Federal Insurance (Welfare) Program Covers (Mandates) Pre-Existing Conditions

The federal agency Centers For Medicare & Medicaid Services is hoping to boost enrollment in a public insurance program  (welfare program) for U.S. residents who have been denied private health insurance because of pre-existing illness or disability.

In Texas, less than 1,200 have joined the new plan. Texans must be a damn healthy group of people.

CMMS estimates that more than a quarter-million uninsured Texas residents with pre-existing medical conditions are eligible for its “Pre-Existing Condition Insurance Plan.”  (Pre-Existing condition Public Welfare Plan) As many as 7 million U.S. residents may be eligible for the plan, which is part of the national Affordable Care Act passed last year. The PCIP program, which started last August in Texas, will end in 2014, when the Affordable Care Act stipulates that private insurance companies begin to cover people regardless of pre-existing illness or disability. (End of insurance and beginning of single payer Federal Entitlement Program funding with other people’s money). But as of Feb. 1, only 1,007 Texas residents had signed up for the PCIP program, according to an official tally. (the entitlement crowd  dont want to pay for something they believe they are entitled to get for free).

CCMS touts the new plan as a less costly alternative to the “high-risk pools” that many states maintain for residents unable to get insurance on the private market. (High risk pool is losing money, so how can this plan operate with less money?) The Lone Star state has its own version, the “Texas Health Insurance Pool,” established in 1998. The federal PCIP program hasn’t replaced the state program. Rather, they exist side by side.

To qualify for the PCIP, you must be a U.S. citizen or legal resident, must have a pre-existing condition and must have been uninsured for at least six months prior to applying. Income is not a factor in determining eligibility. The PCIP plan is comprehensive, covering primary and specialty care, hospital stays, skilled nursing care, home health care and prescription drugs for the same price people without pre-existing conditions pay for private insurance, according to the CMMS. PCIP enrollees pay premiums of between $174 to $749 a month, depending on which of three coverage options they choose.

Applicants to the federal program typically will need to provide a denial letter from an insurance company for individual coverage, or an offer of individual coverage that states the applicant’s illness or disability will not be covered if the policy is purchased. Applicants may also submit a letter from an insurance agent or broker confirming the applicant is not eligible for individual coverage due to a pre-existing medical condition. There is no pre-existing condition “waiting period exclusion” for new enrollees in the PCIP program. The Texas Health Care Pool, in contrast, mandates a waiting period for those who did not have insurance in the 12 months prior to applying.

Officials with the Texas Health Care Pool note that premium rates for the PCIP program are generally lower than the rates Texas law requires for the state pool. At the same time, the PCIP’s requirement that applicants be uninsured for at least six months prior to applying means that the state pool may be a better choice for those who have recently been dropped by their insurer but can’t afford to go six months without insurance.

For specifics on premium rates, coverage and other aspects of the PCIP program, go to the Texas Consumer Health Assistance Program website at www.texashealthoptions.com, or call (855) 839-2427. To enroll in the Pre-Existing Condition Insurance Plan go to www.pcip.gov, or call (866) 717-5826 and request an application

Editor’s Note: This is not insurance. This is just another government provided entitlement program. Why now should an employer pay for group health insurance? Cancel group insurance, and tell employees to wait six months without coverage, then after the six month period, tell them they can apply for a Pre-existing Health Care Policy whenever they get sick. So Billy Bob Six Pack can rock and roll without paying for health insurance, but when he is diagnosed with liver disease, he can rush down to the government building and get quality health “insurance” right away that will cover his malfunctioning liver. Hell of a deal! Im cancelling my Blue Cross policy today!