Belgian Health Care System. Jo DE COCK - CEO National Institute Health & Disability Insurance (NIHDI) Brussels 9 November 2011
|
|
- Sabrina Ellis
- 5 years ago
- Views:
Transcription
1 Belgian Health Care System Jo DE COCK - CEO National Institute Health & Disability Insurance (NIHDI) Brussels 9 November
2 The Belgian health insurance is a system of reimbursement fees Doctor, dentist, physiotherapist, wheelchair,... patients Affiliation Reimbursement = fee - PATIENT S CONTRIBUTION Health insurance funds 2
3 System of third party paying Insured people/ patients Patient s contribution Health care providers Health insurance funds 3
4 HISTORICAL FACTS 1945: introduction of social security and compulsory health care insurance for workers 1963: basic law and establishment of NIHDI : changes in management and introduction of a system of financial responsibility : successive reforms in order to make NIHDI more accessible and sustainable 4
5 NIHDI: Organizational chart General Management General Management Committee Sector Management General Council Committee for Health Care Insurance Management Comitee Wage-earners Management Comitee Self-employed persons Committee Department for Administrative control General Support Departments Administration Health Care Department Department for Invalidity Benefits Department for Medical Evaluation and Control 5
6 1. Administrative organization REGULATION Federal Public Services: exercising the art of healing hospital legislation (hospital budget, accreditation standards, planning) medicines marketing authorization & drugs/medical devices policy (through Agency) Other public health issues NIHDI: Management of the health care insurance 6
7 1. Administrative organization REGULATION (2) NIHDI (continued) financial management of the system administrative organization of the system support provided during consultation process development of databases granting special provisions 7
8 1. Administrative organization REGULATION (3) NIHDI STRUCTURE Management bodies: General Board (Government, workers, employers, mutualities) Insurance Committee (mutualities, health care providers) Insurance bodies: Conventions and agreements commissions Technical boards 8
9 1. Administrative organization REGULATION (4) NIHDI STRUCTURE (continued) Scientific bodies: Scientific Board for Chronic Diseases National Board for Quality Promotion Assessment Committee for Drug Prescription 9
10 1. Administrative organization EXECUTION MUTUALITIES reimbursement to all persons insured negotiating prices and fees (collectively) information 10
11 1. Administrative organization CONTROL Mutualities NIHDI Administrative control Medical evaluation and control (reality/conformity and overconsumption) Mutualities Control Body 11
12 2. Entitlement Starting from 1/01/2008, there is only one scheme with the same risks covered for all entitled persons and their dependants The scheme covers active and nonactive people and their dependants. The main insured members are entitled to health insurance on the basis of their current or previous profession. 12
13 2. Entitlement The main entitled persons have the right to health care only if contributions have been paid and equal a minimum amount (i.e. contributions paid on a minimum wage of 4.162,47 for employees below 21 years and 5.549,96 for employees of 21 years and over). The contribution can be in the form of social security contributions or personal payments. If the main entitled person has the right to health care, his dependants will have that same right also. 13
14 3. Funding SOURCES OF FUNDING Social contributions (through social security NSSO) employers (3,80 % of the salary) workers (3,55 % of the salary) State subsidies and taxes (VAT) Specific contributions, such as Insurance companies Pharmaceutical industry 14
15 3. Funding Flux Social Contributions NATIONAL LEVEL Public Health Social Affairs State contributions, taxes, VAT, Supervision National Office of Social Security Regulation NIHDI 3rd party payer system Mutualities transfers Reimbursement Services, regulation, supervision Funds Health care provides Direct payment Services Insured people (patients) Regulation Health promotion SUBNATIONAL LEVEL Communities and regions 15
16 3. Funding Year 2010 In billions of In % Global management ,7 VAT / Excises ,9 Contributions pensioners and others 864 3,1 Insurance companies 733 2,6 Taxes on pharmaceutical products 255 0,9 External transfers 479 1,7 Others 30 0,
17 Estimated composition of the public financing of the Belgian health system 2009 (in million ) Own receipts Transfers from general scheme Transfers from self-employed Total Social contributions Subsidies Alternative financing Allocated receipts Divers (66,3 %) (10,4 %) (13,7 %) (5,8 %) (3,7 %) Total (100,0 %) 17
18 Some important data from 2007 with regard to Belgian health care expenses (Source : FPS Social Security and NIHDI) TOTAL HEALTH CARE EXPENSES ,3 (in millions of ) GDP = ,80 Mio EUR 9,8 % GDP Private Public , ,90 Reimbursements through security social Through NIHDI (excl. Soc & fisc MAF + regul 171,90) , ,40 Out of pocket 6.226,80 Insurances 1.627,20 Through Mutualities 889,30 In pharmacies 2.340,70 18
19 BELGIAN HEALTH CARE SYSTEM 3. Funding Expenditure Health care budget of the NIHDI ,3 billion ,3 billion ,4 billion ,5 billion ,6 billion ,4 billion ,1 billion ,2 billion 19
20 3. Funding Source : OECD Health Data Version: October 2009 Total health expenditure as % of GDP, 2007 (US $) per capita / Belgium 2007 Public health expenditure as % of total health expenditure, 2007 % GDP % % BE 10,2 100 % 72,3 NL 9,8 * 107 % 74,8 FR % 79 DE 10,4 100 % 76,9 UK 8,4 83 % 81,7 CZ 6,8 45 % 85,2 US % 45,4 * Exclusive investment 20
21 Figure 1. Total health expenditure expressed as % of GDP in selected OECD countries,
22 Figure 2. Total health expenditure expressed per capita (US$ PPP) in selected OECD countries,
23 3. Funding RESOURCES OF THE MUTUALITIES Budget : distribution based on» real expenses (70 %)» risk profile (30 %) Accounts : in case of a surplus or deficit, the insurance carriers can keep part of the surplus or they have to cover part of the deficit (max 25 % and limited to 2 % of the budget share) 23
24 4. Coverage WHICH PROVISIONS ARE COVERED? Preventive and curative care mentioned in a nomenclature (consultations, visits, special technical provisions, dental care, nurse care, physiotherapy, implants, prostheses, equipment, ) mentioned on the positive list of medicines intervention for a hospital stay or for treatment in a health care institution Are excluded: esthetic care provisions that do not meet the reimbursement criteria 24
25 4. Coverage HOW MUCH DOES THE INSURANCE PARTICIPATION AMOUNT TO? Medical care: 75 % of the conventional fees Medicines: according to the category of medicine» cat A (severe and prolonged diseases) 100%» cat B (medicines useful from a social and medical point of view) 75%» cat C, Cs, Cx (medicines with a low therapeutic value) 50% to 20% Hospitalization: fix amount per admission + fix amount per day to be paid by the people insured (cost of stay and medicines) 25
26 4. Coverage HOW MUCH DOES THE INSURANCE PARTICIPATION AMOUNT TO? (2) Social corrections Increased reimbursement beneficiary (IRB) - OMNIO Maximum Billing (MAF) Special Solidarity Fund Real personal contribution on average 7.07 % (2007) after being taken into account in the maximum bill 26
27 4. Coverage WHO DOES DETERMINE WHICH PROVISIONS CAN BE REIMBURSED? Legal definition of the health care package Establishment of the nomenclature of the medical provision of services and related lists by mixed technical commissions of NIHDI (health care providers, universities, insurance carriers) and confirmation by the management bodies and the minister Determination of the relative values of the provisions 27
28 4. Coverage FEES Fees for service or drug delivery Fix fees (per day, per admission) Mixed fees REIMBURSEMENT BASES Medicines and medical devices BUDGETS ACTIVITY BASED OR PER DIEM Hospitals, day centers, rest homes, rehabilitation centers 28
29 4. Coverage HOW TO FIX TARIFFS? Conventions (equal composition) Agreement within a national joint commission Approval by the management bodies and the minister Adhesion of a minimum amount of health care providers (60 %) If no agreement: reference tariff or government tariff 29
30 Basic characteristics of the system Compulsory social insurance (refund system); Close to a universal coverage; Management, consultation and agreements on fees by and with the social partners, health insurance funds and health care providers; Freedom to choose the health care provider and major therapeutic freedom; Reasonable prices but sometimes big quantities; 30
31 Basic characteristics of the system Pretty good score in terms of accessibility; Financial solidarity (contributions completed by state interventions); Fee of the health care provider is mainly based on the operation performed; Large selection of health care providers and structures; Focus on the vertical organization (structure with compartments) rather than the horizontal approach (integrated care). 31
32 Major health care reforms : 1. Increasing accessibility Protection measures The compulsory coverage of self-employed has been extended to minor risks Extension of the OMNIO-system to all persons under a fixed income limit More categories of out-of-pocket payment are progressively integrated in the MAB-counter Fixed payments systems (chronically ill patients, incontinence material, ) Plan for chronically ill patients Supplements in two-person rooms forbidden 32
33 Major health care reforms : 1. Increasing accessibility Mechanisms to provide an adequate supply Reinforcement of attractiveness of the GP profession (Impulseo fund, ) the nursing profession in hospitals, nursing homes and home care (VINCA project, ) Improving elderly care Innovative projects to allow older people to remain as long as possible in their homes Converting beds in homes into nursing home beds Prevention measures National Cancer plan National Action Plan for Alcohol 33
34 Major health care reforms : 2. Assuring health care quality Assessing the performance of the health system Regular reporting on health system performance in Belgium (1 st report June 2010) Making health care providers accountable Improving prescribing behaviour Additional feedback on prescription (e.g. Prenatal care) Recommendations for pharmaceutical products Medical evaluation and inspection departement Reform (structure, mission and enforcement rules) New definitions on breach of responsibilities from health care providers + penalties and measures 34
35 Major health care reforms : 2. Assuring health care quality Strengthening primary care Expanding the preventing role of GP Promoting grouping of GP s (Impulseo II) Promoting the integration of health services and multidisciplinarity Patient pathways (chronic renal failure and types 2 diabetes) Therapeutic projects in mental health care National Cancer plan 35
36 Major health care reforms : 3. Maintaining financial sustainability Fund for the future of healthcare Pharmaceuticals Provisional fund for pharmaceuticals Reforms of the reference reimbursement system New system of remuneration for pharmacists Implants and medical devices New Commission Notification for each implant New reimbursement procedure 36
37 Future development Simplification of administrative procedures (OMNIO, ) Additional measures for chronically ill Increasing attractiveness of GP and nursing profession Improving organization of medical emergency Reducing medical radiation exposure Recognition standards for paramedical professions 37
38 MORE QUESTIONS? 38
SYSTEM. Ri DE RIDDER Chief Executive of the Health Care Department NIHDI
BELGIAN HEALTH CARE SYSTEM Ri DE RIDDER Chief Executive of the Health Care Department NIHDI 1 The Belgian health insurance is a system of reimbursement fees Doctor, dentist, physiotherapist, wheelchair,...
More informationThomas Rousseau NIHDI - COOPAMI 2. Ulla Cahay NIHDI - COOPAMI
11-05-2017 Thomas Rousseau NIHDI - COOPAMI 2 Ulla Cahay NIHDI - COOPAMI Agenda Characteristics of the Belgian health care system Standard procedure : reimbursement NIHDI? Questions? Characteristics of
More informationA Belgian cooperation platform Thomas Rousseau NIHDI - COOPAMI. Thomas Rousseau NIHDI - COOPAMI 2
A Belgian cooperation platform www.coopami.org Thomas Rousseau NIHDI - COOPAMI Thomas Rousseau NIHDI - COOPAMI 2 24-10-2013 The Belgian health insurance I. Basic principles of the Belgian health insurance
More informationThe NIHDI. A closer look. National Institute for Health and Disability Insurance. Thomas Rousseau Coopami
The NIHDI National Institute for Health and Disability Insurance A closer look Thomas Rousseau Coopami 8 March 2016 NIHDI? Governance and regulation of the Belgian compulsory health care (and benefits)
More informationA Belgian cooperation platform Thomas Rousseau NIHDI - COOPAMI. Thomas Rousseau NIHDI - COOPAMI 2
A Belgian cooperation platform www.coopami.org Thomas Rousseau NIHDI - COOPAMI Thomas Rousseau NIHDI - COOPAMI 2 29-02-2012 What i m going to talk about Social security Presentation: ti only on social
More informationCompulsory Health Insurance in Lithuania
Compulsory Health Insurance in Lithuania Aurimas Baliukevičius Acting Director and Jūratė Sabalienė Head of International Affairs Department NATIONAL HEALTH INSURANCE FUND Riga 31/03/2017 Outline History
More informationFREQUENTLY ASKED QUESTIONS SUNSHINE ACT
FREQUENTLY ASKED QUESTIONS SUNSHINE ACT 1. What exactly is the obligation of transparency? The obligation of transparency imposes pharmaceutical and medical devices companies, both Belgian and foreign,
More informationFREQUENTLY ASKED QUESTIONS SUNSHINE ACT
FREQUENTLY ASKED QUESTIONS SUNSHINE ACT 1. What exactly is the obligation of transparency? The obligation of transparency imposes amongst others pharmaceutical and medical devices companies, both Belgian
More informationOECD Health Committee Survey on Health Systems Characteristics 2016 ROUND
OECD Health Committee Survey on Health Systems Characteristics 2016 ROUND PART I. HEALTH CARE FINANCING Section 1: Characteristics of basic health care coverage Section 2: Regulation of health insurance
More informationNew Era of National Health Insurance in Taiwan. Huang San-Kuei Director General, National Health Insurance Administration October 31, 2014
New Era of National Health Insurance in Taiwan Huang San-Kuei Director General, National Health Insurance Administration October 31, 2014 Contents 1 Current Development and Challenges 2 Innovation in NHI
More informationEFFICIENCY AND TRANSPARENCY IN PRICING
1 EFFICIENCY AND TRANSPARENCY IN PRICING SHANG-PING CHEN RESEARCHER DIVISION OF MEDICAL REVIEW AND PHARMACEUTICAL BENEFITS NATIONAL HEALTH INSURANCE ADMINISTRATION (NHIA), TAIWAN 2014/10/31 Outline 2 Drug
More informationNIHDI INAMI RIZIV- LIKIV NOMENCLATURE AND ALTERNATIVE WAYS OF FINANCING MEDICAL ACTS
NIHDI INAMI RIZIV- LIKIV NOMENCLATURE AND ALTERNATIVE WAYS OF FINANCING MEDICAL ACTS Dr Antonine Wyffels 11/03/2014 Introduction National Institute for Health and Disability Insurance: organizes the reimbursement
More informationReporting of Transfers of Value to HCPs and HCOs Methodological Note for Reporting of 2017 Data in 2018
NV ASTRAZENECA SA BE 0400.165.679 110, rue Egide Van Ophemstraat B-1180 Brussels Belgium Reporting of Transfers of Value to HCPs and HCOs Methodological Note for Reporting of 2017 Data in 2018 Contents
More informationThe Netherlands. Health Care & Long-Term Care Systems
The Netherlands Health Care & Long-Term Care Systems An excerpt from the Joint Report on Health Care and Long-Term Care Systems & Fiscal Sustainability, published in October 2016 as Institutional Paper
More informationThe Estonian Health Insurance System
The Estonian Health Insurance System Pille Banhard Estonian Health Insurance Fund Member of the Board 31.03.2017 Background Estonian health insurance is a social insurance and it relies on the principle
More informationMultinational Comparisons of Health Systems Data, Roosa Tikkanen The Commonwealth Fund
Multinational Comparisons of Health Systems Data, 217 Roosa Tikkanen The Commonwealth Fund Health Care Spending HEALTH CARE SPENDING Health Care Spending per Capita, 2 216 Adjusted for Differences in Cost
More informationPocket Statistics. The Social Insurance Institution of Finland
Pocket Statistics 2013 The Social Insurance Institution of Finland pocket statistics The Social Insurance Institution 2013 general 1 pensions 6 disability 12 health insurance 13 rehabilitation 19 unemployment
More informationThe Performance of the Greek NHS and the Economic Adjustment Programme. Babis Economou Assistant Professor, Panteion University
The Performance of the Greek NHS and the Economic Adjustment Programme Babis Economou Assistant Professor, Panteion University The Structure of the Presentation The performance of the Greek NHS The Relation
More informationTakeda Belgium - Methodological note 2015
Takeda Belgium - Methodological note 2015 Accompanying document for the public transparency of transfer of value to Healthcare Professionals and Healthcare Organisations 1. General introduction... 2 2.
More informationPocket Statistics. The Social Insurance Institution of Finland
Pocket Statistics 2015 The Social Insurance Institution of Finland pocket statistics The Social Insurance Institution 2015 General 1 Pensions 7 Disability 12 Health insurance 13 Rehabilitation 20 Unemployment
More informationExhibit ES-1. Total National Health Expenditures (NHE), Current Projection and Alternative Scenarios
Exhibit ES-1. Total National Health Expenditures (NHE), 2009 2020 Current Projection and Alternative Scenarios NHE in trillions $6 $5 Current projection (6.7% annual growth) Path proposals (5.5% annual
More informationSanofi-Aventis Bulgaria EOOD Methodological Note
Sanofi-Aventis Bulgaria EOOD Methodological Note INTRODUCTION Collaboration between healthcare professionals and Pharmaceutical Companies has long been a positive driver for advancements in patient care
More informationYour Healthcare Package
Your Healthcare Package The Sickness Insurance Ordinance The medical services that are covered in the Sickness Insurance Ordinance is based on the regulations established by the law in the Sickness insurance
More informationUnitedHealthcare Choice Plus. United HealthCare Insurance Company. Certificate of Coverage
UnitedHealthcare Choice Plus United HealthCare Insurance Company Certificate of Coverage For the Definity Health Savings Account (HSA) Plan 7PC of East Central College Enrolling Group Number: 711369 Effective
More informationHealth Expenditure and Finance Data presented in OECD Health Data 2013 are based on:
Hungary Health Expenditure and Finance Data presented in OECD Health Data 2013 are based on: Joint OECD-Eurostat-WHO SHA-consistent national Locally produced national SHA collection health accounts health
More informationHEALTHCARE: INTRODUCTION MAIN ISSUES IDENTIFIED BY THE COMMITTEE:
HEALTHCARE: The Future of Health in Estonia Multi-Sector Collaboration to Ensure Proper Business Climate, Healthy Workforce, and Attractiveness for Current & Future Investment INTRODUCTION The Estonian
More informationMultinational Comparisons of Health Systems Data, 2010
1 Multinational Comparisons of Health Systems Data, 21 Gerard F. Anderson and Patricia Markovich Johns Hopkins University November 21 Support for this research was provided by The Commonwealth Fund. 2
More informationGENERAL INFORMATION INDEX
INDEX INDEX... 3 GENERAL... 4 1. SCOPE & APPLICATION OF THE SCOTTISH DRUG TARIFF... 4 2. FREQUENCY OF PUBLICATION... 5 3. DETAILS OF AMENDMENTS SINCE LAST PUBLISHED EDITION... 5 4. STANDARDS OF QUALITY
More informationThe Affordable Care Act and the Essential Health Benefits Package
October 24, 2011 The Affordable Care Act and the Essential Health Benefits Package A. Background Under the Affordable Care Act (the ACA or the Act ), and starting in 2014, certain low to moderate income
More informationPriority Series PRIORITY SERIES
PRIORITY SERIES 35 Key features Benefits available on the Priority Series Unlimited cover in any private hospital Guaranteed full cover in hospital for specialists on a payment arrangement, and up to 200%
More informationPharmacy Coverage and Claim Submission Guidelines
P R O V I D E R B U L L E T I N B T 2 0 0 0 0 1 8 J U N E 1, 2 0 0 0 To: Subject: All Indiana Health Coverage Programs Providers Overview The purpose of this bulletin is to provide coverage and reimbursement
More informationANNUAL NOTICE OF CHANGES FOR 2019
Cigna HealthSpring Advantage (HMO) offered by Cigna HealthSpring ANNUAL NOTICE OF CHANGES FOR 2019 You are currently enrolled as a member of Cigna HealthSpring Advantage (HMO). Next year, there will be
More informationBulgaria. Health Care & Long-Term Care Systems
Bulgaria Health Care & Long-Term Care Systems An excerpt from the Joint Report on Health Care and Long-Term Care Systems & Fiscal Sustainability, published in October 2016 as Institutional Paper 37 Volume
More informationUnitedHealthcare Choice Plus. UnitedHealthcare Insurance Company. Certificate of Coverage
UnitedHealthcare Choice Plus UnitedHealthcare Insurance Company Certificate of Coverage For the Plan 21D of Big Walnut Local School District Enrolling Group Number: 753271 Effective Date: January 1, 2016
More informationALLIANCE DOUBLE PLUS VITAL ESSENTIAL FIRST CHOICE NETWORK CHOICE
HOSPITAL ACCOMMODATION INCLUDING CONFINEMENTS SUBJECT TO PRE-AUTHORISATION ATTENDING DOCTORS AND SPECIALISTS CONSULTATIONS MEDICAL AND SURGICAL PROCEDURES INCLUDING CONFINEMENTS AUXILIARY HEALTHCARE IN
More informationA SUMMARY OF MEDICARE PARTS A, B, C, & D
A SUMMARY OF MEDICARE PARTS A, B, C, & D PROVIDED BY: RETIRED INDIANA PUBLIC EMPLOYEES ASSOCIATION RIPEA AUTHOR: JAMES BENGE, RIPEA INSURANCE CONSULTANT 1 M E D I C A R E A Summary of Parts A, B, C, &
More informationDrug Reimbursement - Croatia. Roganovic Jelena
Drug Reimbursement - Croatia Roganovic Jelena Population: 4,292,095 (July 2017) Area: 56,594 km 2 Density: 75.8/km 2 21 counties http://www.lokalniizbori.com/wp-content/uploads/2013/04/hrvatska-%c5%beupanije.jpg;
More informationOECD Financial sustainability of healthcare systems Healthcare Productivity in the UK
OECD Financial sustainability of healthcare systems Healthcare Productivity in the UK Anita Charlesworth Chief Economist, Nuffield Trust 26 March 2013 This presentation covers: The budget outlook for publicly
More informationFirst Balkan Forum on: Health Care Reform
First Balkan Forum on: Health Care Reform ALBANIA: AN OVERVIEW of THE HEALTH SYSTEM & HEALTH INSURANCE SCHEME Ms. Elvana Hana General Director Albanian Health Insurance Institute November 2007 1 Albania
More informationSaver Series. The most cost-effective in-hospital and out-of-hospital cover. Unlimited private hospital cover. Essential cover for chronic medicine
Saver Series Classic Classic Delta Essential Essential Delta Coastal The most cost-effective in-hospital and out-of-hospital cover Unlimited private hospital cover Essential cover for chronic medicine
More informationYour cover for day-to-day medical expenses
Your cover for day-to-day medical expenses We pay day-to-day medical expenses like GP visits, radiology and pathology from your Medical Savings Account, as long as you have money available. If you run
More informationHong He Min-Min Lyu Nari Park May 2, 2012 South Korea Health Care System South Korea formed a Universal Healthcare system in 1977 which is controlled
Hong He Min-Min Lyu Nari Park May 2, 2012 South Korea Health Care System South Korea formed a Universal Healthcare system in 1977 which is controlled by the government and managed under the NHIC (National
More informationHealth Sector Dynamics
Issue 1 January 216 Health Sector Dynamics Contents At a glance 1 Expenditure on health 2 Health system characteristics and reforms 6 Recent developments 12 Abbreviations 13 Definitions 13 References 13
More informationExtended Health Care Benefits
Extended Health Care Benefits Insurance companies, through the employer and under a group insurance plan, offer extended health care benefits beyond what is provided under Government plans (e.g. OHIP and
More informationUniversal health coverage roadmap Private sector engagement to improve healthcare access
Universal health coverage roadmap Private sector engagement to improve healthcare access Prepared for the World Bank February 2018 Copyright 2017 IQVIA. All rights reserved. National health coverage has
More informationWhatever your Medicare needs, we can help you choose the solution that s right for you.
UnitedHealthcare offers a family of Medicare options to help you get the most from your Medicare coverage, including: Whatever your Medicare needs, we can help you choose the solution that s right for
More informationChoices NL. Comprehensive local & international medical insurance for expats living in the Netherlands.
Choices NL Comprehensive local & international medical insurance for expats living in the Netherlands. Introducing Choices NL Alexander Beard International Benefits is the broker and advisor of the insured
More informationPriority Series PRIORITY SERIES PLAN SUMMARY CLASSIC ESSENTIAL
Priority Series 2014 PRIORITY SERIES PLAN SUMMARY 2014 CLASSIC ESSENTIAL KEY FEATURES Classic Essential Unlimited cover in any private hospital Guaranteed full cover in hospital for specialists on a payment
More informationReporting of Transfers of Value to HCPs and HCOs Methodological Note for Reporting of 2017 Data in 2018
Reporting of Transfers of Value to HCPs and HCOs Methodological Note for Reporting of 2017 Data in 2018 AstraZeneca Pharmaceuticals (Ireland) DAC, Company registration number: 55502 Ireland, Address of
More informationBERMUDA HEALTH INSURANCE (FUTURECARE PLAN) (ADDITIONAL BENEFITS) ORDER 2009 BR 26 / 2009
QUO FA T A F U E R N T BERMUDA HEALTH INSURANCE (FUTURECARE PLAN) (ADDITIONAL BENEFITS) ORDER BR 26 / The Minister responsible for health, in exercise of the powers conferred by section 13B of the Health
More informationCoverage Period: 07/01/ /31/2018 Coverage for: Individual, Family Plan Type: EPO
Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services New England Health Care Employees Welfare Fund: Wage Class I Coverage Period: 07/01/2018 12/31/2018 Coverage
More informationDeductible plus $50 Deductible plus $50 40% after Deductible 1, 6. Deductible plus $50
204 Benefits Summary - RETIREMENT VISION PAID TIME OFF MEDICAL DENTAL LIFE DISABILITY RETIREMENT VISION PAID TIME OFF MEDICAL DENTAL LIFE DISABILITY RETIREMENT VISION PAID TIME OFF MEDICAL DENTAL LIFE
More information2017 Health Plan Comparison Chart
207 Health Plan Comparison Chart Tenet Network: Tenet-employed physicians, Tenet-owned facilities, Tenet ACO/CIO physicians In-Network: Physician or facility within carrier network Out-of-Network: Physician
More informationAdditional Information Provided by Aetna Life Insurance Company
Additional Information Provided by Aetna Life Insurance Company Inquiry Procedure The plan of benefits described in the Booklet-Certificate is underwritten by: Aetna Life Insurance Company (Aetna) 151
More informationReporting of Transfers of Value to HCPs and HCOs Methodological Note for Reporting of 2017 Data in 2018
Reporting of Transfers of Value to HCPs and HCOs Methodological Note for Reporting of 2017 Data in 2018 AstraZeneca Pharma Poland Sp. z o.o. 0000117902 Postepu 14, 02-676 Warsaw Contents 1. Introduction...
More informationBenefits and Premiums are effective January 01, 2018 through December 31, 2018 PLAN DESIGN AND BENEFITS PROVIDED BY AETNA HEALTH PLANS INC.
Benefits and Premiums are effective January 01, 2018 through December 31, 2018 PLAN FEATURES Network Providers Annual Maximum Out-of-Pocket Amount $6,700 The maximum out-of-pocket limit applies to all
More informationAdditional Information Provided by Aetna Life Insurance Company
Additional Information Provided by Aetna Life Insurance Company Inquiry Procedure The plan of benefits described in the Booklet-Certificate is underwritten by: Aetna Life Insurance Company (Aetna) 151
More informationBenefits Table. Your Health First. Worldwide Plans. effective 1/1/ Additional Options
Maternity - waiting period of 12 months applies - benefit limits on a per pregnancy basis - elective caesarean surgery excluded - Pregnancy 8% Not 8% Not Not Not Not - Childbirth The covered amount includes
More informationSchedule of Benefits. Plumbers Union Local 12 PPO. A Prime Solutions PPO Plan
Schedule of Benefits Plumbers Union Local 12 PPO A Prime Solutions PPO Plan health plan meets Minimum Creditable Coverage standards and will satisfy the individual mandate that you have health insurance.
More informationCHOOSING A PRODUCT ACCORDING TO YOUR LIFESTYLE NEEDS:
Feel confident that someone is always on your side. 2014 CHOOSING A PRODUCT ACCORDING TO YOUR LIFESTYLE NEEDS: I need quality care where I control my benefits Bonitas offers you unlimited hospitalisation
More informationCOVENTRY HEALTH CARE OF DELAWARE, INC. DIAMOND PLAN 2 (Maryland)
COVENTRY HEALTH CARE OF DELAWARE, INC. DIAMOND PLAN 2 (Maryland) The benefits described in this Diamond Plan 2 are in addition to the benefits offered under Coventry Health Care of Delaware, Inc. Small
More informationCommon Managed Care Terms & Definitions
Contact Us: Email: info@emedbiz.com Phone: 561-430-2090 Fax: 561-430-2091 Website: www.emedbiz.com Common Managed Care Terms & Definitions Balance billing: The practice of billing a patient for the amount
More informationIntroduction to the US Health Care System. What the Business Development Professional Should Know
Introduction to the US Health Care System What the Business Development Professional Should Know November 2006 1 Understanding of the US Health Care System Evolution of the US health care system to its
More informationMedicare Educational Video. Presented by: Medicare Simplified Medicare Simplified. All rights reserved.
Medicare Educational Video Presented by: Medicare Simplified Copyright 2014 Medicare Simplified. All rights reserved. TABLE OF CONTENTS SUBJECT TIME ON CLOCK(HR/MIN/SEC) INTRODUCTION 00:00:00 YOUR MEDICARE
More informationSaskatchewan Ministry of the Economy
Saskatchewan Ministry of the Economy June 2014 SASKATCHEWAN WAGE SURVEY 2013 - HEALTH CARE AND SOCIAL ASSISTANCE INDUSTRY DETALED REPORT SASKATCHEWAN WAGE SURVEY 2013: HEALTH CARE AND SOCIAL ASSISTANCE
More informationAffordable Care Act Affordable Care Act
Affordable Care Act 2010 Affordable Care Act Objectives Overview of the Affordable Care Act (ACA) 2010 Background Medicare Parts A, B, C, and D Medicaid and Medicare: Dually Eligible Social Security Benefits
More informationMINISTRY OF HEALTH APPLICATION FOR MEDICAL CARD (To be submitted to the nearest Hospital or Health Centre)
MINISTRY OF HEALTH APPLICATION FOR MEDICAL CARD (To be submitted to the nearest Hospital or Health Centre) WARNING: Any person who, with a view to obtaining a medical card, either for himself or for any
More informationUnitedHealthcare Choice Plus. UnitedHealthcare Insurance Company. Certificate of Coverage
UnitedHealthcare Choice Plus UnitedHealthcare Insurance Company Certificate of Coverage For the Health Savings Account (HSA) Plan 7PA of Educators Benefit Services, Inc. Enrolling Group Number: 717578
More informationMedicAre: don t delay. apply for Medicare as soon as you become eligible. You ve earned it. Make the most of it.
2015 don t delay. apply for Medicare as soon as you become eligible. MedicAre: You ve earned it. Make the most of it. You can enroll in Medicare the three months before, during and the three months after
More informationReporting of Transfers of Value to HCPs and HCOs Methodological Note for Reporting of 2017 Data in 2018
Reporting of Transfers of Value to HCPs and HCOs Methodological Note for Reporting of 2017 Data in 2018 AstraZeneca Österreich GmbH Landstraßer Hauptstraße 1A, 1030 Wien Firmenbuch FN 51184x, HG Wien Contents
More informationMetadata (SHA 2011) Respondent. To be returned: By: 31/03/2017 To: OECD Eurostat WHO
Metadata (SHA 2011) Country Croatia Respondent To be returned: By: 31/03/2017 To: OECD SHA.Contact@oecd.org Eurostat ESTAT-SHA@ec.europa.eu WHO NHA@who.int General remarks and metadata concerning the tables
More informationBenefits Administrations Checklist
Benefits Administrations Checklist ü Healthcare Exchange Notifications to W-2 Employees Sample letter to employees ü Medical Dues Increase for Traditional Plan for 2014. Medical Dues will increase to 23%
More informationMONGOLIAN HEALTH INSURANCE SCHEME
MONGOLIAN HEALTH INSURANCE SCHEME About Mongolia ABOUT MONGOLIA Landlocked country Population: 2.83 million Territory: 1,564,116 km 2 (603,909 sq mi) 1,580 m above sea-level Average summer temperature
More informationHealth Saving Account. Facts, Rules & Regulations
Health Saving Account Facts, Rules & Regulations 1 Table of Contents Page 3 Page 3 Page 4 Page 4 Page 4 Page 5 Page 5 Page 7 Page 7 Page 7 Page 8 Page 9 Page 9 Page 9-10 Page 10 Page 10 Page 10 What is
More informationNo An act relating to health care financing and universal access to health care in Vermont. (S.88)
No. 128. An act relating to health care financing and universal access to health care in Vermont. (S.88) It is hereby enacted by the General Assembly of the State of Vermont: Sec. 1. FINDINGS * * * HEALTH
More informationCancer Supplemental Insurance Policy with Transplant & Chronic Illness
Marketed by Cancer Supplemental Insurance Policy with Transplant & Chronic Illness SUPPLEMENTAL INSURANCE POLICY Insurance Coverage underwritten by R. 9-2-15 Cancer Lump Sum Benefit 1 50,000 * CANCER LUMP
More informationUniversal Healthcare. Universal Healthcare. Universal Healthcare. Universal Healthcare
Universal Healthcare Universal Healthcare In 2004, health care spending in the United States reached $1.9 trillion, and is projected to reach $2.9 trillion in 2009 The annual premium that a health insurer
More informationReporting of Transfers of Value to HCPs and HCOs Methodological Note for Reporting of 2017 Data in 2018
AstraZeneca Latvija 40103252820 Skanstes iela 50, Rīga, LV-1013 Reporting of Transfers of Value to HCPs and HCOs Methodological Note for Reporting of 2017 Data in 2018 Contents 1. Introduction... 4 Approach
More informationExpatPlus Benefits Guide Effective 1 st January 2008
In the tables below we have summarised the benefits applicable for each product option. Please refer to the general conditions for full benefit details and definitions. All benefits shown are per insured
More information1199SEIU NATIONAL BENEFIT FUND FOR ROCHESTER AREA MEMBERS OVERVIEW OF YOUR BENEFITS
1199SEIU NATIONAL BENEFIT FUND FOR ROCHESTER AREA MEMBERS OVERVIEW OF YOUR BENEFITS Medical Benefits are provided through MVP Health Care. Dental Benefits are provided through Excellus BlueCross BlueShield.
More informationLong-term care the problem of sustainable financing (Ljubljana, November 2014) 1
Long-term care the problem of sustainable financing (Ljubljana, 18-19 November 2014) 1 Matěj Lipský Social Services Centre Tloskov Vojtěška Hervertová Ministry of Labour and Social Affairs 1. How would
More informationReporting of Transfers of Value to HCPs and HCOs Methodological Note for Reporting of 2017 Data in 2018
AstraZeneca Eesti OÜ Reg. kood 11733875 Järvevana tee 9 11314 Tallinn Estonia Reporting of Transfers of Value to HCPs and HCOs Methodological Note for Reporting of 2017 Data in 2018 Contents 1. Introduction...
More informationSchedule of Benefits
Schedule of Benefits NHP Prime HMO plan for GIC members Exclusively for members of the Group Insurance Commission health plan meets Minimum Creditable Coverage standards and will satisfy the individual
More informationNotes to the hospitalisation plan
Policyholder: VUB Policy number: 07/2793.01 07//2793.03 Notes to the hospitalisation plan This version is valid as of 1/10/2016. This group insurance policy, which is concluded by VUB on behalf of its
More informationMedical & Dental Benefit Plan. Sample Employee Benefit Booklet Describing a Health Spending Account
Medical & Dental Benefit Plan Sample Employee Benefit Booklet Describing a Health Spending Account 1 Table of Contents Benefit Plan Description Purpose 2 Participation 2 Plan Changes 2 Funding - Deposits
More information2017 Health Plan Comparison Chart
207 Health Plan Comparison Chart Tenet Network: Tenet-employed physicians, Tenet-owned facilities, Tenet ACO/CIO physicians In-Network: Physician or facility within carrier network Out-of-Network: Physician
More informationTerms Defined. Participating/Non-Participating Provider. Benefits Coverage Charts. Prescription Drug Purchases. Pre-Authorization
Medical Coverage Terms Defined Participating/Non-Participating Provider Benefits Coverage Charts Prescription Drug Purchases Section Two MEDICAL COVERAGE Pre-Authorization Coordination of Benefits Questions
More informationReporting of Transfers of Value to HCPs and HCOs Methodological Note for Reporting of 2017 Data in 2018
Reporting of Transfers of Value to HCPs and HCOs Methodological Note for Reporting of 2017 Data in 2018 AstraZeneca Bulgaria EOOD Registration number 201340239 36 Dragan Tsankov, Bulgaria, Sofia1057 Contents
More informationUnderstanding Your Medicare Options. Medicare Made Clear
Understanding Your Medicare Options Medicare Made Clear 1. Eligibility 2. Coverage Options 3. Enrollment 4. Next Steps 5. Resources Agenda 2 ELIGIBILITY Medicare Made Clear ELIGIBILITY Original Medicare
More informationSame-sex Marriages Affect on Employee Benefit Plans. General rule Follow the same rules that apply to married employees.
Same-sex Marriages Affect on Employee Benefit Plans General rule Follow the same rules that apply to married employees. Retirement Plans - Beneficiary The primary beneficiary must be the spouse unless
More informationEmployee Health Benefits
Employee Health Benefits Table of Contents 1. Overview... 1 2. Training Objectives... 2 3. Resources... 3 4. Health Savings Accounts... 4 a. Benefits of an HSA account... 4 b. Who Qualifies for an HSA?...
More informationBenefits and Premiums are effective January 01, 2019 through December 31, 2019 PLAN DESIGN AND BENEFITS PROVIDED BY AETNA HEALTH PLANS INC.
Benefits and Premiums are effective January 01, 2019 through December 31, 2019 PLAN FEATURES Network Providers Annual Maximum Out-of-Pocket Amount $3,400 The maximum out-of-pocket limit applies to all
More informationThe HPfHR 3-Tier System
The HPfHR 3-Tier System The basic level (Tier 1) of the new healthcare system would cover the entire population- from cradle to grave and would include, based on evidenced based data, all medical, surgical
More informationHealth Insurance Terms You Need To Know
From [C_Officialname] Health Insurance Terms You Need To Know The health care system in the United States can be confusing. In order to get the most out of your health care benefits, you need to understand
More informationSchedule of Benefits. Plumbers Union Local 12 HMO. A Prime Solutions HMO Plan
Schedule of Benefits Plumbers Union Local 12 HMO A Prime Solutions HMO Plan health plan meets Minimum Creditable Coverage standards and will satisfy the individual mandate that you have health insurance.
More informationStandard Life And Accident Insurance Company: PremiumSaver
This is only a summary. This plan is supplemental to your group s major medical plan. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document
More informationMETHODOLOGY NOTES. TRANSPARENCY DISCLOSURE FOR TRANSFERS OF VALUE (ToV) TO HEALTHCARE PROFESSIONALS (HCP) AND HEALTHCARE ORGANISATIONS (HCO)
METHODOLOGY NOTES TRANSPARENCY DISCLOSURE FOR TRANSFERS OF VALUE (ToV) TO HEALTHCARE PROFESSIONALS (HCP) AND HEALTHCARE ORGANISATIONS (HCO) Country of Disclosure: Belgium Year of Disclosure: 2017 for 2016
More informationGUIDE TO MEDICAL AND DENTAL PLANS
GUIDE TO MEDICAL AND DENTAL PLANS B e n e f i t s e f f e c t i v e J u l y 1, 2 0 1 4 t h r o u g h J u n e 3 0, 2 0 1 5 Choosing your benefits is an important decision. This guide provides you with the
More informationAnthem Blue Cross Your Plan: USC HMO Plan (Two Tiered Network) Your Network: California Care HMO
Anthem Blue Cross Your Plan: USC HMO Plan (Two Tiered Network) Your Network: California Care HMO This summary of benefits is a brief outline of coverage, designed to help you with the selection process.
More informationSUMMARY OF COVERAGES AZPAS BASIC HEALTH INSURANCE & AZPAS PLUS INSURANCE PER
SUMMARY OF COVERAGES AZPAS BASIC & AZPAS PLUS PER 01 10 2017 COVERAGE CONSULTATIONS GENERAL PRACTITIONER CONSULTATIONS BY HEALTHCARE PROVIDERS RELATED TO PREVENTIVE CARE, EXAMINATIONS AND MEDICATION COSTS
More information