Health plan for the uninsured just got better
The feds have made it easier for those with pre-existing conditions to sign up for affordable coverage.
Have you been enjoying the benefits of health care reform, like being able to keep your jobless adult child on your insurance plan, and getting mammograms and other preventive care without a co-pay?
Major improvements are coming July 1 to another part of health care reform -- a limited program of reasonably priced coverage for people who can't buy private health insurance because they've been sick in the past (those pre-existing conditions insurers want nothing to do with). It's a stopgap until 2014, when everyone will be able to buy health insurance, regardless of their medical history.
Here's how it works: All 50 states are required to provide a new type of high-risk pool, called a Pre-existing Condition Insurance Plan or PCIP, to people who have been denied coverage because of pre-existing conditions. States can either run their own plans or have the feds do it for them. Twenty-three states have gone that route.
Enrollment in PCIPs nationwide has been low -- only 18,313 people, far fewer than the 200,000 projected -- probably because the premiums have been too high for many folks. Plus, eligibility rules have limited the coverage to people who have applied for private insurance and been denied coverage in the last year. Post continues after video about other health care news.
Now the feds have cut the cost of premiums and streamlined the rules for the PCIPs they administer:
The premiums will drop by up to 40% in 17 of the 23 states next month, as well as Washington, D.C. The drop will be 18.4% in Tennessee. "A 50-year-old in Tennessee will be able to get comprehensive health coverage for as low as $305 per month," The Tennessean reports. In Florida, a 40% reduction means a person older than 55 will pay only $376 a month. That's a monthly savings of $150.
According to Kaiser Health News:
These decreases will help bring premiums closer to the rates in each state's individual insurance market. In the six states where high-risk plan premiums were already similar to what healthy people pay for individual plans, premiums will remain the same.
People still have to be uninsured for six months before they can enroll, but in those 23 states and D.C., they won't need to show that they've been denied coverage. They'll simply need a note from a doctor, physician's 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," a U.S. Department of Health and Human Services press release said.
On or before Oct. 1, the government will pay insurance brokers $100 for each person they successfully refer to the PCIP coverage in the 23 states and D.C. Most of the states that run their own program already pay a fee, says Healthcare Finance News.
The federal government has informed the states that administer their own plans that they can make similar changes.
A $5 billion allocation that was part of health care reform pays for the programs. (You can learn more about PCIPs at this government website, and go here to learn more about the plan in your state.)
Another reason why so few people have enrolled -- when so many are in need -- is that many people still don't know that PCIPs are available. The Washington Post said:
As recently as late February, a poll conducted by Kaiser Family Foundation found that nearly half of Americans thought that health reform had been repealed or said they didn't know whether that was the case.
The Congressional Budget Office estimated that 4 million Americans would be eligible for PCIP. If you or someone you know is uninsured and has a pre-existing condition, this could be a life saver.
More on MSN Money:
I pay $106 a week for health coverage. The employer pays the other 2/3...meaning he pays almost $850 a month.
Yet my health coverage does not pay for anything. At first, it was because I had to pay a deductibleof $1500 per person or $3000 for the family per year. After the deductible is met, I then have to pay 20% of medical costs. This does not include the copays I must pay.
Now the health insurance company just denies my claims and trivializes serious health issues. For example, my son had his first asthma attack. It was late at night, and he just could not breathe. He was turning a purplish blue. A call to the pediatrician's office and the nurse determined that to delay was not an option and an ambulance was needed to get immediate medical assistance. We were rushed to the ER, and it was there that he was diagnosed with asthma.
The insurance company is trivializing this by stating my son only had a cough and it was a minor illness, so they will not cover the bills that are over $2250.
So here we are in June...let us add up what has been paid so far...$106 a week for approximately 26 weeks...that is $2756...then we have my son's deductible of $1500...oh and the medical bills that should be paid but the insurance company refuses...$2250..so far that is $6506...then add another $1250 for a medical item not covered under the policy...and we havent even added all the co-pays. We are talking close to $8k in medical costs for my son. Heaven forbid if anyone else in my family gets sick.
As it is...we are fast approaching bankruptcy. The greed of the insurance companies is astounding. They practice in murder for profit if you sit down and really think about it...and yet they are not held accountable. I was told by their M.D. that I should not have received medical tratment for an uncontrollable asthma attack for my child. Now if I follow that directive should my child suffer another attack, it is a strong possibility that he could suffer brain damage due to lack of oxygen or even death. But hey that's ok...as long as the CEO can afford another overpriced rolex.
Quite frankly...when physical harm or a death results from the practices of these health insurance companies...those involved in the process...all the way up to the CEO should be criminally prosecuted. Throw them in jail with the hardened criminals and let them get what is coming to them. And should they need medical attention after a well deserved beating...just deny it because it is not medically necessary to keep these sociopaths alive.
What works for the Europeans is cost sharing and higher taxes. They don't pay so much for their military so that money can be used for other things and everyone pays into the health plan. That's how they're able to give everyone free health care.
I know that kind of thinking is anathema to Americans, but we can't keep going the way we are with ever-rising health care costs. We just can't. First it will bankrupt individuals, then companies, then the nation. It's unsustainable. (And that's not even getting into pre-conditions and rising co-pays.)
As long as everyone has access to health care through the ER and Medicaid without paying anything into it, hospitals and doctors will continue to subsidize their care through higher rates to the rest of us. They have no choice.
We need some sort of national health care program. Single payer, if not public option. And we need to pay for it out of our military budget and taxes. I know, no one wants to hear this, but do you have a better solution? One not driven by party lines?
Why don`t we just cut out all the BS and make it a crime to be poor in america?
Forcing minimum wage workers to pay 1/4 to 1/3 of their weekly pay for health ins is just insane. If they can`t afford to pay that much then they will be labeled a criminal?
It`s cheaper for everyone if we make sure that everyone has affordable health care. people without health care will usually end up on disability and we all pay more taxes for their disability checks.Keep them healthy and off the disability roles and we will all benefit in the long run.
Quote: Would someone, please anyone, show me how having health insurance is so great. Anyone????
Do I really need to tell you? Apparently so...here's my personal reason why:
In 1992 I was 36 years old and never had health issues. One day I woke up and felt like I had the flu. After a couple of days of not seeing any improvement, I went to my doctor (I had insurance at the time). I went into the doctor, he did a blood test, found unusual results, was worried and said I needed to get a cat scan. I got the cat scan (paid by insurance) and found stage 4 lymphoma in my liver and spleen (stage 4 is when it travels to other organs). I was checked for any cancer in my lymph nodes (thankfully none was found) and did a bone marrow test. I then went thru chemo for 6 months (I did not work for 13 mnonths but had disability insurance to help cover bills - another godsend), got rid of the cancer (thank god) and have been in remission since (my oncologist said after 5 years the possibility of return is nil). After all the tests, retests, repeated cat scans and treatment, I never paid a penny out of pocket.
Now, does that explain to you why insurance (health and other types) can be a lifesaver????
Also, for those that are writing here that malpractice insurance is the only reason why health care is so expensive, prove it. I haven't seen one bit of evidence here (other than some one "hearing" someone else got a huge award for some small mistake a doctor made). Let's see some actual statistics if we're going to have a intelligent debate about malpractice, rather than regurgitating the remarks conservative pundits make.
If you have a beef with the new health care program, then that is all right. I do have issues with some parts of it. But I am tired of people going on about it is helping people on welfare. People on welfare already get free health care. You may not know that since you may not deal with it or know much about the system. But this is about low income working families that do not have the cash to afford health care.
The middle class and up are covered for the most part as well as those on welfare for health care. But the ones in the middle of these two groups are the ones who have a very hard time affording health care.
For those of us with jobs that have health insurance, we are blessed. It is a big difference paying around $100 a month at your job compared to $300 and up. Just go to one of the health insurance web sites and do a free quote estimate to see the prices. You will be amazed with the high prices for most decent plans.
This is about low income families that are hard workers, but just can't afford a good health care insurance. Sure, you can always find someone abusing the system. But think about someone you may know that is hard working, but just making it from one pay day to the next because they do not make a lot of money. And yes like I said, I do not like some parts of this bill. But I have no problem with the concept of helping a hard working low income family that is struggling so they can afford a doctor.
All this bickering!!!!!!! You know even when I had a job and my employer paid 2/3 rds of my premium I still could not afford my share of my insurance. Now that I lost my job, how does anyone think I can pay it now? I keep pinching my penny so hard now for so long old Abe's head is just about to pop off. All my life working, raising children, working some more, losing my job, 401 K gone and heavily taxed on that for early withdrawal, I really don't care any more. I hope the 2012 end of the world wobbling earth comes true. This world needs to start over again. Maybe the next inhabitants will not be so greedy.
What kind of a bias question is that? No, I'm not enjoying any of it. Keep your deadbeat child on your insurance plan? Lets encourage our kids to stay dependent until 26. Geez, what a joke.
REPEAL this monstrosity!
It's laughable how little people actually know about the healthcare system. Everyone is complaining about the money grubbing insurance companies, their profits are less than 1% of healthcare spending = fact. Not the unfounded numbers people are throwing around here. The price of healthcare is so expensive for all of us because of so many individuals abusing the system.
Doctors charging for services never performed, script mills (writing unnecessary prescriptions, then selling them on the black market), uninsured going to the emergency room after they are very ill for something that probably could of been prevented. The list goes on and on. There is plenty of blame to go around.
I hear so much complaining about health care reform, do you people think you are never going to get sick or age? No your just gonna piss and moan about having to have insurance now but will probably expect the taxpayers to take care of your medical costs when you become sick. EVERYONE DOES NEED INSURANCE. Wake up.
"A 50-year-old in Tennessee will be able to get comprehensive health coverage for as low as $305 per month,"
I agree with the previous posters. But, all obamacare did for me was raise my out of pocket insurance premium costs by 59% as soon as it passed, with less coverage and higher deductibles. What most companies will do is stop providing insurance, it's much cheaper for them to pay the fine.
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