‘Pre-existing’ hurdles eased

By Renee Dudley
Saturday, June 4
Premium rates will drop and eligibility will get easier for South Carolinians applying for health coverage through the state’s insurance program for people with so-called “pre- existing” medical conditions, the U.S. Department of Health and Human Services announced this week.

In South Carolina, rates for the Pre-Existing Condition Insurance Plan will drop 14.7 percent, according to the announcement. Beginning in July, monthly premiums will range from $139 a month for people younger than 19 to $596 for people older than 55, according to the U.S. Department of Health and Human Services.

Also beginning in July, applicants no longer need to provide letters from insurance companies denying coverage.

They still must provide letters from health professionals, dated within a year, disclosing medical conditions or disabilities. They also still are required to show they have been without health coverage for six months and prove citizenship or legal resident status.

The Pre-Existing Condition Insurance Plan, created under the federal Affordable Care Act, was intended to provide health coverage to people with pre- existing conditions — cancer, diabetes and asthma, for example — that usually disqualify them for coverage by private insurers. The plans, available in each state, are meant to be in place until 2014 when insurers no longer will be allowed to deny coverage to people with pre-existing conditions.

To learn more

For more information, visit www.pcip.gov or call 866-717-5826.

The federal government is subsidizing the plans to the tune of $5 billion nationally over four years. About $74 million of that is set aside for South Carolina.

Currently, 18,313 individuals nationally are covered through the Pre-Existing Condition Insurance Plan. In South Carolina, 301 people were enrolled as of March 31, according to the U.S. Department of Health and Human Services.

The latest state enrollment figure is up from about 100 enrollees late last year. At that time, advocates for the uninsured complained that enrollment was disappointingly low because the plans were expensive and required people to obtain paperwork from insurance companies. And because of insufficient outreach, some people who could afford the coverage and obtain the necessary paperwork did not know the plans existed, they said.