Reduced premiums and easier enrollment - no longer need to wait for insurance denial letter

May 31, 2011

> Date: Tue, 31 May 2011 13:55:36 -0400

> From: lei.chou@...

> Subject: [HB] Reduced premiums and easier enrollment - no longer need to wait

for insurance denial letter

> hepatitis-b@...

>

> FOR IMMEDIATE RELEASE Contact: HHS Press Office

> Tuesday, May 31, 2011 (202) 690-6343

>

> HHS to Reduce Premiums, Make it Easier for Americans with Pre-Existing

> Conditions to Get Health Insurance

>

> The U.S. Department of Health and Human Services (HHS) today announced new

> steps to reduce premiums and make it easier for Americans to enroll in the

> Pre-Existing Condition Insurance Plan. Premiums for the

> Federally-administered Pre-Existing Condition Insurance Plan (PCIP) will

> drop as much as 40 percent in 18 States, and eligibility standards will be

> eased in 23 States and the District of Columbia to ensure more Americans

> with pre-existing conditions have access to affordable health insurance.

> The Pre-Existing Condition Insurance Plan was created under the Affordable

> Care Act and serves as a bridge to 2014 when insurers will no longer be

> allowed to deny coverage to people with any pre-existing condition, like

> cancer, diabetes, and asthma.

>

> ³The Pre-Existing Condition Insurance Plan changes lives, and in many

> cases, literally saves lives,² said HHS Secretary Kathleen Sebelius.

> ³These changes will decrease costs and help insure more Americans.²

>

> In 23 States and the District of Columbia, the PCIP program is

> Federally-administered. The remaining States operate their own PCIP

> programs using Federal funds provided by the Affordable Care Act.

>

> Under the changes announced today, PCIP premiums will drop as much as 40

> percent in 18 States where the Federally-administered PCIP operates. These

> premium decreases help bring PCIP premiums closer to the rates in each

> State¹s individual insurance market; in the six States where PCIP premiums

> were already well-aligned with State premiums, premiums will remain the

> same.

>

> The changes announced today will make enrolling in the

> Federally-administered PCIP in 23 States and the District of Columbia

> easier. Starting July 1, 2011, people applying for coverage can simply

> provide a letter from a doctor, physician assistant, or nurse practitioner

> dated within the past 12 months stating that they have or, at any time in

> the past, had a medical condition, disability, or illness. Applicants will

> no longer have to wait on an insurance company to send them a denial

> letter. This option became available to children under age 19 in February,

> and this pathway is being extended to all applicants regardless of age.

> Applicants will still need to meet other eligibility criteria, including

> that they are U.S. citizens or residing in the U.S. legally and that they

> have been without health coverage for six months.

>

> HHS also sent letters today to the 27 States running their own programs to

> inform them of the opportunity to modify their current PCIP premiums.

>

> To further enhance the program, beginning this fall, HHS will begin paying

> agents and brokers for successfully connecting eligible people with the

> PCIP program. This step will help reach those who are eligible but

> un-enrolled. Several States have experimented with such payments with good

> success. This is a part of continuing HHS outreach efforts with States,

> insurers, providers, and agents and brokers to reach more eligible people

> and let them know that coverage is available. HHS is also working with

> insurers to notify people about the PCIP option in their State when their

> application for health insurance is denied.

>

> Congress created the temporary PCIP program as part of the Affordable Care

> Act to help uninsured Americans with a variety of medical conditions get

> affordable coverage rather than be locked out of the system by insurance

> companies. In 2014 and beyond, insurers will be prohibited from denying

> coverage to anyone with a pre-existing condition and new competitive

> marketplaces called Health Insurance Exchanges will give people the

> opportunity to shop for the policy that best suits their needs. Millions of

> Americans also will receive tax credits to help make coverage affordable.

>

> Enrollment in PCIP programs has begun to grow rapidly. In the period

> between November 2010 and March 2011, enrollment in all programs rose 129

> percent to more than 18,000 Americans enrolled in PCIP.

>

> ³These changes will get more people covered,² said Larsen, the

> Director of the Center for Consumer Information and Insurance Oversight.

> ³We¹re encouraged by recent increases in enrollment and we¹re excited to

> build on these efforts and reach even more people.²

>

> PCIP provides comprehensive health coverage, including primary and

> specialty care, hospital care, prescription drugs, home health and hospice

> care, skilled nursing care and preventive health and maternity care. It

> limits annual out-of-pocket spending and does not carve out benefits the

> people need. Eligibility is not based on income and people who enroll are

> not charged a higher premium because of their medical condition.

>

> To find a chart showing changes to PCIP premiums in the States with

> Federally-administered PCIP programs, visit

> www.HealthCare.gov/news/factsheets/pcip05312011a.html.

>

> For more information, including eligibility, plan benefits and rates, as

> well as information on how to apply, visit www.pcip.gov and click on ³Find

> Your State.² Then select your State from a map of the United States or

> from the drop-down menu. The PCIP Call Center is open from 8 a.m. to 11

> p.m. Eastern Time. Call toll-free 1-866-717-5826 (TTY 1-866-561-1604).

> #####

> Note: All HHS press releases, fact sheets and other press materials are

> available at http://www.hhs.gov/news.

>

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May 31, 2011