhiwhinga Iti me te Hauora Motuhake 60-Ra Whakatarewa): Ka mau tonu nga kainoho whai mana katoa ki te hohipera a-iwi me te urunga rongoa a te PBS na roto i te Medicare, ahakoa te ngaronga mahi. Mena ka tino heke to moni whiwhi i muri i te ngaronga o to mahi, tono ki Services Australia (Centrelink) mo te Kaari Tiaki Hauora Whakawhiwhinga Iti (kua whakatauhia i runga i te 8-wiki huri noa i te matapihi whiwhinga moni, ehara i te moni taake a-tau), e whakaheke ana i to Pharmaceutical Benefits Scheme (PBS) whakahaunga utu tahi ki te reiti tukunga o te Haumarutanga (\(700) me te utu Haumaru Haumaru (\)70. (EMSN)** paepae. Mena kua kore e taea e koe te utu mo to Inihua Hauora Motuhake mo nga utu hōhipera (kei te pirangi ranei koe ki te karo i te utu utu mo te Medicare Levy me te Utapa mo te Ora mo te Ora), patai ki to kaiinihua hauora motuhake mo te Whakatarewatanga Kaupapa Here mo te Whakauaua Putea / Nga Mahi Karekau (ko te nuinga o nga moni ka whakaae kia whakatarewahia nga utu mo te 2 marama ki te 2 tau me te kore e ngaro to wa tatari mo te Uwhi Ora Ora ranei).

Pātai auau¶

Kua tirohia nga puna¶

• U.S. Department of Health and Human Services (HHS) and Centres for Medicare & Medicaid Services (CMS, United States): Mandatory 90-Day Retroactive Medicaid Eligibility Statute (42 U.S.C. § 1396a(a)(34)) and Regulations (42 C.F.R. § 435.915) C.F.R. § 435.603), Hospital Presumptive Eligibility (42 C.F.R. § 435.1110), me te * Ture Tiaki Hauora ohorere me te Reipa (EMTALA, 42 U.S.C. § 1395dd)*.
• ** Pokapū mo nga Ratonga Hauora me te Medicaid (CMS / HealthCare.gov, United States):** Whakawhitinga ACA mo nga wa whakaurunga motuhake (45 C.F.R. § 155.420), Paetanga o nga takoha COBRA Kaimahi SEP (45 C.F.R. § 155.420)(d), *155.420(d)(d) 155.420(d)(d) Nga Ra Whai Mana (45 C.F.R. § 155.420(d)(9) me § 155.420(b)(2)(iii)), me te Ture Whakamutunga Inihua mo te wa poto, iti te roa (45 C.F.R. § 144.103).
• U.S. Te Tari Reipa (EBSA) me te Ratonga Putea Roto (United States): Ture Whakakotahitia Omnibus Budget Reconciliation Act (COBRA, ERISA §§ 601 ki 608, 29 U.S.C. §§ 1161 ki 1168) me Treasury CBRA Regulation Continuation Coverage6.§R. 54.4980B-6 mo nga Wa Pooti me te § 54.4980B-8 mo nga Matapihi Utu 45-Ra/30-Ra me nga Popoto Iti).
• Te Manatū Hauora o Ontario me te Manatū Hauora o BC (Kanata): Nga Aratohu Aromatawai Moni Moni Moni Trillium mo te Tau me Nga Ture Arotake Moni Moni Moni a BC Fair PharmaCare.
• NHS Business Services Authority (NHSBSA, United Kingdom): NHS Low Income Scheme (HC1/HC2/HC3) and Retroactive Prescription/Dental Refund Ture (Puka FP57 me HC5).
• Ratonga i Ahitereiria me te Kaitiaki Tiaki Inihua Hauora Motuhake (Ahitereiria): Kari Tiaki Hauora Moni iti mo te 8-wiki Whakamātautau Whiwhinga Putea, Kupenga Haumaru Hauora Hauora Whaiaro, me te Aratatohu Whakatarewa Whakatarewa i te Putea Inihua Hauora Motuhake.

Nga kaiarahi e pa ana¶

• Te ngaronga o te inihua hauora, COBRA, me te Whakauru Motuhake
• Ko nga kohinga pire rongoa, he awhina putea mo te hohipera, me te atawhai atawhai
• Whakakahoretanga kerēme inihua hauā wā poto me te wā roa (piira ERISA)
• Te ngaronga mahi ohorere me te oranga moni tonu
• Te karanga i nga turoro me te tango whakamatuatanga hauora (FMLA)
• Ko nga nama ohorere ma te whenua