A New Option for Uninsured Residents in Louisiana

If you’ve been unable to get private health insurance because of an illness or disability, you may now have an answer to your dilemma.

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

The Pre-Existing Condition Insurance Plan (PCIP), created as part of last year’s Patient Protection and Affordable Care Act (ACA), is making health care coverage available to people who previously did not have access or could not afford it because they have a pre-existing medical condition.

99,036 uninsured Louisiana residents with pre-existing conditions, may be eligible for the new insurance.

The publicly funded PCIP program has been designed to help the uninsured until 2014, when the ACA will begin requiring the private insurance industry to cover people despite their pre-existing illnesses or disabilities.

The new plans are an alternative to the high-risk pools that many states now offer to people locked out of the insurance market. The PCIP’s have lower premiums, and they require no waiting period for the coverage of pre-existing conditions.

The PCIP program will improve the health care of the previously uninsured, help them become more self-sufficient and ease the financial burden on the health care professionals and facilities that have had to provide uncompensated care.

Who’s eligible?

• You must be a U.S. citizen or legal resident.
  
• You must have a pre-existing condition.
  
• You must have been uninsured for at least the last six months.
  

What’s covered?

This is comprehensive coverage. A PCIP covers primary and specialty care, hospital stays, skilled nursing care, home health care and prescription drugs. The coverage comes at the same price that healthy people pay for individual insurance policies.

You may choose from three coverage options in the federally administered plan in Louisiana: standard, extended and a health savings account, which is a tax-exempt account where you can make deposits to pay for medical expenses.

All three options provide preventive care, paid in full with no annual deductible, when you see an in-network physician. Included are annual physical exams, flu shots, routine mammograms and other cancer screenings.

To find out more about these new insurance options available in Louisiana, visit the Pre-Existing Condition Insurance Plan’s website, and look at the side-by-side comparisons of both the coverage and the costs of the three choices.

How can you apply?

You can also enroll online or by calling 1-866-717-5826 and requesting an application. Typically, you’ll need a denial letter from an insurance company for individual insurance coverage, or an offer of individual coverage that says your illness or disability won’t be covered if you purchase the policy. You can also submit a letter from an insurance agent or broker that shows you aren’t eligible for individual coverage because of your medical condition.

If you’ve thought you were out of options and out of luck because of a disability or illness, you owe it to yourself to consider this insurance. Assuming you’re eligible, your coverage will start several weeks after the PCIP has received your completed application and all required documents.