States/Federal Government initiate Affordable Health Care Act Provisions

Ohioans with pre-existing health conditions, such as cancer or diabetes, can apply for coverage under a new high-risk insurance pool beginning Aug. 1, USAToday reported this morning.

That pool is a key piece of President Barack Obama's health care overhaul, with programs being in place until 2014 when health insurance companies will no longer be allowed to deny coverage to people in poor health.

The law, the Affordable Care Act, creates a new program – the Pre-Existing Condition Insurance Plan -- to make health coverage available to you if you have been denied health insurance by private insurance companies because of a pre-existing condition. (Major Provisions of the Act in Chronological Order)

The Pre-Existing Condition Insurance Plan (PCIP), which is administered by either your state or the U.S. Department of Health and Human Services, will provide a new health coverage option for you if you have been uninsured for at least six months, have a pre-existing condition, or have been denied health coverage because of your health condition, and are a U.S. citizen or legally residing here.

Kentucky and Indiana's programs are being administrated thru the Department of Health & Human Services. As of July 1st., eligible residents were able to apply for coverage through the state's Pre-Existing Condition Insurance Plan program run by the U.S. Department of Health and Human Services. Residents in those two states can simply log onto the Plan's website, where they’re taken directly to the application page. The website says for states federally administrated, applicants will need at a minimum:

• A completed and signed application form, and


• A copy of a letter dated within 6-months of your application from an insurance company or health plan showing that you have been completely denied individual coverage because of a pre-existing condition, or you were offered coverage but were denied certain benefits (for example, by a rider to an insurance policy) because of a pre-existing condition.

More information for Kentucky residents is ( Here )and Indiana residents is ( Here ), and more in-depth information for all of the states can be found ( Here ).

Eligible residents of Ohio will be able to apply for coverage through the state's Pre-Existing Condition Insurance Plan program run by Medical Mutual of Ohio through the Ohio Department of Insurance on August 1.

To qualify for coverage:

• You must be a citizen or national of the United States or lawfully present in the United States.


• You must have been uninsured for at least the last six months before you apply.


• You must have had a problem getting insurance due to a pre-existing condition.

"Applications for Ohio's pool will available through a website managed by the state's Insurance Department and Medical Mutual of Ohio, a nonprofit insurance company selected by the state to administer the program," usatoday said. Further information for Ohio residents is available ( Here ) and on the Ohio Dept. Insurance’s site ( Here ) and ( Here ).

MSNBC.com also reported this morning that "Patients will find it easier to appeal denials of health insurance claims under the rules issued yesterday which guarantee consumers the right to appeal denials — directly to their insurers and then, if necessary, to external review boards." Additional information about the new appeals regulation or Consumer Assistance Grants program is available ( Here ) and ( Here ).