New Pre-Existing Condition Insurance Plans Now Available

Horizons in Hemophilia, September, 2010

By Jeff Cornett RN MSN, Director of Training, Research, & Advocacy

The Affordable Care Act offers a way for everyone to get quality, affordable health insurance starting January 1, 2014.  Until that date, the federal government is offering a way for people who have been denied health insurance to get coverage.  In Georgia, these are called Pre-Existing Condition Insurance Plans.  They are offered through GEHA, a not-for-profit insurer who currently provides insurance to almost 1 million civilian federal employees.  The health insurance is a high quality plan but it is expensive.  However, for people with hemophilia, the cost of the plan is far less than the cost of factor concentrate.  This program is a bridge to 2014 when people with pre-existing conditions will not be charged more than anyone else for health insurance.

In order to qualify for the Pre-Existing Condition Insurance Plans, you must have been uninsured for at least six months because of a pre-existing condition.  It is not enough that you don’t have health insurance -- you must be unable to get it from any source.  You have to have a written letter of denial from a health insurance company.  If a company offers to sell you a health insurance policy with a “rider” that says they won’t pay for a particular condition, that counts as a denial of insurance.  People with hemophilia must go through the motions of applying for health insurance in order to get the written letter.  However, the payoff is access to quality insurance that will pay for factor and other treatment.  Hemophilia of Georgia’s Social Workers are assisting people with bleeding disorders in getting the written letters of denial.

With the written letter of denial, applying for the Pre-Existing Condition Insurance Plan is a simple process.  The application can be completed online.  To find out what your insurance options are, visit https://finder.healthcare.gov.  The government website site will link eligible people to more information about the Pre-Existing Condition Insurance Plans.