Premiums Reduction Makes It Easier for Americans with Pre-Existing Conditions

On May 31, 2011 HHS announced new steps to make it easier for Americans to enroll in the Pre-Existing Condition Insurance Plan. Premiums for the Federally-administered Pre-Existing Condition Insurance Plan (PCIP) will drop as much as 40 percent in 18 States. These premium decreases help bring PCIP premiums closer to the rates in each State’s individual insurance market. In the six States where PCIP premiums were already well-aligned with State premiums, premiums will remain the same.

Eligibility standards will be eased in 23 States and the District of Columbia to ensure more Americans with pre-existing conditions have access to affordable health insurance. Starting July 1, 2011, people applying for coverage can simply provide a letter from a doctor, physician assistant, or nurse practitioner dated within the past 12 months stating that they have or, at any time in the past, had a medical condition, disability, or illness. Applicants no longer have to wait for an insurance company to send them a denial letter. Applicants will still need to meet other eligibility criteria, including that they are U.S. citizens or residing legally and that they have been without health coverage for six months. Eligibility is not based on income and people who enroll are not charged a higher premium because of their medical condition.

The PCIP plan was created by the Affordable Care Act to help people with pre-existing conditions receive health coverage.  In 2014 insurance companies will not be allowed to deny coverage to those with a pre-existing condition.

For more information, including eligibility, plan benefits and rates, as well as information on how to apply, visit www.pcip.gov and click on “Find Your State.” The PCIP Call Center is open from 8 am to 11 pm Eastern Time. Call toll-free 1-866-717-5826 (TTY 1-866-561-1604).

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