New pre-existing condition insurance plans (PCIP). These plans are designed to help people who have difficulty buying health insurance due to pre-existing health conditions.
To join the plans, you must be a U.S. citizen who has gone without health insurance coverage for at least six months. If you qualify, the plan includes a full range of services such as primary and specialty care, hospital care and prescription drugs.
This summer, the U.S. Department of Health and Human Services began offering PCIP plans in 21 states. Plan premiums range from $320 to $570 per month for a 50-year-old enrollee, depending on where you live. Policyholders pay premiums, deductibles and co-pays.
Twenty-nine states and the District of Columbia operate their own plans. Check with HealthCare.gov to research both state and federally run plans. You can also apply for both types of PCIP plans online.
Qualification requirements vary from state to state, but generally you’ll need to be uninsured and have trouble getting insurance. States such as Florida also require a letter from at least one insurer that denied you coverage within the past six months.
Some states still are scrambling to flesh out plan details. PCIPs will only be available until 2014; after that, all health insurance companies must provide coverage to any person with a pre-existing condition.
Young adults now covered up to age 26. Children up to age 26 who do not have access to coverage through an employer-sponsored health plan are now eligible for health care coverage under their parents’ health insurance policy. Children may remain on the plan even if they’re married, living away from home or attending school. This provision applies to policies that began after Sept. 23, 2010.
No rescission of health insurance. Insurance companies can no longer cancel — or rescind — your insurance because you unintentionally left out personal information on your application. Intentional fraud is, of course, an exception.
This provision applies to policies that began after Sept. 23, 2010, and it applies to both employer and individual plans.
No lifetime or annual limits on coverage. Insurers can’t impose lifetime cost limits on medical coverage, as of Sept. 23, 2010. This key reform means people with serious illnesses such as leukemia won’t be cut off from their insurance.
Annual limits, which are less common and affect 19 percent of individual plans, are being phased out and eventually will not be allowed.
View the original article here
Filed under insurance by on Dec 30th, 2010. Comment. 
“Let there be no doubt: health care reform cannot wait, it must not wait, and it will not wait another year.”
President Obama made this bold promise to hopeful Americans in his recent address to Congress. Few listeners debate the importance of health care, but providing quality affordable health care for every American will clearly challenge Democrats and Republicans to work together to meet this goal.
As unemployment rises, even fewer Americans will have health insurance through an employer. And, rising medical costs are forcing small and large businesses to reduce coverage, increase co-pays and deductibles and raise the amount that employees must pay each month. Some small business owners have even converted traditional health insurance plans to high deductible plans.
Insurance.com offers these tips for evaluating your health care options and saving money on your medical bills.
My employer offers an HMO and a PPO. How do I decide?
Both provide excellent care, but you may want to choose an HMO if its network of doctors and hospitals matches your needs. Health insurance with a Health Maintenance Organization (HMO) is generally less expensive. You’re required to select an HMO physician to be your primary health care provider. This doctor will coordinate all of your medical care, including referrals to specialists within your HMO network. If you seek treatment from a non-network physician, you will generally pay most of the cost yourself.
A Preferred Provider Organization (PPO) is more flexible than an HMO plan, but it still operates with a list of physicians and hospitals that are “within the PPO network.” You may visit an out-of-network provider, but you will pay the difference between the PPO network and out-of-network prices. Both plans usually offer a prescription drug benefit, as well. Some companies are offering options that allow you to combine features of both HMO and PPO plans.
I can’t afford full health insurance, but I want coverage for major emergencies.
A high deductible health insurance plan or catastrophic health insurance offer coverage for major illnesses or accidents. For example, a plan with a $5,000 deductible requires you to pay all of your medical expenses up to $5,000 before your insurer begins to pay. If you choose a high deductible plan, try to save a small amount of money each month in a Health Savings Account (HSA) so that you’re not overwhelmed by routine medical expenses.
I have health insurance, but it seems like I’m always paying for something.
Sad but true. You may owe a co-payment for doctor’s visits or a trip to the ER. Usually, this is a flat fee, but it can get expensive if you don’t stay within your plan network.
Secondly, payment for expenses is subject to your annual deductible, which is the amount you pay toward your medical expenses before the insurance company begins to pay claims. Some HMO plans do not have deductibles but do have co-payments.
Lastly, there’s co-insurance, which is the percentage of your medical costs that you pay after you reach your annual deductible. 80/20 co-insurance is a common option, and that means that your insurer pays 80% of your bills and you pay 20%—after your deductible. So, anything you can do to reduce your medical bills will help you reduce your out-of-pocket expenses, too.
I don’t have health insurance. What can I do?
Almost every hospital has a financial aid office that will evaluate your personal situation and determine your ability to pay for required care. Generally, a hospital will provide sliding scale fees if your income is 400% or less of federal poverty limits and may eliminate bills entirely if your income is 200% or less of federal poverty limits. But hospitals have to make money, too, so they may not publicize these programs or provide much assistance in applying. Be prepared with recent copies of your tax returns and W-2′s to prove your need.
We agree with President Obama that all Americans deserve quality affordable health care and look forward to the details of its delivery. What do you think? Looking for different information? Have questions or feedback? Please let us know.
Filed under insurance by on Dec 28th, 2010. Comment.
If you’re like most Americans, you’ve been keeping at least one eye on the endless back-and-forth over health insurance reform that’s been going on for months in the halls of Congress. If you listen to the way the politicians and pundits are talking lately it can seem as if the upcoming legislation will make so many changes that any health insurance you have right now might be something totally different once the proposed regulations make it past the president’s desk. Combine that with recent controversial rises in premiums among certain health insurers— with no real guarantee that it won’t happen again next year— and (superficially) it can seem as though a “wait-and-see” approach to shopping for health insurance might be the most prudent one. To counter this misconception, here are a few of the reasons why waiting isn’t a good idea:
It’s moving at the speed of Congress. While the current bill has been in the works for months— and some kind of health reform has been waiting in the wings for decades— it’s still got an enormous amount of political ground to cover before it crosses the president’s desk. While it’s possible that this bill, in one form or another, is going to pass in the next few weeks, bear in mind that this was also Many states, as well as many insurers, currently require a fixed duration of continuous coverage before certain benefits take effect. The specifics can vary state by state and from insurer to insurer, but acquiring some degree of health coverage as early as possible will almost always provide major advantages down the road, even after any of the proposed reforms take effect.Any impending changes will affect current policy-holders as well as those who are not yet covered. Most of the proposed reforms will require insurers to re-vamp their current “basic” policies to provide more comprehensive coverage, so getting even a barebones health plan now may well get you a foot in the door for much better health coverage later on. On the flip-side, assuming that the upcoming reforms somehow make things worse for current policy-holders, it will still be much easier to cancel an existing policy— or switch from one to another— than to obtain one from a standing start.Life happens. By definition, none of us can know for certain whether something unexpected might come up in the near future and give even the most healthy individual a need for urgent medical attention. Even if one assumes that sweeping health insurance reforms are due to land next week, it can make all the difference to have coverage now to provide relief from an unforeseen calamity.While the tension and uncertainty induced by the unfolding debates over health insurance reform can be considerable, there’s no reason to let these things cloud your judgment or create needless risk.
Filed under insurance by on Dec 27th, 2010. Comment.