According to a report released recently, approximately 4,000 of Florida’s sickest uninsured residents have enrolled and started receiving benefits in the new health insurance program of the federal government.
What Is This Pre-Existing Condition Insurance Plan All About?
Nationwide, approximately 49,000 people are enjoying the benefits of this new health insurance program sponsored by the federal government. This new health insurance program was created by the Patient Protection and Affordable Care Act to help people who have been without any form of health insurance coverage for at least six months or have been denied coverage due to a pre-existing condition. This federal health insurance program is called the Pre-Existing Condition Insurance Plan or PCIP for short.
This is a temporary program created to give assistance to people with health problems. It allows them to get the health coverage they deserve while they wait for the full implementation of the health care reform law in 2014. Beginning in 2014, insurance companies will no longer be allowed to charge higher rates or deny a person health coverage due to a pre-existing condition as mandated by law. People with pre-existing conditions can also join the state-based health insurance exchange for individuals and small businesses to get affordable Florida health insurance premiums.
The health care reform act gave the states the authority to create their own pre-existing condition plans. However, since Florida and 22 other states did not establish their own PCIP, these states are now part of a federal plan. The PCIP program was allotted $5 billion in federal funds. But, this is not enough so individuals will still have to pay hefty premiums.
What Florida Health Insurance PCIP Means For Those Who Joined The Federal Program?
For some people who enrolled in a PCIP plan like Kathleen Watson, 50, who runs a small medical transport business in Lake City, the plan meant that she now got “excellent insurance.” After her husband became disabled in 2004, she lost her health care coverage because she could not stay under her husband’s employer-provided Florida health plan. She couldn’t get any individual Florida healthcare policy because she has a series of health problem that includes non-Hodgkin lymphoma (cancer of the lymph nodes). Watson said she attempted to pay off her medical bills. However, this only resulted in their finances hitting rock-bottom.
It is common for Florida insurance companies to reject the application of people with medical problems. Because of the fact they pose a greater financial risk.
When the PCIP program started two years ago, she couldn’t afford to pay the $700-plus monthly premiums that come along with it. Fortunately, the federal government cut premiums by 50 percent last year. That was the reason why she was able to afford it. In July, she paid $363 per month for her PCIP that allowed her to get the medical treatments she needed and couldn’t have afforded on her own.
As of December 31, 2011 in Florida, 3,736 people are covered by this plan. This number represents less than one-tenth of the one percent of the 3.8 million uninsured residents in Florida. According to Steve Larsen, a deputy administrator with the U.S. Department of Health and Human Services, he said that the national participation of uninsured Americans in the PCIP program increased by 400 percent from the first to the second year. He is expecting that numbers will keep on rising.
Aside from the monthly premium paid by Watson, she also has to pay an in-network $1,000 deductible for medical services, another $500 deductible for preferred list prescriptions and a $750 deductible for prescriptions that are not included on the list.
She also must pay a co-insurance charge of 20 percent for most in-network healthcare costs. In order for her Florida health insurance PCIP to cover all in-network costs, she needs to spend an out-of-pocket cost of $4,000. For out-of-network providers, she has a $1,500 deductible and maximum $7,000 out-of-pocket.
Unlike other Florida health insurance plans, the PCIP does not have a waiting period to get treatment. This is how the new health program helped people with medical issues get their much needed healthcare.