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PCIP and MRMIP (California) insurance plans -- Part Deux : NO POLITICS


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2013 Feb 17, 6:22am   4,267 views  6 comments

by justme   ➕follow (1)   💰tip   ignore  

A recent thread on the Preexisting Condition Insurance Plan (PCIP) degraded into pages and pages of political squabbling and very little useful information.

I would like to invite everyone to join a new thread about the national PCIP insurance programs and the California MRMIP (Major Risk Medical Insurance Plan) insurance programs.

In this thread, we should discuss ONLY the practicalities of these insurance plans. Please contribute any useful information you can find about these plans, whether or not you are subscribing to them (I'm not but PCIP looks tempting). Feel free to discuss pros and cons that you see, experiences, cost, availability, restrictions, problems, quality and anything else that is crucial to be people who might consider these plans.

Here are the links to the government web sites:

Federal PCIP site: http://www.pcip.gov

California PCIP site: http://www.pcip.ca.gov/Home/default.aspx

California MRMIP site: http://www.pcip.ca.gov/PCIP_Program/PCIP_MRMIP_Comparison.aspx

#politics

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1   justme   2013 Feb 17, 6:25am  

The first order of business is to note that the FEDERAL version PCIP is **suspended* for new applicants as of YESTERDAY, per the following statement that pops up on

https://www.pcip.gov/#StateInformation


Pre-Existing Condition Insurance Plan - Notification

Enrollment Suspension

Beginning February 16, 2013, the federally-run Pre-Existing Condition Insurance Plan (PCIP) is suspending acceptance of new enrollment applications until further notice. State-based PCIPs may continue accepting enrollment applications through March 2, and will then suspend acceptance of new enrollment applications until further notice. PCIP will continue providing coverage to more than 100,000 people currently enrolled nationwide. We encourage you to visit http://finder.healthcare.gov to explore your other health care options.

Note: If you lost PCIP coverage during the past 6 months because you moved out of state, you may be eligible to re-enroll in PCIP in your new state of residence. Please call 1-866-717-5826 (TTY: 1-866-561-1604), Monday – Friday, 8 a.m. to 11 p.m. EST, if you believe you are eligible.

Why is PCIP enrollment being suspended?

PCIP is a temporary program for those locked out of the current insurance marketplace. The program has a limited amount of funding from Congress.

Based on program experience and trends since the start of the program, PCIP enrollees have serious and expensive illnesses with significant and immediate health care needs. More information can be found in the Annual Report on the Implementation and Operation of the PCIP Program
available here .

This suspension will help ensure that funds are available through 2013 to continuously cover people currently enrolled in PCIP.

The Health Insurance Marketplace

Starting next year, the Affordable Care Act guarantees that all Americans – regardless of their health status or pre-existing conditions – will finally have access to quality, affordable coverage. People will be able to apply for affordable health insurance coverage choices in Health Insurance Marketplaces when open enrollment begins on October 1. The Health Insurance Marketplace will offer a choice of quality, affordable health plans. Coverage begins on January 1, 2014. Visit www.healthcare.gov to learn more about the Marketplace.

2   justme   2013 Feb 17, 6:28am  

Next, we need to find out whether California is still in the PCIP game until March 2, and whether MRMIP is affected as well.

On the following site, the cost pdf and application pdf are dead links, at least for me at the moment.

http://www.pcip.ca.gov/PCIP_Program/PCIP_MRMIP_Comparison.aspx

That may be a bad sign.

3   justme   2013 Feb 17, 6:35am  

Let's talk pricing: PCIP in California was cheaper than MRMIP. MRMIP uses commercial heath plans, but with special pricing. The following is California MRMIP pricing as of 2013-0101:

http://www.pcip.ca.gov/Publications/MRMIP_Premium_Rates_2013.pdf

KPNC = Kaiser Permanente Northern California
Area 3 PC HB ER EN 11/15/2012
Counties: Alameda, Contra Costa, Marin, San Francisco, San Mateo, Santa Clara
Below are available health plans listed by service area and ZIP codes. Some health plans may not be available in your area.

Subscriber Only
Rating Group Age Anthem CC KPNC
under 15 $366.78 $232.46 $268.44
15-29 $493.14 $295.64 $317.43
30-34 $680.68 $418.99 $375.09
35-39 $775.88 $418.99 $402.77
40-44 $764.26 $477.96 $451.95
45-49 $732.97 $477.96 $496.57
50-54 $934.40 $636.25 $573.42
55-59 $1,123.20 $636.25 $656.42
60-64 $1,416.80 $822.46 $727.13
65-69 $1,587.20 $1,080.10 $1,268.58
70-74 $1,672.00 $1,080.10 $1,339.22
over 74 $1,771.20 $1,080.10 $1,420.82

I apologize for the bad formatting, but at least you can see the numbers. The Kaiser prices are not that bad compared to others I have seen. Prices are less than Kaiser's OWN individual plans. Anthem Blue Cross plans are atrociously expensive, no surprise there. I think all the plans are HMO type plans, and the Kaiser plan looks like a 20/2500 HMO plan.

Note: I tried to use http://www.textfixer.com/html/csv-convert-table.php to make a nice html table, but wordpress (is that what you use, Patrick?) did not understand the result.

4   justme   2013 Feb 17, 12:51pm  

Chirp...chirp...chirp (that is the sound if the crickets chirping in the otherwise silent California evening, as heard in many Hollywood movies and TV programs).

I borrowed that one from leo707, I think.

5   David Losh   2013 Feb 18, 2:49am  

OK, I applied for and was accepted on February 1st for PCIP through the State of Washington.

Yes, it was running out of funding at the time.

The greatest applicant pool was people with cancer who were referred to the program by hospitals already burdened by catastrophic care payments to patients they were treating.

The program will need more funding to get through the year, and possibly beyond.

My thought was that this was a benefit to hospitals who were already over burdened.

I think this is a better use on my tax payer dollars, than bailing out banks.

6   justme   2013 Feb 19, 5:22am  

Congratulations. Would you mind posting the cost as a function of age ( a table like the one above )?

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