Humana exchange rates here…..
BLUE CROSS BLUE SHIELD (BCBS) exchanges rates here…..
Now available to Texans that have A Pre-Existing Condition and have been declined. THIS IS NOT A DISCOUNT PLAN but the Government Guarantee Issue Health Insurance.
THE PCIP PLAN ENDED IN FEBRUARY 2013….YOUR NEXT CHANCE IS OCTOBER 2013. BOOKMARK THIS PAGE AND CALL ME IN OCTOBER 2013.512-963-5000 SCOTT
Premium rates for Texas
Here are the 2011 monthly PCIP premium rates for Texas by the age of an enrollee, effective July 1, 2011.
|Age||Standard Option||Extended Option||HSA Option|
|0 to 18||$133||$179||$138|
|19 to 34||$199||$268||$207|
|35 to 44||$239||$323||$248|
|45 to 54||$306||$412||$318|
PCIP enrollees can choose from three plan options, with different levels of premiums,
calendar year deductibles, prescription deductibles and prescription copays. The
HSA Option provides an opportunity to open a Health Savings Account, a tax-exempt
account where you can deposit funds for eligible medical expenses.
Each of the three PCIP plan options provides preventive care (paid at 100%, with no
deductible) when you see an in-network doctor and the doctor indicates a preventive
diagnosis. Included are annual physicals, flu shots, routine mammograms and
cancer screenings. For other care, you will pay a deductible before PCIP pays for
your health care and prescriptions. After you pay the deductible, you will pay 20%
of medical costs in-network. The maximum you will pay out-of-pocket for covered
services in a calendar year is $5,950 in-network/$7,000 out-of-network. There is
no lifetime maximum or cap on the amount the plan pays for your care.
Are you eligible?
To be eligible for the Pre-Existing Condition Insurance Plan, you must be a citizen
or national of the United States or residing in the U.S. legally, have been uninsured
for at least the last six months, and have a pre-existing condition or have been
denied coverage because of your health condition.
My Rx Choices
If you are a PCIP enrollee and you take medications on an ongoing basis, you could potentially save hundreds of dollars a year when you use Medco’s My Rx Choices online benefit service.
After you access My Rx Choices, you’ll get a confidential and personalized prescription drug comparison, listing the drugs you’re taking on an ongoing basis, your current out-of-pocket costs and any lower-cost alternatives – including lower-cost brand or generic drugs. From your personalized comparison, you can choose which lower-cost alternatives you want to try, confirm with your doctor that the alternatives are appropriate for you, and start saving money. Medco will not make changes without your doctor’s approval, and will notify you if and when changes are made.
Reduced rates on July 1
The premiums for all three PCIP plan
options were lowered significantly
on July 1 in several states. If you
are already an enrollee in one of
these states, your plan’s rate
was reduced automatically. If
you have been thinking about
PCIP coverage but have not
yet applied, this is a great time
to look again. Click to see plan
option benefits and reduced
PCIP varies depending on your current state of residence. GEHA is administering PCIP benefits in more than 20 states for HHS, while other states will run their own Pre-Existing Condition Insurance Plan. To find out about your state.
Consumers unable to get health insurance because of a pre-existing medical condition now have a new option.
The federal government on Thursday began accepting applications for its new Pre-existing Condition Insurance Plan, which was authorized by the health care overhaul signed into law this year by President Barack Obama.
To be eligible, people must be uninsured for at least six months and have been turned down for coverage by a private insurer because of a medical problem. Applications for the insurance are available online at www.HealthCare.gov. Coverage starts Aug. 1.
The Pre-existing Condition Insurance Plan is a separate program from Texas’ high-risk pool, the Texas Health Insurance Pool. In the existing Texas Health Insurance Pool, premiums are set by state law at twice the standard individual market rates.
But in the new Pre-existing Condition Insurance Plan, premiums will be similar to average individual market premiums charged to healthy people in Texas.
Estimates on HealthCare.gov show premiums for a 50-year-old in Texas will be $491 to $600 for the Pre-existing Condition Insurance Plan. The size of the deductible has not been released.
In comparison, the state’s high-risk pool offers insurance for a 50-year-old nonsmoking man living in Dallas’ 75202 ZIP code for $520 a month with a $7,500 deductible.
If he wants a smaller deductible, say, $1,000, his monthly premiums would jump to $1,171.
As of June, there were 26,894 in the state’s high-risk insurance pool.
People in the state’s high-risk pool would not qualify for the government’s pre-existing condition insurance, because one of the requirements is to be without insurance for at least six months.
Stacey Pogue, senior policy analyst with the Center for Public Policy Priorities, a nonprofit, nonpartisan Austin-based public policy research group, says the high-risk insurance pool will still be needed after the federal insurance plan goes into effect in August.
“It’s not a permanent solution,” Pogue said of the federal government’s new plan. “It’s just a temporary bridge to help them get to 2014.”
At that time, many of the main provisions of the health care overhaul will go into effect, including a rule requiring insurers to accept applicants with pre-existing health conditions.
Pogue said there’s little chance that a private insurer would start accepting people with pre-existing conditions now, because it would create an imbalance of unhealthy, expensive claim-filers.
“If you only have sick people in your pool, affordable premiums can never cover claims,” Pogue said.
Insurers have said they are willing to accept applicants with pre-existing conditions in 2014 because the law would then require everyone – healthy people included – to purchase insurance.
The risk and costs would be shared among more people.