Some of the folks that we serve in our diverse mission have complicated medical conditions and may have had trouble in the past finding health insurance because of a pre-existing health problem. The new federal healthcare reform law may be able to help some of these folks under the newly created “Pre-Existing Condition Insurance Plan (PCIP)”… which is designed to help people with pre-existing conditions find health insurance. In Arizona, the Pre-Existing Condition Insurance Plan (administered by HHS) went live this week. In order to qualify for the program, folks need to have been uninsured for at least six months, have been denied health coverage because of a health condition, and be a US citizen (or living here legally).
The monthly premiums for the Arizona PCIP range from $323/month for people 0-34 years old to $688/month for people over 55. There’s a $2,500 annual deductible and a $25 copayment for doctor visits after that. There are also some medicine co-pay costs. The person’s out-of-pocket costs are capped at $5,950 per year. Of course, there’s a lot more to the plan than this… so folks that are interested should go to the Pre-existing Condition Insurance Plan Website and can Apply on the HHS web site.
Make sure you reach out to your Stakeholders and clients to ensure they’re aware of this new program. Examples of people that might be interested include Non Title XIX behavioral health patients, children with special healthcare needs and folks enrolled in the AIDS Drugs Assistance Program etc.
I am a High risk pre-existing condition female ,58 years old who will be running out of my employee based Cobra in 1 year. Why do I have to be Without any health insurance for six months before I can apply? Just on monthly prescripton prices without insurance It would financially break me in four months. Not counting any hospital or doctors visits. I have worked hard all my life, paid all my taxes. Do I have to be without a dollar to my name to qualify? I am willing to pay high co-pays, but if I have to wait six months without anything, I dont understand the purpose. Thankyou for letting me vent…even though it does not help anyone.
I have a child with type 1 diabetes and fear that he will be discriminated against for health insurance as he gets older. Hopefully common sense will prevale
Why do we need to go and get denied for insurance first. Don’t the people at PCIP know what health conditions will be declined? Where do I go to get this?
I am interested in the answer to Paula’s question. I want to move to Arizona (have already purchased a home), but am afraid to be without insurance for 6 months. My current health is good, but I will likely be turned down based on past history. What if I had an accident during the 6 months I don’t have coverage? Please help us understand the 6-month rule.
You may want to reach out to the Arizona Department of Insurance for more information.
Mr. Humble, I am in a situation similar to Laurel Bailey’s. I have just returned from overseas and I am considering settling in Arizona, but I have pre-existing conditions and a COBRA policy that soon expires. Why the six month wait w/o insurance and why the rejection letter? In Oregon where I’m staying temporarily neither is required to qualify for their high risk pool. A diagnosis of a listed condition is sufficient, surely Arizona can do the same. Also, I suggest you take a look at the Arizona Department of Insurance website and try to find answers to the questions posed above. I think you’ll find that a referal there is as good as a brush off.
Please visit the Department of Inurance’s website. for further clarification.
Where can I find a current price list for premiums in 2012?
Please follow the link in the blog post named “Pre-existing Condition Insurance Plan Website” for further information. Thank you!