Aug 26, 2010 - 9:40 pm
You can't be denied health coverage
States and the federal government now offer temporary insurance to buyers who have been denied insurance because of pre-existing conditions.
The new Pre-existing Condition Insurance Plan will provide health insurance for those who have been without coverage for at least six months, who have a health condition that has kept them from getting medical coverage, and who are U.S. citizens or who reside legally in the United States.
Created under the federal Affordable Care Act and developed by the U.S. Department of Health and Human Services, the plan covers a broad range of health benefits, including primary and specialty care, hospital care and prescription drugs. It does not base premiums on income and does not charge higher premiums because of medical conditions.
Those who participate will pay rates no higher than the standard individual health insurance premium in their state. The insurance covers major medical and prescription costs, with some out-of-pocket expenses, such as deductibles. The plan is funded with $5 billion from the Affordable Care Act.
States are in control
According to HHS, this arrangement gives the states flexibility in how to run their PCIPs, because state programs can vary on cost, benefits and determination of pre-existing conditions. State funding is based on the same allocation formula as the Children's Health Insurance Program, but unlike CHIP there is no requirement for states to match federal dollars, and the federal government will cover the entire cost of the pre-existing condition plan.
To apply for the pre-existing condition insurance plan, go to HealthCare.gov. Those living in a state where HHS is administering the plan will be linked directly to the federal application page, where applications are available for download. You must complete the application and supply a copy of a letter dated within six months of the application from an insurer or health plan showing denial of coverage because of a pre-existing condition.
Premiums vary from state to state
If HHS runs the plan, premiums will range from $320 to $570 a month for a 50-year-old enrollee, depending on state. But prices can go as high as $600 in Texas and $675 in Florida and Massachusetts for a 50-year-old.
The plan is not available for those with COBRA or any existing health insurance.
Pre-existing condition insurance plans
This article was reported by Laurie Ledgard for Insure.com.