Dear Addy: Pre-Existing Condition Insurance Plan
I have a young child with substantial medical costs. For the past couple of years I have spent 20-40% of my income on medical bills. Unfortunately my income is “too high” for Medicaid. I live in Texas and I currently have PCIP (pre-existing condition insurance plan) insurance which ends this month. What do I do?
~Pre-existing Plan Ending
Dear Plan Ending,
You are not alone. There are many people facing the end of PCIP coverage who are trying to figure out their options. In your case unlike others, your state is not expanding Medicaid to include people with income currently “too-high-to-qualify” for Medicaid. Fortunately, there are still options for you.
You can find a new health insurance plans via “The Marketplace” at www.healthcare.gov. The deadline to sign up for coverage is December 23, 2013. The plan must be chosen and the first premium paid by December 23, 2013 if you want coverage to begin on January 1, 2014. The final deadline to sign up for coverage without facing a penalty is March 31, 2014. Here is a chart with deadlines and coverage dates:
|Date Plan Chosen & Paid||Date Plan Becomes Effective|
|by December 23, 2013||January 1, 2014|
|by January 15, 2014||February 1, 2014|
|by February 15, 2014||March 1, 2014|
|by March 15, 3014||April 1, 2014|
|by March 31, 2014||May 1, 2014|
Visit www.healthcare.gov and review the health insurance plans that are available to you and make sure the plans cover your needs. You can use the NHF Health Insurance Toolkit to help you evaluate each plan. Use the income calculator on the www.healthcare.gov to determine if you are eligible for tax-credits and/or subsidies to help with the cost of your insurance.
If you need help, there are local application assisters in your area. On www.healthcare.gov, type your zip code in the “Find Local Help” section and you will see facilities that offer in-person assistance with completing the application process. If you do not have access to the internet, you can speak to someone by phone with questions and enroll in a health plan for the state of Texas by dialing: 1-800-318-2596.
If you still need assistance with medical expenses, you should contact Patient Services, Inc. (PSI) at 800-366-7741 or email@example.com or visit their web site www.patientservicesinc.org for more information. Thanks for your question.
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HFA frequently receives questions from the bleeding disorders community related to advocacy issues. The questions often impact the entire community. In an effort to reach the largest audience possible with our responses to these widely applicable questions, HFA developed “Dear Addy.” Questions submitted to this column are edited in order to protect privacy and should be considered educational only, not individual guidance.
Assisting and Advocating for the Bleeding Disorders Community