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Home ยป An Overview of Contributory Health Service Schemes
Health Updated:April 16, 2023

An Overview of Contributory Health Service Schemes

Amber HeardBy Amber HeardNovember 15, 2022Updated:April 16, 2023No Comments4 Mins Read
An Overview of Contributory Health Service Schemes
An Overview of Contributory Health Service Schemes
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Table of Contents

  • An Overview of Contributory Health Service Schemes
    • Sources of funding
    • Extensibility
    • Restrictions
    • Exclusions
      • Related posts:

An Overview of Contributory Health Service Schemes

This article provides a brief overview of the main features of a contributory health service scheme and explains where the funding comes from. It also covers the exclusions and restrictions. After reading this article, you should be better prepared to make your own informed decision regarding this scheme. It’s important to remember that a contributory health service scheme is funded from public money and is not a “free” scheme.

Sources of funding

For countries with a contributory health service scheme, one option is to increase general or dedicated taxes. Such an approach would be less expensive and more sustainable than relying on the health sector to generate revenues. Moreover, it would enable governments to divert funds from other sectors of the economy. However, such an approach would require some innovative financing methods.

In contrast, in the contributory scenario, government expenditure is higher than in the non-contributory scenario. This is due to the fact that more people are covered by the scheme, which would require higher government expenditure. Furthermore, the government would also have to spend more money on non-health insurance services.

However, a contributory health service scheme is difficult to target because premium rates are too high for low-income groups. Furthermore, most potential contributors in Kenya are in the informal sector, and their incomes are low. Therefore, it is difficult to determine how much the government should spend. However, it is worth noting that in contributory health systems, government subsidies are as low as 5.0% of health expenditure.

Extensibility

The Extensibility of Contributory Health Service Scheme (ECHS) is an extension of the National Health Service (NHS). This type of healthcare coverage helps lower out-of-pocket healthcare expenses, particularly in low-income households. The ECHS is administered by the Department of Ex-Servicemen Welfare and is an attached office. The ECHS is headed by a Managing Director, a serving Major General.

Restrictions

There are many restrictions and stipulations for a contributory health service scheme. It is important to understand the benefits and restrictions that apply to your individual circumstances. For example, you may be limited to a particular primary care physician, or you may not be able to see a pediatrician or obtain obstetrical care without prior authorization. The Secretary of Health and Human Services’ guidance will provide specific information about what the requirements are, as well as how to apply for a waiver.

There are certain annual and lifetime limits that may be imposed by a contributory health service scheme. These are set in order to ensure that individuals have access to health care that they need, without affecting their premiums. The regulations also provide for staged implementation of these limits, so that they don’t adversely impact coverage and premiums.

Lastly, under the PHS Act section 2719A, there are other types of cost-sharing that are permitted. These include deductibles, coinsurance, and copayments. There is an anti-abuse rule in the interim final regulations to prevent abuse of these requirements.

Exclusions

There are many reasons why a person might be excluded from a contributory health service scheme. These reasons include a lack of evidence for safety, efficacy, and clinical relevance. The government has set out criteria to determine the eligibility of services. Once approved, a health service or technology will be included in a contributory health service scheme. However, there are certain categories of services that cannot be included.

Preexisting conditions are not covered in most individual health plans. However, if you have an existing individual health policy, you may be able to continue your existing coverage. However, you will have to wait for a specific timeframe to get covered. The government estimates that around 90,000 children in the U.S. will qualify for coverage after the new rules go into effect.

The Affordable Care Act has added a new section 2704 to the PHS Act that prohibits the exclusion of people with preexisting conditions. The new section makes it illegal for companies to completely exclude someone with a preexisting condition from their health insurance plans. This is an important step towards ensuring that all Americans have access to high quality health care.

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