HHS Launches Insurance to Cover Preexisting Conditions

Patients with preexisting conditions can now get insurance coverage through their states or through the U.S. Health and Human Services department, the federal agency announced July 1.

The Pre-Existing Condition Insurance Plan is a stopgap program that will exist until 2014 when insurance companies will be prohibited from denying coverage to, or discriminating against, anyone who has had a previous serious illness or chronic condition.

The plan, established as part of the Affordable Care Act, was hailed by patient advocacy organizations.

John R. Seffrin, Ph.D., CEO of the American Cancer Society Cancer Action Network, said in a statement that the program will “give at least hundreds of thousands of uninsured people with cancer and other preexisting conditions access to health care.” Dr. Seffrin said that the program was not likely to be able to enroll everyone who needed coverage, but that it “is an important first step toward transforming the health care system to one that provides meaningful coverage to all Americans.”

American Heart Association CEO Nancy Brown said in a statement that the program provides a “valuable new alternative for coverage.” She noted that the “exact terms and coverage will vary depending upon the state in which a person lives.”

That is because states were given the option of letting the HHS administer the plan or running it themselves. Twenty-one states chose the former, while 29 states and the District of Columbia are running their own programs. Enrollment has begun for the HHS plan and will possibly begin by the end of the summer for the state-run programs. Coverage begins Aug. 1 for the HHS plan.

To receive coverage, people must be U.S. citizens or legal residents, and must have been uninsured for at least 6 months, or unable to purchase coverage because of a preexisting condition.

The plan is supported by $5 billion in federal money, but some states have been concerned that the money won’t last and that they would end up having to subsidize the program. Many of those states, like Louisiana, which has an estimated 700,000 uninsured residents, decided to let the federal government run their plans.

The program will cover primary and specialty care, hospitalization, and prescription drugs. Premiums may not exceed the standard individual premium for a policy in that particular state and age may be used to help determine premium rates. The HHS estimated, for instance, that in its plan, the premium for a 50-year-old would range from $320 to $570, depending on where the patient lives. More details on premium pricing will be available in mid-July.

Also on July 1, the federal government launched an online tool that lets anyone seeking insurance see what options are available – from public programs such as Medicaid, to state-run plans, to private insurance. After answering a series of questions, the tool, at www.healthcare.gov, gives the user concrete data on where and how to purchase coverage or to sign up for federal or state-run programs.

This, too, is valuable, said the AHA’s Ms. Brown. “For the first time, consumers faced with an array of choices will have a single site to go to help them understand their coverage options,” she said.

Patients with preexisting conditions can now get insurance coverage through their states or through the U.S. Health and Human Services department, the federal agency announced July 1.

The Pre-Existing Condition Insurance Plan is a stopgap program that will exist until 2014 when insurance companies will be prohibited from denying coverage to, or discriminating against, anyone who has had a previous serious illness or chronic condition.

The plan, established as part of the Affordable Care Act, was hailed by patient advocacy organizations.

John R. Seffrin, Ph.D., CEO of the American Cancer Society Cancer Action Network, said in a statement that the program will “give at least hundreds of thousands of uninsured people with cancer and other preexisting conditions access to health care.” Dr. Seffrin said that the program was not likely to be able to enroll everyone who needed coverage, but that it “is an important first step toward transforming the health care system to one that provides meaningful coverage to all Americans.”

American Heart Association CEO Nancy Brown said in a statement that the program provides a “valuable new alternative for coverage.” She noted that the “exact terms and coverage will vary depending upon the state in which a person lives.”

That is because states were given the option of letting the HHS administer the plan or running it themselves. Twenty-one states chose the former, while 29 states and the District of Columbia are running their own programs. Enrollment has begun for the HHS plan and will possibly begin by the end of the summer for the state-run programs. Coverage begins Aug. 1 for the HHS plan.

To receive coverage, people must be U.S. citizens or legal residents, and must have been uninsured for at least 6 months, or unable to purchase coverage because of a preexisting condition.

The plan is supported by $5 billion in federal money, but some states have been concerned that the money won’t last and that they would end up having to subsidize the program. Many of those states, like Louisiana, which has an estimated 700,000 uninsured residents, decided to let the federal government run their plans.

The program will cover primary and specialty care, hospitalization, and prescription drugs. Premiums may not exceed the standard individual premium for a policy in that particular state and age may be used to help determine premium rates. The HHS estimated, for instance, that in its plan, the premium for a 50-year-old would range from $320 to $570, depending on where the patient lives. More details on premium pricing will be available in mid-July.

Also on July 1, the federal government launched an online tool that lets anyone seeking insurance see what options are available – from public programs such as Medicaid, to state-run plans, to private insurance. After answering a series of questions, the tool, at www.healthcare.gov, gives the user concrete data on where and how to purchase coverage or to sign up for federal or state-run programs.

This, too, is valuable, said the AHA’s Ms. Brown. “For the first time, consumers faced with an array of choices will have a single site to go to help them understand their coverage options,” she said.

Patients with preexisting conditions can now get insurance coverage through their states or through the U.S. Health and Human Services department, the federal agency announced July 1.

The Pre-Existing Condition Insurance Plan is a stopgap program that will exist until 2014 when insurance companies will be prohibited from denying coverage to, or discriminating against, anyone who has had a previous serious illness or chronic condition.

The plan, established as part of the Affordable Care Act, was hailed by patient advocacy organizations.

John R. Seffrin, Ph.D., CEO of the American Cancer Society Cancer Action Network, said in a statement that the program will “give at least hundreds of thousands of uninsured people with cancer and other preexisting conditions access to health care.” Dr. Seffrin said that the program was not likely to be able to enroll everyone who needed coverage, but that it “is an important first step toward transforming the health care system to one that provides meaningful coverage to all Americans.”

American Heart Association CEO Nancy Brown said in a statement that the program provides a “valuable new alternative for coverage.” She noted that the “exact terms and coverage will vary depending upon the state in which a person lives.”

That is because states were given the option of letting the HHS administer the plan or running it themselves. Twenty-one states chose the former, while 29 states and the District of Columbia are running their own programs. Enrollment has begun for the HHS plan and will possibly begin by the end of the summer for the state-run programs. Coverage begins Aug. 1 for the HHS plan.

To receive coverage, people must be U.S. citizens or legal residents, and must have been uninsured for at least 6 months, or unable to purchase coverage because of a preexisting condition.

The plan is supported by $5 billion in federal money, but some states have been concerned that the money won’t last and that they would end up having to subsidize the program. Many of those states, like Louisiana, which has an estimated 700,000 uninsured residents, decided to let the federal government run their plans.

The program will cover primary and specialty care, hospitalization, and prescription drugs. Premiums may not exceed the standard individual premium for a policy in that particular state and age may be used to help determine premium rates. The HHS estimated, for instance, that in its plan, the premium for a 50-year-old would range from $320 to $570, depending on where the patient lives. More details on premium pricing will be available in mid-July.

Also on July 1, the federal government launched an online tool that lets anyone seeking insurance see what options are available – from public programs such as Medicaid, to state-run plans, to private insurance. After answering a series of questions, the tool, at www.healthcare.gov, gives the user concrete data on where and how to purchase coverage or to sign up for federal or state-run programs.

This, too, is valuable, said the AHA’s Ms. Brown. “For the first time, consumers faced with an array of choices will have a single site to go to help them understand their coverage options,” she said.