Government program assists in health care for people with pre-existing medical conditions

According to information received by the KMUD News Department on May 11, 2011 from Jack Cheevers, Public Information Officer, Region IX U.S. Centers for Medicare and Medicaid Services:
The Commonwealth Fund recently estimated that more than 870,000 Californians are potentially eligible for the Pre-existing Condition Insurance Plan (PCIP), a new program created under the Affordable Care Act. These are Californians with cancer, heart disease, lupus, multiple sclerosis, or other serious medical problems that have caused them to be turned down for insurance coverage, or for whom insurance coverage is far too expensive. PCIP could be a life-saver for many of these California residents. But so far, the program has gotten too little public attention.
PCIP is a bridge program for children and adults in all 50 states and the District of Columbia who’ve been locked out of the health insurance market because of a pre-existing condition. About $5 billion has been appropriated to fund PCIP. In 2014, Americans—regardless of their health status—will have access to affordable health insurance when the nation transitions to a new marketplace. Under PCIP, Californians with pre-existing conditions can receive coverage for a wide range of medical benefits, including physician’s services, hospital care, and prescription drugs. They won’t be charged a higher premium because of their medical condition and their eligibility isn’t based on income. Like standard health insurance plans, they’re required to pay a monthly premium, a deductible, and some cost-sharing expenses. Premiums may vary depending on where they live, their age, and which health plan they choose.
To qualify for PCIP, you must:

  • be a citizen of the United States or residing here legally;
  • have been uninsured for at least 6 months before applying (Congress did this in order to target uninsured people, and to keep insured people from switching from other coverage to PCIP and crowding out the uninsured);
  • have a pre-existing condition or have been denied insurance coverage because of your health condition.

To find out more about the Pre-Existing Condition Insurance Plan, including eligibility, plan benefits and rates and how to apply, visit: Click on “Find Your State” and select your state from a map of the United States or from a drop-down menu for details.
To read the Commonwealth Fund report on PCIP, click here.

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