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  2. Provisions of the Affordable Care Act - Wikipedia

    en.wikipedia.org/wiki/Provisions_of_the...

    Section 2708 to the Public Health Service Act becomes effective, which prohibits patient eligibility waiting periods in excess of 90 days for group health plan coverage. The 90-day rule applies to all grandfathered and non-grandfathered group health plans and group health insurance issuers, including multiemployer health plans and single ...

  3. Medicare dual eligible - Wikipedia

    en.wikipedia.org/wiki/Medicare_dual_eligible

    Under Medicaid, states are required to cover certain items and services for dual-eligibles, including long-term nursing facility services and home health services. Although states are required to cover certain populations and services, they have the option to expand coverage beyond these mandatory levels (i.e., offer home and community-based ...

  4. Medicaid - Wikipedia

    en.wikipedia.org/wiki/Medicaid

    Medicaid is a government program in the United States that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a significant ...

  5. Exclusive provider organization - Wikipedia

    en.wikipedia.org/wiki/Exclusive_provider...

    In the United States, an exclusive provider organization (EPO) is a hybrid health insurance plan in which a primary care provider is not necessary, but health care providers must be seen within a predetermined network. Out-of-network care is not provided, and visits require pre-authorization.

  6. Physician Payments Sunshine Act - Wikipedia

    en.wikipedia.org/wiki/Physician_Payments...

    The Sunshine Act requires manufacturers of drugs, medical devices, biological and medical supplies covered by the three federal health care programs Medicare, Medicaid, and State Children's Health Insurance Program (SCHIP) to collect and track all financial relationships with physicians and teaching hospitals and to report these data to the Centers for Medicare and Medicaid Services (CMS).

  7. Medi-Cal - Wikipedia

    en.wikipedia.org/wiki/Medi-Cal

    The California Medical Assistance Program (Medi-Cal or MediCal) is the California implementation of the federal Medicaid program serving low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults with incomes below 138% of federal poverty level.

  8. Universal health care by country - Wikipedia

    en.wikipedia.org/wiki/Universal_health_care_by...

    Algeria operates a public and universal healthcare system. A network of hospitals, clinics, and dispensaries provide treatment to the population, with the social security system funding health services, although many people must still cover part of their costs due to the rates paid by the social security system remaining unchanged since 1987.

  9. Health care provider - Wikipedia

    en.wikipedia.org/wiki/Health_care_provider

    A health care provider is an individual health professional or a health facility organization licensed to provide health care diagnosis and treatment services including medication, surgery and medical devices. Health care providers often receive payments for their services rendered from health insurance providers.

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    medicaid eligibilitymedicare dual eligible providers