PCIP is a part of the Affordable Care Act.  It essentially allows people who do not have access to health insurance through their (or their spouse’s) employment, and who have been shut out of the individual market, to secure comprehensive insurance, 

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including coverage for pre-existing conditions, at the same rates that are available to healthy people (the government pays the difference).

 Wyoming has chosen not to operate this plan on its own, so it is operated through the Department of Health & Human Services (HHS).  There are three plan options, with varying levels of coverage and premiums (example:  cheapest premium plans have $2000 deductible, more costly plan has $1,000 deductible).  Premiums are also based on the age of the applicant, but NOT on the applicant’s previous medical history.  Premiums in WY range from $126 to $542 per month. These are set to be comparable with currently available policies for healthy people.  Applicants must have been uninsured for the previous six months, be able to show proof of residence/citizenship, and that they have a pre-existing condition that has resulted in denial of coverage, or an offer of coverage that excludes coverage of the condition, or an offer of coverage that costs at least twice as much as the rate in the program.

They estimate that there are just short of 10,000 Wyoming residents who are eligible, but that fewer than 100 have enrolled.  Congress funded this program with $5 billion, in order to cover people from now until January 1, 2014, when the Affordable Care Act creates health insurance exchanges for everyone, making coverage available even with pre-existing conditions, with costs on a sliding scale depending on income.

We visited with Jeff Hinson, Denver Regional Administrator for the Centers for Medicare & Medicare Services this morning about the program.

After our conversation i recieved this information from one of our listeners.

I am enrolled in the PCIP and wanted to give your listeners additional information. Prospective enrollees must have a letter from an insurance company showing proof of denial of services.
While I am excited about the services provided for me I am dismayed by the fact that only a few doctors in the state of WY accept the insurance, thus making my office visits out of network and costing more money. I hope that your discussion this morning with the gentleman on PCIP will encourage more medical professionals to accept this important program.

for more information visit www.pcip.gov or call 1-866-717-5826

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