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Government Website Outlines New Insurance Options For Patients With Pre-existing Conditions, Including HIV/AIDS

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Published: Jul 9, 2010 6:05 pm
Government Website Outlines New Insurance Options For Patients With Pre-existing Conditions, Including HIV/AIDS

A new government website, Healthcare.gov, offers information about insurance options created by the recent health care reform act, including the Pre-Existing Condition Insurance Plan (PCIP).

The website, created by the United States Department of Health and Human Services, features a “Find Insurance Options” tool to help patients find the health insurance best suited to their needs, including the PCIP program.

A pre-existing condition is defined as a medical condition that exists before a patient enrolls in a new health insurance plan. Conditions that a person has received treatment for, or should have received treatment for, are included in this definition.

People with HIV/AIDS as a pre-existing condition are often denied coverage or have to pay significantly higher rates for health insurance.

The PCIP program covers a broad range of health services, including primary and specialty care, hospital care, and prescription drugs.

PCIP is available in all states. To be eligible for the program, applicants must:

  • Be a citizen or national of the U.S. or be lawfully present in the country
  • Be uninsured for at least the last six months
  • Have a problem getting insurance due to a pre-existing condition.

Eligibility does not depend on the individual’s income.

Premiums will vary depending on the state. For example, the premium in the state of Pennsylvania is $283.20 per month, while premiums in Washington state range from $177 per month to $1,577 per month.

The PCIP program is in response to the Affordable Care Act, which President Obama signed into law on March 23. The law puts into place health insurance reforms that are intended to hold insurance companies more accountable and lower health care costs. The Act also aims to enhance the quality of health care.

Health insurance reforms enacted by the law will roll out over the next four years and beyond, with most changes taking place by 2014.

Discrimination by insurers against pre-existing conditions will be prohibited under the new law; until then, however, the PCIP program is intended to bridge the gap.

To assist people with HIV/AIDS with low incomes, several government programs will remain in place, including the AIDS Drug Assistance Program (ADAP) and the Ryan White Program.

ADAP provides HIV medications approved by the Food and Drug Administration to those with low incomes and limited or no health insurance. This program runs in all 50 states.

The Ryan White Program provides funding to cities to help provide services for low-income people with HIV. Specifically, this program pays for emergency room visits, dental visits, laboratory costs, transportation, and housing assistance for uninsured or under-insured individuals with HIV.

For more information and to enroll in PCIP, please see the HealthCare.gov website.

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