Wednesday, September 22, 2010

For Adults With Pre Existing Conditions

President Obama is set to do some events today to roll out some provisions of the Affordable Care Act which are going into effect like prohibiting lifetime caps on coverage and prohibiting denial of coverage to kids with preexisting conditions. These are great milestones to be sure but I think an earlier milestone went largely overlooked. As of July of this year adults with preexisting conditions had the ability to purchase insurance coverage through the Pre-Existing Condition Insurance Plan program run by the U.S. Department of Health and Human Services.

Now to be sure the coverage isn't cheap and the deductible is high, but for many people who can't get coverage of any kind for any price it could be a god send.

Unfortunately I would bet most people have no idea that this option is even available because as I said before there has been very little written about it. I don't know why the White House hasn't played this up more but I think it would definitely be a good idea if they did. Hell if I were them Id be looking to find a success story from the program of a person who had the money to buy insurance but kept getting denied but now has it.

Regardless here is the link to the explanation of the program. And here is an example of what that coverage would look like in Florida.

To qualify for coverage:
  • You must be a citizen or national of the United States or lawfully present in the United States.
  • You must have been uninsured for at least the last six months before you apply.
  • You must have had a problem getting insurance due to a pre-existing condition.
PCIP will cover a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs.  All covered benefits are available for you, even if it’s to treat a preexisting condition.
Below are the monthly PCIP premium rates for Florida by the age of an enrollee.
Ages 0 to 34: $363

Ages 35 to 44: $435

Ages 45 to 54: $556

Ages 55+: $773
In addition to your monthly premium, you will pay other costs. You will pay a $2,500 deductible for covered benefits (except for preventive services) before the plan starts to pay. After you pay the deductible, you will pay a $25 copayment for doctor visits, $4 to $30 for most prescription drugs, and 20% of the costs of any other covered benefits you get. Your out-of-pocket costs cannot be more than $5,950 per year. These costs may be higher, if you go outside the plan’s network.

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