Your Health: Plan enrolls people who have been denied insurance - Richmond Times Dispatch

Q: I find that a lot of people still are not aware of the federal health insurance plan for people who have pre-existing medical conditions. How many Virginians are enrolled in the program?

A: The Pre-existing Condition Insurance Plan created as part of the 2010 federal health care reform law has been around for about two years. At a recent cancer program, a care advocate said she still finds people unaware of the plan.

The PCIP is designed to be a bridge to 2014 when many of the provisions of the broader health reform law are supposed to go into effect. States were given the option to create a state plan or have the feds run a program for them. Virginia chose the latter.

To qualify for the PCIP (www.pcip.gov), a person must be uninsured for at least six months, have a pre-existing medical problem and/or have been turned down for coverage because of a pre-existing medical condition. They also must be a legal resident.

Initial enrollment in the program nationally was lower than expected, which prompted loosening of enrollment criteria and, in some cases, lower premiums in 2011.

Federal figures show that as of March 31, a total of 1,343 Virginians had signed up. That's up from April 2011, when about 300 people were enrolled.

Among the Virginians in the PCIP, about 58 percent were female; 43 percent were male. By age, 21 percent were 19-34 years old, 17 percent were 35-44 years old, 24 percent were 45-54 and 34 percent were 55-64 years old.

Monthly premiums vary by age and plan benefits. They can be as little as $93 per month for someone 18 or younger for a standard plan or up to $401 per month for a 55-year-old who chooses a plan with more benefits. There also is a plan with a health savings account option.

All the plans cover preventive care 100 percent and include deductibles, co-insurance and a cap on the maximum amount people pay out of pocket annually.

The application is online at www.pcip.gov. It can be completed online or printed out and mailed in. People can receive help completing the application by calling (866) 717-5826.

The PCIP website advises people to be careful of "phony calls or letters asking you to enroll for a fee." There is no charge to apply for the program. A federal official last fall also warned people not to provide their personal information to a website that purported to sign people up for the program but had no official affiliation with the government plan.

21 May, 2012