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Greetings,
The Obama
administration has officially launched the Pre-Existing
Condition Insurance Plan (PCIP), a new federal high-risk pool
created to provide temporary insurance coverage for uninsured
individuals with health problems until 2014. In 2014,
insurance companies will be barred from turning away people in
poor health and most Americans will be required to carry
coverage. This is one of the first major initiatives to be
implemented since President Obama signed the health care
overhaul bill in March.
The
Pre-Existing Condition Insurance Plan will be available to
U.S. citizens and legal residents who have a
pre-existing medical condition, have been without health
insurance coverage for at least six months, and have been denied
coverage (or offered insurance without coverage for the
pre-existing condition) by a private insurance
company. It will provide coverage for a range of
major medical and prescription drug benefits. Members
(i.e., beneficiaries) will be responsible for paying any
premium, deductible, copayments, and coinsurance. Though
rates will vary by state, they are expected to be no more than
what a person would typically pay for a standard individual
health insurance policy. (Please be aware that you may
be asked to provide documentation to show you meet the
qualifications, so please have those
handy.)
PCIP will be available in each state
and in the District of Columbia. States had the option of
having the U.S. Department of Health and Human Services (HHS)
administer their plan or do so themselves. Enrollment for
individuals in states where HHS will administer the plan begins
today, Thursday, July 1. Coverage for
those individuals is expected to begin around August
1. Enrollment for all states administering their
own Pre-Existing Condition Insurance Plans will begin by the end
of the summer; however, many have also begun enrollment today as
well.
While
specific premium and benefit information for both the HHS and
state administered plans are not yet available, NHF
encourages everyone who believes they meet the qualifications
above to enroll as soon as possible. The
Affordable Care Act provided $5 billion in federal funding to
support the program through 2013. It is widely believed
that those funds could run out before then.
As many of
you know, several states already run high-risk pools that
provide coverage to individuals who have been denied other
coverage. This plan will be completely separate from
existing state high-risk pools. If you are already
receiving coverage through a state high-risk pool, please be
aware that you cannot simply drop that policy. You will
still need to meet all of the qualifications above to be
eligible for this new plan.
For
information on PCIP and how the plan is being administered in
your state, as well as other insurance options available to you,
visit HHS’ new consumer Website: www.HealthCare.gov. A PDF of the PCIP
application can also be downloaded from the plan’s new
Website: www.pcip.gov.
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