Have you been without insurance for six months or more? Have you applied for health insurance but were rejected because of your weight or some pre-existing condition? If you answered “yes” to both questions, you can go to http://healthcare.gov to sign up for coverage through the new Pre-existing Condition Insurance Plan, which is part of the health care reform legislation that was passed earlier this year.
The Pre-existing Condition Insurance Plan was launched on July 1 and it covers every state – even though 19 states, like Arizona, refused to participate in the program. This health insurance program is meant for people who have been denied health insurance and have been uninsured for at least six months. An applicant will need to provide a rejection letter from an insurance company in order to qualify.
The good news is that people who want insurance, but have been rejected by an insurance company, should be able to get coverage through the Pre-existing Condition Insurance Plan. The bad news is that the HealthCare.gov website doesn’t offer a lot of information for the 19 states that refused to participate.
Because Arizona does not have a high risk pool – and refused to set one up under this program – the federal government is organizing coverage for Arizonans who qualify. If you want to apply, the website instructs you to print out an application and mail it to an address in New Orleans. No information is provided on premium costs, deductibles, co-pays, or a network of providers. I guess you just send in the application and see what you are offered by this program.
In contrast to Arizona, the page on New Mexico offers lots of information and has several options for deductibles and annual maximum out-of-pocket amounts (MOOP). The New Mexico page says premiums will range from $183 to $526 per month. New Mexico already has a high risk insurance program, so they appear to be taking advantage of federal subsidies to expand their offerings.
The California page says a 50-year old in San Francisco will pay $575 per month for a plan with a $1,500 deductible and a $2,500 MOOP.
Arkansas looks like a good place to go if you are uninsured. Their plan will cost between $156 and $624 per month with a $1,000 deductible and $2,000 MOOP. This means the most a person will spend on healthcare costs each year is $3,000 (in addition to their premium) – a really good deal.
Even Alaska is participating and their plan will have premiums between $434 and $1,735 per month. The deductible will be $1,500 and the MOOP is $3,000. Things are obviously expensive up there, but the deductible and MOOP are pretty reasonable.
The big question for me is what the network of doctors, labs, and hospitals will be for the Pre-existing Condition Insurance Plan. I have a friend in Connecticut who needs this plan, but the current high-risk plan in Connecticut has no doctors in her part of the state. She would have to drive an hour to see a doctor who is contracted with the plan, so she didn’t join it. If the new plan in Connecticut is using the same network, it will be of no use to my friend (who had health insurance until her husband retired last year).
States with a good high-risk insurance program are way ahead of the game. For people in states like Arizona, Texas, Nevada, Florida (and others run by Republicans), they will just have to apply and see what the feds can put together for their state. Insurance coverage is supposed to begin in August, so it will be interesting to see what can be done in my home state of Arizona.