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New Federal High-Risk Pool Accepting Applications
 

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: http://www.healthcare.gov/. A PDF of the PCIP application can also be downloaded from the plan's new Website: http://www.pcip.gov/.