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Providing Healthcare for Children and Adults with Pre-Existing Conditions

Summary: 
HHS Center for Faith-based and Neighborhood Partnerships hosted a conference call to provide faith and community leaders with information and resources about the Pre-Existing Condition Insurance Plan (PCIP) which was established through the Affordable Care Act. PCIP was created to make health coverage available to the uninsured that have been denied health insurance by private insurance companies because of a pre-existing condition.

Cancer, traumatic brain injury and congestive heart failure are among the medical conditions that private insurance companies have cited as pre-existing conditions to deny millions of Americans healthcare coverage.  Before the passage of the Affordable Care Act (ACA), those who were classified as having a pre-existing condition were simply shut out of the healthcare market.  With the passage of health reform, the Pre-Existing Condition Insurance Plan (PCIP) was created, making health coverage available if you are uninsured and have been denied health insurance by private insurance companies because of a pre-existing condition.   

Last week, we hosted a nation-wide conference call to discuss PCIP and provide faith and community leaders with valuable information and resources about the program to share with their communities and congregations.

I had the pleasure of moderating the discussion and was joined by the White House Office of Faith-Based and Neighborhood Partnerships and Richard Popper, Director of the Office of Insurance Programs at the Center for Consumer Information and Insurance Oversight.  Richard, who leads a dedicated staff implementing several provisions of the Affordable Care Act, is directly responsible for the administration of the Pre-Existing Condition Insurance Plan and shared his expert knowledge with all of us.

He began by outlining the criteria to qualify for PCIP.  First, you must be a U.S. citizen or residing in the U.S. legally, second, you must have been uninsured for a minimum of six months before applying to PCIP and third you must have a pre-existing condition or have been denied coverage because of a health condition. 

Richard made a point to state that PCIP is available to everyone, regardless of income, and benefits are available immediately upon enrollment. PCIP insurance plans are similar to health plans offered to federal employees, he said. 

Children with pre-existing conditions only need a note from their doctor’s office stating that the child has been sick. Community or faith-based organizations can help cover the costs for the premium, deductible and copays.

This program is improving and saving the lives of people who’ve been locked out of the health care market.  PCIP offers emergency services, prescription drugs, in-and out-of-network benefits, hospital services and other benefits to those enrolled in the program. 

More information on PCIP is available at www.pcip.gov. You can apply for the plan and learn more about specific guidelines for your state and find detailed information on your plan, including the monthly premium as well as deductibles, coinsurance and other copays.

Faith-based and community organizations are encouraged to share this information with their communities and congregations. Together we can help people in need receive the valuable health benefits they deserve.

Mara Vanderslice is the Acting Director of the Center for Faith-based and Neighborhood Partnerships (The Partnership Center) at the U.S. Department of Health and Human Services.