A new insurance plan is available for uninsured people with pre-existing health conditions. The Pre-Existing Condition Insurance Plan – also known as the “federal high-risk pool” – is expected to cover as many as 350,000 individuals.
U.S. citizens or legal residents are eligible if they have been uninsured for at least six months and if a private health insurance company has denied them coverage because of a pre-existing condition.
“Health coverage for Americans 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 at the Department of Health and Human Services, the federal agency overseeing the program. “The Pre-Existing Condition Insurance Plan is designed to address these challenges by offering comprehensive coverage at a reasonable cost.”
The federal government will run the program in 21 states, including Arizona, Florida, Georgia, Kentucky, Louisiana and Texas. The other 29 states, including Kansas and Missouri will run the so-called “high-risk pool” themselves. A state-by-state list is available here.
The same plan design will be available in all of the 21 states where the federal government is administering the program, with individual premiums ranging from $140 to $900 per month. Cost and benefits will vary by state and the age of the applicant, but health conditions will not affect premium rates.
The federal plan began taking applications on July 1 through this page. at the new Healthcare.gov website, and the administration says people who apply by July 15 will have their coverage begin August 10.
Many states also began enrollment July 1 and others are scheduled to begin enrollment by the end of the summer. Information about state plans is also available at healthcare.gov.
The high-risk pool program is intended to bridge the gap until new health insurance exchanges open in 2014, but with just $5 billion in federal funding available, many believe the dollars won’t last long enough. That’s why some states were reluctant to run their own program, fearing they could be left without adequate funding to continue offering the plan.
An HHS fact sheet about the Pre-Existing Condition Insurance Plan is available here., and a news release announcing the program is available here.
Not to be used for implementation purposes. This is intended as an advisory only and does not constitute legal or tax advice. Consult a legal or tax professional for guidance.
