Seminar clarifies muddy health coverage issues

 The pre-existing condition insurance plan is an option for people who have been unsuccessful in obtaining health care coverage because they have an illness or condition, allowing them to receive the same coverage that a healthy person receives and at the same rate. The consumer assistance plan (CAP) offers counseling and resources to help state officials educate consumers about health care coverage and how to obtain simple and correct information.
    To receive coverage under pre-existing condition plan an applicant must show proof of citizenship or that he or she has been residing here legally; have been uninsured for six months; have a pre-existing illness; or have been denied medical coverage. Benefits include immediate comprehensive coverage, no surcharges because health conditions and a maximum out-of-pocket cost of $3,000 per year.
    The CAP assists consumers with filing complaints and appeals that relate to coverage offered by any health care insurance issuer; the enrollment process in any health care plan; and the education of consumers about their rights and responsibilities with respect to group health plans and individual insurance.   
    The federal government issued $30 million in grants to 35 states to establish plans covering pre-existing conditions. Rhode Island’s plan started three months ago, and there are already 302 enrollees in the program. The federal government will subsidize the difference between premiums paid and actual cost of claims. For more information about the plan, go online to www.pcip.gov and click on the Rhode Island find your state link; or go to www.dbr.ri.gov/divisions/insurance/consumers.php.
    There is no question about the significance of those new programs and the importance of providing consumers with detailed information. Speakers at the seminar were Elizabeth Roberts, lieutenant governor of Rhode Island; Jan Angoff, senior adviser to the secretary of the U.S. Department of Health and Human Services; Christie Hager, regional director for the U.S. De-partment of Health and Human Services; Holly Whelan, health insurance resource specialist for the Center for Medicare and Medicaid Services’ Office of Consumer Support Center for Consumer Information and Insurance Oversight, Monica Neronha, vice president for legal services for Blue Cross & Blue Shield of Rhode Island – the only provider in Rhode Island of the pre-existing condition program; and Chris Koller, Rhode Island health insurance commissioner.    

    Kathleen Heren is executive director of the Alliance for Better Long-Term Care. You can contact her at (401) 785-3340.