|Federal insurance now available for uninsured |
|Posted: Friday, July 9, 2010 11:17 am |
|The Press 7.9.10 Nashville – The United States Department of Health and Human Services today announced the formation of the Pre-Existing Condition Insurance Plan, which will serve as the new, nationwide high risk pool. |
The addition of PCIP provides an additional option for uninsurable Tennesseans, who already have an option for coverage through AccessTN, the state’s existing high risk pool.
While some details about benefits and premiums for PCIP are yet to be finalized, there are some clear differences between the new plan and AccessTN.
In order to qualify for AccessTN, an individual must be uninsured for at least three months, though special provisions apply for those finishing COBRA, CoverKids or TennCare policies. PCIP requires applicants to be uninsured for six months.
Both AccessTN and PCIP require applicants to be medically uninsurable.
Those applying for AccessTN can prove uninsurability through either a letter of denial of coverage from a private insurer or a physician’s statement indicating someone has one of 55 pre-existing conditions. For PCIP, applicants can only prove uninsurability through a denial letter from a private insurer.
AccessTN offers three plan options with deductibles of $1,000, $3,000 and $5,000. Monthly premiums vary among the three plans and are based on an individual’s age, weight and tobacco use.
AccessTN also provides premium assistance of 20, 40 or 60 percent of the total amount to those who qualify.
The plan options and premiums for PCIP are not yet available, but premium assistance will not be offered through the federal pool.
However, monthly premiums for PCIP will be priced at the standard commercial rate, unlike AccessTN which has premiums at 130 percent of the commercial rate, though many AccessTN members pay less than the commercial rate as a result of premium assistance. Current members of AccessTN will not be impacted by the addition of PCIP and enrollment in Tennessee’s plan will continue. With a current membership of nearly 3,900, AccessTN is a program of Cover Tennessee, Gov. Phil Bredesen’s initiative to address the health care needs of Tennessee’s uninsured. Additional information about AccessTN is available online or by phone at AccessTN, www.CoverTN.gov, 1-866-636-0080. For more information about PCIP, visit www.HealthCare.gov or call 1-866-717-5826.