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New Plan Covers Nebraskans with Pre-Existing Conditions

The federal government recently announced changes to reduce premiums and make it easier for Americans to enroll in the Pre-Existing Condition Insurance Plan (PCIP) – the new program created by the Patient Protection and Affordable Care Act to help uninsured people with a pre-existing condition get high quality care at affordable prices.

See Also: Health Care Reform: What's in Effect, What's Still to Come

“The PCIP is a first step to help people with pre-existing health conditions receive the treatment they need,” said Robert Eppler, state president of AARP Nebraska. “In a little over two years from now, barring people from insurance coverage based on their health status will be a thing of the past.”

Today, Nebraskans with pre-existing conditions who have been uninsured for six months can apply for coverage through the PCIP, which is administered by the federal government in Nebraska. Here’s what you need to know:

  • New Reduced Premiums: Starting July 1, premiums for Nebraskans have dropped more than 20 percent. Now a 50-year-old in Nebraska can get comprehensive health coverage for $303 per month. Find more information on premiums online.
  • Simplifying Eligibility: Now 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. Applicants will still need to meet other eligibility criteria including proving that they are U.S. citizens or residing in the U.S. legally, and that they have been without health coverage for six months.
  • Life-Changing Coverage: 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. Eligibility is not based on income and people who enroll are not charged a higher premium because of their medical condition.
  • Extensive Provider Network: Nebraskans enrolled in the PCIP have access to a provider network that includes 6,781 physicians, 460 pharmacies and 73 hospitals throughout the state.

Find more information on the PCIP, including eligibility, plan benefits and rates, as well as information on how to apply, online (select Find Your State). Then, select Nebraska from a map of the United States or from the drop-down menu. The PCIP Call Center is open from 7 a.m. to 10 p.m. Central Time. Call toll-free 1-866-717-5826 (TTY 1-866-561-1604).

The PCIP will operate until 2014, when the health insurance exchanges and ban on pre-existing condition exclusions take effect. Insurance companies will be required to insure people even if they are or have been sick or disabled and they cannot drop people when they get sick.

People without coverage will be able to buy insurance through these exchanges and those with incomes below 400 percent of poverty ($88,200 for a family of four) will qualify for tax credits that will keep premium costs below 10 percent of the family’s income. There also will be protections in place to curb excessive premium rates because of age, gender, or health condition.

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