Physicians can help patients obtain immediate health insurance coverage for preexisting conditions, now that the federal government has relaxed eligibility requirements.
Previously, patients had to submit a letter from a private insurer denying coverage because of a preexisting condition before obtaining coverage under the Pre-Existing Condition Insurance Plan (PCIP). Now, patients can submit a letter from a physician, physician assistant, or nurse practitioner dated within the preceding 12 months stating that they have or had a medical condition, disability, or illness. The letter must include the patient’s name; the medical condition, disability, or illness; and the name, license number, state of licensure, and signature of the physician, physician assistant, or nurse practitioner.
PCIP is a health coverage option for patients who have been uninsured for six months or more due to a preexisting condition. Enrollees have a choice of three plan options: Standard Plan, Extended Plan, or HSA Plan. Each plan has different premium costs, calendar year deductibles, prescription deductibles, and prescription copays. The plans cover a broad range of health benefits.
In Texas, PCIP is provided by the U.S. Department of Health and Human Services and administered by GEHA.
Revised Sept. 26, 2011
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September 13, 2011