Your Prescription for Health: Provincial Drug Insurance Options

Canadians are privileged to have access to universal health care coverage - from annual physical check-ups to emergency medical services, and more. Provincial health plans include coverage for medications you require while you are hospitalized; however, prescription drugs needed outside of an inpatient care setting are not covered.

In order to assist Canadians with the cost of their prescription drugs, each province has a variety of drug insurance program options available to its residents. The program for which you qualify will depend on a few factors including your age, income level, employment status, and whether you are part of other private insurance plans. Here is a quick overview of each province's drug insurance coverage.

British Columbia - Drug insurance in British Columbia (BC) is available through the BC Pharmacare programs. BC residents under the provincial health plan are eligible for the Fair Pharmacare program, which sets your coverage level depending on your income and establishes an appropriate per-person deductible based on that information. Under Pharmacare, there is a variety of other plans including one for people in Licensed Residential Care Facilities, for children living at home with disabilities requiring prescription care, and for victims of Cystic Fibrosis and HIV/AIDS. There are also plans for individuals receiving income assistance and for those with mental health issues.

Alberta - Residents of Alberta are eligible for the Alberta Health and Wellness Prescription Drug Program, which is available to all who are registered with the provincial health care plan. Low-income families can receive subsidized rates on their coverage. There are plans for people under 65 and for seniors, as well as for children of limited income families. Among the specialty programs are plans for those with rare diseases and for patients under palliative care.

Manitoba - Like BC, Manitoba drug insurance coverage is provided to all eligible residents, with the deductible being based on one's income level. To qualify for Pharmacare, you need only be a Manitoba resident who is registered with the provincial health plan, and do not have existing drug coverage from other government programs.

Saskatchewan - Residents of this province have access to drug coverage through the Saskatchewan Drug Plan. All residents of Saskatchewan who are registered under the provincial health plan and do not receive other government assistance for prescriptions are eligible for the Saskatchewan drug insurance program. The program offers a range of options depending on your needs and income level. Programs are available for low income families, and a special program offering reduced costs is available for seniors.

Ontario - The Ontario drug insurance system offers several different coverage options. The Ontario Drug Program (ODP) provides prescription drug coverage to residents who are 65 years of age or older, living in a long term or special care home, or receiving home care or income assistance. For those residents who do not qualify for ODP, the province offers the Trillium Drug Program, which provides assistance to anyone who is registered with the provincial health plan and does not receive 100% prescription drug coverage under an existing group plan. This plan uses an income-based deductible.

Quebec - All residents of Quebec who do not receive drug coverage from other insurance providers are eligible for the Quebec drug insurance program, Regie de l'assurance maladie du Quebec (RAMQ). Premiums for the plan are determined based on income. In Quebec, you must register for either a private prescription drug plan, or for the public health plan by law.

New Brunswick - New Brunswick drug insurance is available through the New Brunswick Prescription Drug Plan, which provides coverage to eligible residents. There are ten separate plans in the program, offering coverage to seniors, people living with illnesses such as Cystic Fibrosis and HIV/AIDS, patients in care facilities, and children in specific circumstances including those with special needs. 

Nova Scotia - Residents of Nova Scotia, who meet the eligibility requirements, can qualify for Pharmacare. The Nova Scotia drug insurance plan is available to individuals receiving income assistance, seniors covered by Medical Services Insurance, and low-income cancer patients. There is also a program for patients with Multiple Sclerosis.

Prince Edward Island - Drug insurance coverage in this province is available through the PEI Drug Programs to residents who meet eligibility requirements. Residents who are 65 or older are eligible for PEI Medicare, while low-income families and their children, people on welfare services, as well as patients with Diabetes or Multiple Sclerosis can apply for the coverage.

Newfoundland/Labrador - Newfoundland drug insurance covers both Newfoundland and Labrador residents who meet the eligibility requirements for the program. The Newfoundland and Labrador Prescription Drug Program is available to residents who qualify for benefits through the Department of Human Resources and Employment, Food Bank recipients, seniors, and select residents who cannot afford prescribed high cost medications. There is also coverage for people with Cystic Fibrosis and Growth Hormone Deficiency.

Yukon - The Yukon drug insurance program provides assistance to a range of residents via several plans. Pharmacare is available to seniors 65 and over and their spouses 60 and over, as well as extended benefits as needed. There is a program for families with children, living under limited income. Drug coverage is also available to those with certain chronic illnesses.

Northwest Territories - You can obtain Northwest Territories drug insurance if you are a resident and if you meet the eligibility requirements. Drug benefits are extended to senior citizens as well as to people facing diseases that are part of the Specified Diseases list. Drug benefits are available through the program to people of Métis descent not otherwise covered.

Nunavut - Residents who meet eligibility requirements can receive Nunavut drug insurance via the Nunavut Health Plan's prescription drug program. Senior citizens, residents who receive income assistance, and individuals facing certain illnesses or conditions are also eligible.

Private drug insurance plans are often available through an employer and should be a person's first choice. There are other nationally-run prescription drug programs that are offered to First Nations members, veterans and current military members, refugees, government employees, and various other groups. For most Canadians, one of the available options, from private to public, will make prescription drugs affordable.

5 Key Principles in HIPAA Training

HIPAA (Health Insurance Portability and Accountability Act)training courses are offered by a large number of health care training companies so there is plenty to choose from. However, not all HIPAA training course are proficient and not all of them contain every necessary topic. There are certain principles, or guidelines, that any HIPAA training module should follow to ensure that trainees truly comprehend the Accountability Act. Read below to find out what these principles are.

Introduction

In the introductory portion of the HIPAA training course, attendees should learn a few things about the statutory and regulatory background of the act, the goals HIPAA strives to achieve, a short overview of Privacy Rule regulations and, in case it is a HIPAA advanced course, a summary of the Security Rule principles. This portion of the training course should help trainees get familiarized with the terms used throughout the course and prepare them for more detailed information surrounding HIPAA.

Covered Entities

The phrase "covered entities" regarding HIPAA requirements has been a subject of controversy ever since the enactment of the law. This is why any proficient HIPAA training course should have a section detailing the various entities which fall under the Privacy Rule so that attendees truly understand what the term comprises. This section of the course should also provide a definition of the term "business associates" and the requirements they have to comply with when performing health care activities on behalf of the above mentioned covered entities.

Protected Health Information (PHI)

This section of HIPAA training should deal with detailing what kind of PHI falls under Privacy or Security Rule regulations. Attendees will learn what PHI includes,how they can use PHI, and how much they are allowed to disclose under these two rules. The training program should detail both what each individual staff member is supposed to do and what administrative safeguards management has to impose to secure the safety and privacy of PHI. Trainees should also find out who they have to contact if they wish to report a misconduct incident.

Policies, Procedures, Enforcement, and Penalties

After presenting the minimum requirements of the Privacy and Securing Rules, HIPAA training should focus on describing the exact policies and procedures health care workers have to follow. The training course should also detail how organizations should enforce these two rules and provide a list of penalties for anyone who does not comply.

Compliance and On-going Programs

Ending the HIPAA training course should be a section where trainees learn what each institution affected by HIPAA regulations should do to make sure they are complying with the legislations. For example, creating compliance programs to ensure that all employees are in tune with privacy rules or designating privacy and security officers that can overview the company's compliance.

These are the key topics any proficient HIPAA training course should cover. If you are looking to attend this type of training module, first make sure that the course you want to enroll in deals with all these very important principles.

Problems in Getting Health Insurances Claim

Health is the bigger issue in today's life and people have to be very much cautious to know about their health and related issues. The changed life style, wrong eating habits, excessive junk food and late night working has become the prominent cause of health issues. The major problems like obesity, heart disease, cancer etc silently penetrate into individual's life without giving any early warning signal. It becomes more complicated when these diseases crosses the limit and individual have no other option just to surrender, so it becomes essential to constantly monitor the health and right insurance policy give the big way to meet with such challenges of the life which comes before us, in the form of health problems.

What is a health insurance policy?

Health insurance is the insurance by an individual for the risk of incoming medical expenses. Overall health expenses risk is estimated and calculated among target groups, and individual insurer get a routine financial structure like monthly premium where money is available in certain insurance agreements for the health care benefits payments. This benefit is monitored and administered by the reputed organizations like some government agencies, nonprofit groups and private businesses. A health insurance policy is agreement between insurance company and an individual or the family which is applicable for the citizens of the country for covering health care costs for all the diseases or some major diseases. An individual needs to know certain points which are involved in the health care policies. These are:

Premium: The amount to be paid by the policy holder for getting the health coverage.

Deductible: This includes the amount which policy holder have to pay for the doctor visits and prescriptions before the insurance company pays its share.

Co-payment: this is the amount which is paid by the insured person to get the doctor service for every visit which is solely born by the individual.

Co-insurance: This is the fixed percentage of amount which individual have to pay. This is the percentage of the total cost which is shared by the insured person.

Exclusion: This refers to indicate that insurance policy will cover for which services and insurer have to pay for services which are not covered in the policy.

Coverage limits: This would reveal that the health care policy would cover the health care up to maximum limits, remaining expenditure will be born be the individual policy holder.

Capitation: This is the amount paid by the insurer to the health care provider for the treatment of all the members of the insurer.

prior authorizations: This is the authorization or certification necessary for getting the payment for medical services utilized by the insurer.

Explanation of benefits: this is the document which reveals the medical services covered by the insurance policy provider and payment terms and conditions.

Problems in getting heath insurance claims

It is quite complicated to deal with the problems to potential health insurance claims. It is as tedious as maintaining good care of your body. It is utmost essential to thoroughly read the major prospect of the policy and it is quite necessary to know that what all services are covered in by your policy and what not? At that same time the medical service provider must also know that does your policy covers the given medical treatment services. If it doesn't covers the same then it is not possible to get medical insurance claims It is important for the insurer to procure medical service and the policy papers for getting the quick claims. Some of the private investigations on the matter of the medical problems bring out the facts that the insurer gets huge trouble in getting their medical claims. There are few vital point if they are properly followed then surely an individual will have not much problem in getting the medical insurance claims.

First of all you should know what type of coverage is in your policy.

Get the confirmation from the customer service department for your plan in the writing.

Document your contacts.

If your problem is not resolved or getting delayed then you can take up expedite grievance process.

If your problem is not resolved and the condition is not danger to your health then write letter explaining your concern. This is called filing a grievance. This letter will project your problem and initiated steps you took to solve the problem. It should have the copies of any supporting documentation from doctor or the medical representative.

In addition to filing a grievance with your plan, you can also file a complaint with the Insurance Commissioner's office.

Conclusion

At any point in the dispute of getting the claim, it becomes necessary to select an expert medical insurance claim attorney. He must be able to contact the insurance company before commencing a law suit against them preceding a law suit is a costly and stressful affair and will not result in solving the problem.

I am Chandraprakash Babu, a private investigators in Salem. I spent 15 valuable years of my life in the field of private investigation, corporate investigations, insurance investigations, skip tracing, verification services and business investigation. I worked with corporate risk protection management groups in Salem to provide various investigation services in the above mentioned fields. I started my career as a ground investigator, but later on my dedication and consistent hard work made me to get the prestigious position of Managing Director of a multinational group of corporate risk protection companies.

Senior Health Insurance - Where Did It Go?

Once you retire and no longer receive the benefits of a group insurance plan from your employer it cannot be stressed enough how important senior health insurance is.

At one time seniors were able to rely on government help for health concerns that become almost mandatory as a person ages. Medical services such as eye exams, dental care, prescriptions, hospital care and ambulance transport are no longer all available without charges based on provincial medical insurance. Although there are still some coverage for seniors offered by provincial plans, not everything is covered.

At one time it was all so simple, however now we need to take notice and be aware of the situation regarding health care for seniors. To be part of a group insurance plan in the workplace is ideal, but in most cases when one retires,the group insurance coverage also ends. There will be millions of baby boomers retiring now and continuing into the near future, this means more medical services and needs within the senior population.

Timing Be Aware

After the age of 55, it is more difficult to get certain types of insurance, whether it be group insurance at your workplace, or health insurance from private sources that will cost more. After the age of 70 it is very difficult to find any private supplemental health insurance. As time goes by the need for supplemental health insurance becomes more important. Senior health insurance is more expensive in some situations because of the risks the insurance company consider could be involved, for example an extended illness of the insured costing many thousands of dollars, which the insurance company would have to pay, therefore such situations are considered and included in the cost of the policy. We all know that as we age our health becomes more of a concern, therefore getting adequate insurance for possible needs also becomes a concern.

By using good timing and being aware, you can have supplemental insurance that will benefit you when and if you eventually need it. Once you reach the age of retirement, the government will take care of certain medical issues, however, they are limited and supplemental insurance should be high on your list of necessities for all the coverage you may need in case of long term illness, hospital coverage and medication. In addition, you may need long-term therapy, or in home recovery care, these are what supplemental insurance will cover. Speak to an insurance broker about health insurance products that are specifically designed for the needs of seniors. Some plans are meant to take over where the plan from your employer leaves off when you retire so you avoid having a gap when you are not covered.

What you Should Consider

When preparing yourself for retirement and that much-needed extra medical and health insurance, it is a good idea to consider the following:

Different provinces have different plans and so you need to inform yourself on what is covered before you purchase supplemental insurance.

When you buy supplemental health insurance, the older you are on application, the higher the premiums will be. Once you reach the age of 70 it will be more difficult, if not impossible, to find a supplemental health insurance plan.

medical questionnaire and/or exam will be required to sign up for a health insurance plan. Your premium could vary depending on the state of your health.

You do not need to buy everything offered; you can make choices on what coverage you want.

You can get certain individual medical benefits insurance; or insurance that will cover a number of things such as eye health, dental insurance, hospital coverage and many other options.

Whichever plan you choose, you will pay a monthly premium in exchange for those benefits that you have chosen.

The Importance of Senior Health Insurance

By the time we reach the 'seniors' word, our bodies have been ravaged by the wars of life, and sometimes harsh results are forthcoming, these are the times when we definitely need health insurance. Supplemental health insurance is specifically for those needs, the things the government medical plan does not cover. There are special types of supplemental insurance specifically for the senior population. 

Seniors health insurance is an essential commodity. Speak to an insurance specialist about your options.

Why Is Health Insurance a Necessity for Everyone?

What is Health Insurance? Why Do You Need It?

To put it simple, health insurance provides coverage for medical costs incurred from illnesses or injuries. Mediclaim insurance also gives you peace of mind when in times of stress incurred from hospitalization of a loved one. However, it is vital to choose the right kind of insurance as policies provide coverage for a wide range of health needs which may or may not benefit you. In some cases, even a primary Mediclaim insurance will not cover certain illnesses. Hence, choosing the best health insurance is a careful process.

Why Do You Need A Good Mediclaim Insurance?

A good healthcare insurance protects you from medical expenses you can't afford on your own. It also covers a variety of medical expenses including doctor fees, outpatient treatment, hospitalization expenses, prescription medicines, emergency ambulance services, and diagnostics. Mediclaim policies not only provides you with better access to health care, but also reduces your out-of-pocket expenses.

Choosing and Buying A Good Health Insurance

Today, medical expenses are increasing considerably and so are the health risks. Therefore, it is essential to have a Mediclaim policies that not only covers your basic health care expenses, but also miscellaneous expenses. With a wide array of insurance policies, the task of choosing a good medical insurance policy for your needs can be a daunting task. Comparing health policies of different insurance companies will give you a better perspective in finding a good policy. Moreover, there are many insurance companies that offer you policies at affordable rates. Choosing a good Mediclaim insurance policy can help you stay covered from unexpected eventualities.

Here are some things to consider while choosing a good insurance policy:

• Which healthcare insurance plan best suits the needs of you and your family? 

• What are the coverage options available? 

• Does the health insurance policy cover disabilities and other critical illnesses? 

• Does the policy provide extra health covers that could benefit you? 

• Are there any pre-existing clauses that you should know? 

• Most importantly, is your health insurance policy affordable?

While many companies who provide coverage dental and eye care as part of their plan, maternity expenses are covered with a waiting period that differs. Nowadays, even ayurvedic treatments are being covered, making health care, an affordable amenity. A good insurance plan also covers miscellaneous out-of-pocket expenses incurred during or after hospitalization.

Buying Health Insurance Online

Online purchase of insurance is becoming a staple process due to the hassle-free and time-saving processes it includes. The use of an online health insurance calculator is also necessary as it accurately tells you how much you should insure for. Insurance companies also offer a variety of plans that can be easily purchased and renewed online.

Get Your Health Insurance and Ensure a Healthy and Happy Life

We know how much we love our near and dear ones. So much that we would never take a chance of risking their life when they are sick or injured. The cost of health care has been skyrocketing where family loans and personal loans are not reliable; hence we have a health insurance policy. A medical policy insures the cost of an individual's medical expenses. Medical policy additionally consists hospitalization coverage for anyone who is hospitalized intended for in excess of one day. It reimburses you for your regular hospital consultations. It covers the pre and post hospitalization charges. It allows you to access cashless hospitalization in the best hospitals. A medical policy for you and your family offers lots of aids when you have to spend enormous sums on hospital treatments. To keep your medical policy you pay a certain amount (premium) once each year.

There are different types of health insurances. Individual insurance covers only the applicant's health and hospital routines. For those who wish to bring their family members under the shade of health insurance can choose Family Floater plan. The parents, senior citizens, who are more prone to illness, can be covered under Senior Citizen Insurance with extra privileges considering their present health status and Hospitalization Insurance for a hospital procedure like rooms, medicines, treatments etc. You can enjoy the shelter of medical policy even of you fall sick or get injured while traveling if you apply for Travel Health Insurance. Thus, having a health insurance policy assures you each and every moment of your life towards a good life.

Getting health insurance cover for your family is extremely easy. Any person who is above 18 years can apply for the policy. The customer can buy the policy for any family member(s) children and / or parents. The insured should be above 3 months in case of floater and 6 years in case of an individual. To cover children aged between 3 months to 5 years, at least 1 adult must also be covered with the policy. Different companies have their own maximum age restrictions to purchase health insurance, usually 60years. All the applicants need to show their age proof and identity proof.

Often people think that if they do not get any chance to utilize the premium they are paying each year, e.g. if they do not need any kind of medical treatment at all for a year, their premium would be futile. Unfortunately, it is not true. We never know the future and cannot foresee its health hazard coming our way. In such cases, if we are not prepared, we could be in trouble and risk the lives of our beloved ones. This is when medical policies, come into serious help. The premium that we had been paying would come to our rescue.

Health insurance helps protect an individual or family from monetary loss for costs suffered because of disease or damage. Get your health insurance as soon as you can and take a deep breath of relief.

Getting health insurance in place is imperative because coverage helps people get well-timed medical care and improves their lives and fitness. Selecting the right insurer with expert advice is always favorably.

5 Ways How HIPAA Training Can Ensure Patient Confidentiality

The responsibility of protecting patients' sensitive information rests on the Health Insurance Portability and Accountability Act of 1996, which was enforced for this very reason. When a patient gets admitted in a hospital, there is a sharing of patient information. The healthcare organization is required to respect the confidentiality of the patients. However, for the various reasons, sometimes patient information needs to be accessed and used by employees, insurance companies, billing, and the like. Therefore there is a big risk of this sensitive information getting into the wrong hands, which is why it needs to be well protected.

A patient's confidential information can only be accessed a certain number of times for any reason, and healthcare employees need to be aware of little things like this. Thus they need to be adequately trained so they can access and use the information as per the rules laid down by HIPAA. HIPAA lays down strict rules and regulation for the privacy and security of patient health information. Any misuse or violation leads to severe consequences in the form of fines and imprisonment.

Below are mentioned five reasons how HIPAA training for employees can ensure patient confidentiality.

• HIPAA training helps employees become aware of the rules and regulations laid down by HIPAA. It is essential that all covered healthcare organizations make these training sessions available for their employees at regular intervals. Once they are aware of the rules, it will be easier for them comply.

• Non-compliance with HIPAA rules and laws, leads to severe penalties. In the training, the violations and penalties are also explained. The extent of violation will determine the penalty, whether civil or criminal, whether fines or imprisonment.

• The healthcare organization must decide who are to undergo this training program. Some employees enroll only those employees who directly deal with patients' confidential information, whereas others encourage all the employees to attend these training classes. The sessions are not very long and last for a few hours.

• To protect the sensitive information of the patients, to limit access, and to avoid misuse, HIPAA advices the covered healthcare organizations to put certain physical and technical safeguards in place. HIPAA training explains to the employees all about these safeguards and how they help in protecting confidential patient information.

• The training is not just a once-in-a-life class. On completion, employees will have to give a test to ascertain whether they have actually understood about HIPAA and its rules, regulations, etc. Employees who successful pass the test receive a completion certificate. This certificate proves that they have received the said training.

The certificate received has to be renewed every couple of years. HIPAA constantly introduces new laws and modifies others. Hence it is essential to keep yourself up to date about the continuous changes taking place. You will receive regular notices and updates about any changes and you can also take different tests to gain more knowledge. Proper compliance is only possible when there is proper awareness.