Health Insurance: Federal Pre-existing Condition Insurance Plan
Pre-existing conditions can range from the chronic to the terminal
, to the debilitating to the annoying. Regardless of severity, however, it is a fact that obtaining full coverage for pre-existing conditions can be difficult. Individuals that are "poor enough" can receive coverage through Medicare or Medicaid, but those that make too much often find themselves between a rock and a hard place.Anyone that receives health insurance from an employer can breathe a sigh of relief when it comes to pre-existing condition coverage, even if a waiting period is required for the conditions to be covered in entirety. Many states have high-risk insurance pools, but the prices for these are absolutely outrageous, particularly for women, who can pay twice as much per month as a same-age male counterpart. These policies may be designed with good intentions, but for someone who is struggling to make ends meet in the first place, they are often prohibitive when it comes to cost, in spite of the benefits.
Few people, even those that work in county social service offices, are aware that the federal government offers a Pre-Existing Condition Insurance Plan (PCIP). Created by the Affordable Care Act, it is administered in more than twenty states. (The remaining states offer similar plans of their own.)
There are three plans to choose from for this type of health insurance: the Standard Option, Extended Option, and HSA Option. All three offer full preventative care coverage without a deductible when seen by an in-network physician. This includes cancer screenings, routine mammograms, flu shots, and annual physicals.
All three plans have no lifetime cap on coverage as many insurance policies do. In any given calendar year, the maximum out-of-pocket costs for in-network services is $5950, with a limit of $7000 for services provided outside the network. There is really no need to be concerned about finding outstanding physicians, hospitals, and specialists within the network, as many participate in the program.
In order to be eligible for the plan, you must be a U.S. citizen, or are otherwise living in the United States legally. You must have been uninsured for the past six months, and have a pre-existing condition. New legislation enacted July 1, 2011 removes the requirement to submit paperwork proving that you were either denied health insurance coverage or were offered a plan with exclusions in regards to pre-existing conditions.
Coverage is comprehensive, including all aspects of treatment for pre-existing conditions. Deductibles must still be met, and depending on chosen plan range from $1000 to $2500 in-network. Coverage is offered for prescription medication, with an option for discounted 90-day supplies via mail order.
With much lower premiums than the state high-risk pools, anyone that is eligible should strongly consider the benefits of the Federal Pre Existing Condition Insurance Plan, and select whatever plan best fits their personal medical needs.
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