The U.S. Department of Health and Human Services recently announced the establishment of a new pre-existing condition insurance plan that will offer coverage to uninsured Americans who have been unable to obtain health coverage because of a pre-existing health condition.
The pre-existing condition insurance plan, which will be administered either by a state or by the Department of Health and Human Services, will provide a new health coverage option for Americans who have been uninsured for at least six months, have been unable to get health coverage because of a health condition and are a U.S. citizen or are residing in the United States legally.
The state of Georgia has decided to participate in the pre-existing condition insurance plan through the U.S. Department of Health and Human Services. Eligible Georgians are now able to download the PCIP application and apply for coverage. The program will begin providing coverage Aug. 1 if the application is submitted by July 15.
Created under the Affordable Care Act, the pre-existing condition insurance plan is a transitional program until 2014, when insurers will be banned from discriminating against adults with pre-existing conditions, and individuals and small businesses will have access to more affordable private insurance choices through new competitive exchanges.
In 2014, members of Congress also will purchase their insurance through exchanges.
“For too long, Georgia residents with pre-existing conditions have been locked out of our health insurance market,” said Kathleen Sebelius, secretary of the Department of Health and Human Services. “Today, the pre-existing condition insurance plan gives them a new option — the same insurance coverage as a healthy individual if they’ve been uninsured for at least six months because of a medical condition. This program will provide people the help they need as the nation transitions to a more competitive and fair market place in 2014.”
The Affordable Care Act provides $5 billion in federal funding to support pre-existing condition insurance plans in every state. Some states, like Georgia, have requested that the U.S. Department of Health and Human Services run their plan. Other states have requested that they run the program themselves. For more information about how the plan is being administered in different areas, go to the HHS website at www.HealthCare.gov.
“Health coverage for Georgia residents with pre-existing conditions has historically been unobtainable or failed to cover the very conditions for which they need medical care,” said Jay Angoff, director of the Office of Consumer Information and Insurance Oversight, which oversees the program. “The pre-existing condition insurance plan is designed to address these challenges by offering comprehensive coverage at a reasonable cost. We modeled the program on the highly successful Children’s Health Insurance Program, also known as CHIP, so states would have maximum flexibility to meet the needs of their citizens.”
To give states the flexibility to best meet their needs, HHS provides states with the option of running the pre-existing condition insurance plan themselves or having HHS run the plan. Twenty-one states have elected to have HHS administer the plans, while 29 states and the District of Columbia have chosen to run their own programs.
The national PCIP is open to applicants in Georgia and the 20 other states not operating their own programs. Individuals who apply by July 15 will be covered beginning Aug. 1.
All states that are operating their own PCIP will begin enrollment by the end of the summer, with many beginning enrollment today.
“The pre-existing condition insurance plan is an important next step in the overall implementation of the Affordable Care Act,” said Richard Popper, director of insurance programs at OCIIO. “We have been working closely with the states and other stakeholders to make sure this program reaches uninsured Americans struggling to find coverage due to a pre-existing condition.”
The pre-existing condition insurance plan will cover a broad range of health benefits, including primary and specialty care, hospital care and prescription drugs. The plan does not base eligibility on income and does not charge a higher premium because of a medical condition. Participants will pay a premium that is not more than the standard individual health insurance premium in their state for insurance that covers major medical and prescription drug expenses with some cost-sharing.
Like the Children’s Health Insurance Program, the pre-existing condition plan provides states flexibility in how they run their program as long as basic requirements are met. Federal law establishes general eligibility, but state programs can vary on cost, benefits and determination of pre-existing condition. Funding for states is based on the same allocation formula as CHIP, and it will be reallocated if unspent by the states. Unlike CHIP, there is no state matching requirement and the federal government will cover the entire cost of the pre-existing condition plan.
Information on how to apply for the pre-existing condition insurance plan is available at www.HealthCare.gov. Americans who live in a state where the U.S. Department of Health and Human Services is running the plan will be linked directly to the federal application page. Those living in states running their own programs will also find information on how and where to apply at www.HealthCare.gov.
To learn more about the pre-existing condition insurance plan and options available to Georgia residents, go to www.HealthCare.gov.
An informational pamphlet on the pre-existing condition insurance plan can be found at www.healthcare.gov/center/brochures/PCIP.pdf.
The pre-existing condition insurance plan, which will be administered either by a state or by the Department of Health and Human Services, will provide a new health coverage option for Americans who have been uninsured for at least six months, have been unable to get health coverage because of a health condition and are a U.S. citizen or are residing in the United States legally.
The state of Georgia has decided to participate in the pre-existing condition insurance plan through the U.S. Department of Health and Human Services. Eligible Georgians are now able to download the PCIP application and apply for coverage. The program will begin providing coverage Aug. 1 if the application is submitted by July 15.
Created under the Affordable Care Act, the pre-existing condition insurance plan is a transitional program until 2014, when insurers will be banned from discriminating against adults with pre-existing conditions, and individuals and small businesses will have access to more affordable private insurance choices through new competitive exchanges.
In 2014, members of Congress also will purchase their insurance through exchanges.
“For too long, Georgia residents with pre-existing conditions have been locked out of our health insurance market,” said Kathleen Sebelius, secretary of the Department of Health and Human Services. “Today, the pre-existing condition insurance plan gives them a new option — the same insurance coverage as a healthy individual if they’ve been uninsured for at least six months because of a medical condition. This program will provide people the help they need as the nation transitions to a more competitive and fair market place in 2014.”
The Affordable Care Act provides $5 billion in federal funding to support pre-existing condition insurance plans in every state. Some states, like Georgia, have requested that the U.S. Department of Health and Human Services run their plan. Other states have requested that they run the program themselves. For more information about how the plan is being administered in different areas, go to the HHS website at www.HealthCare.gov.
“Health coverage for Georgia residents with pre-existing conditions has historically been unobtainable or failed to cover the very conditions for which they need medical care,” said Jay Angoff, director of the Office of Consumer Information and Insurance Oversight, which oversees the program. “The pre-existing condition insurance plan is designed to address these challenges by offering comprehensive coverage at a reasonable cost. We modeled the program on the highly successful Children’s Health Insurance Program, also known as CHIP, so states would have maximum flexibility to meet the needs of their citizens.”
To give states the flexibility to best meet their needs, HHS provides states with the option of running the pre-existing condition insurance plan themselves or having HHS run the plan. Twenty-one states have elected to have HHS administer the plans, while 29 states and the District of Columbia have chosen to run their own programs.
The national PCIP is open to applicants in Georgia and the 20 other states not operating their own programs. Individuals who apply by July 15 will be covered beginning Aug. 1.
All states that are operating their own PCIP will begin enrollment by the end of the summer, with many beginning enrollment today.
“The pre-existing condition insurance plan is an important next step in the overall implementation of the Affordable Care Act,” said Richard Popper, director of insurance programs at OCIIO. “We have been working closely with the states and other stakeholders to make sure this program reaches uninsured Americans struggling to find coverage due to a pre-existing condition.”
The pre-existing condition insurance plan will cover a broad range of health benefits, including primary and specialty care, hospital care and prescription drugs. The plan does not base eligibility on income and does not charge a higher premium because of a medical condition. Participants will pay a premium that is not more than the standard individual health insurance premium in their state for insurance that covers major medical and prescription drug expenses with some cost-sharing.
Like the Children’s Health Insurance Program, the pre-existing condition plan provides states flexibility in how they run their program as long as basic requirements are met. Federal law establishes general eligibility, but state programs can vary on cost, benefits and determination of pre-existing condition. Funding for states is based on the same allocation formula as CHIP, and it will be reallocated if unspent by the states. Unlike CHIP, there is no state matching requirement and the federal government will cover the entire cost of the pre-existing condition plan.
Information on how to apply for the pre-existing condition insurance plan is available at www.HealthCare.gov. Americans who live in a state where the U.S. Department of Health and Human Services is running the plan will be linked directly to the federal application page. Those living in states running their own programs will also find information on how and where to apply at www.HealthCare.gov.
To learn more about the pre-existing condition insurance plan and options available to Georgia residents, go to www.HealthCare.gov.
An informational pamphlet on the pre-existing condition insurance plan can be found at www.healthcare.gov/center/brochures/PCIP.pdf.