Government unveils Pre-existing Condition Insurance Plan
Consumers unable to get Texas health insurance because of a pre-existing medical condition now have a new option.
The federal government on Thursday began accepting applications for its new Pre-existing Condition Insurance Plan, which was authorized by the health care overhaul signed into law this year by President Barack Obama.
To be eligible, people must be uninsured for at least six months and have been turned down for coverage by a private insurer because of a medical problem. Applications for the insurance are available online at www.HealthCare.gov. Coverage starts Aug. 1.
The Pre-existing Condition Insurance Plan is a separate program from Texas’ high-risk pool, the Texas Health Insurance Pool. In the existing Texas Health Insurance Pool, premiums are set by state law at twice the standard individual market rates.
But in the new Pre-existing Condition Insurance Plan, premiums will be similar to average individual market premiums charged to healthy people in Texas.
Estimates on HealthCare.gov show premiums for a 50-year-old in Texas will be $491 to $600 for the Pre-existing Condition Insurance Plan. The size of the deductible has not been released.
In comparison, the state’s high-risk pool offers insurance for a 50-year-old nonsmoking man living in Dallas’ 75202 ZIP code for $520 a month with a $7,500 deductible.
If he wants a smaller deductible, say, $1,000, his monthly premiums would jump to $1,171.
As of June, there were 26,894 in the state’s high-risk insurance pool.
People in the state’s high-risk pool would not qualify for the government’s pre-existing condition insurance, because one of the requirements is to be without insurance for at least six months.
Stacey Pogue, senior policy analyst with the Center for Public Policy Priorities, a nonprofit, nonpartisan Austin-based public policy research group, says the high-risk insurance pool will still be needed after the federal insurance plan goes into effect in August.
“It’s not a permanent solution,” Pogue said of the federal government’s new plan. “It’s just a temporary bridge to help them get to 2014.”
At that time, many of the main provisions of the health care overhaul will go into effect, including a rule requiring insurers to accept applicants with pre-existing health conditions.
Pogue said there’s little chance that a private insurer would start accepting people with pre-existing conditions now, because it would create an imbalance of unhealthy, expensive claim-filers.
“If you only have sick people in your pool, affordable premiums can never cover claims,” Pogue said.
Insurers have said they are willing to accept applicants with pre-existing conditions in 2014 because the law would then require everyone – healthy people included – to purchase insurance.
The risk and costs would be shared among more people.
Looking for the best information and the best rates on Texas Health Insurance–visit www.texashealthandlife.com or give us a call at or 512-246-9955
Tags: austin health insurance, Goverment health plan, Pre existing Conditions, Texas Health Insurance
