published Thursday, February 17th, 2011

Insurance plan covers pre-existing medical problems

By Martin Coffey

Q: "I can't get health insurance because of my pre-existing condition. Is there anything I can do?"

A: You may be eligible for the new Pre-Existing Condition Insurance Plan -- a program for people who have a pre-existing condition and have been without health insurance coverage for at least six months.

People with pre-existing conditions face daunting challenges -- and high costs -- when they shop for health insurance. This new plan covers physician and hospital services and prescription drugs. Premiums vary by state. Annual out-of-pocket expenses for enrollees are capped.

Details about the program and how to apply may vary depending on what state you live in. In some states, the U.S. Department of Health and Human Services, with the help of the U.S. Office of Personnel Management and the U.S. Department of Agriculture's National Finance Center, will run the Pre-Existing Condition Insurance Plan; other states have asked to run the program themselves.

Regardless of which state you live in, to qualify for the program you must be a U.S. citizen or legal resident, and you must have been uninsured for at least six months. In addition, you must have a pre-existing condition or have been denied insurance coverage because of a medical condition.

For more information, call the Pre-Existing Condition Insurance Plan toll-free at 1-866-717-5826 (TTY 1-866-561-1604) between the hours of 8 a.m. and 11 p.m. EST. Or visit and select "Find Your State" to learn about eligibility and how to apply.

Note: Social Security offices will be closed Monday in observance of Presidents' Day.

Get answers to your Social Security questions each Thursday from the Social Security District Director Martin Coffey. Submit questions by writing to Business Editor John Vass Jr., Chattanooga Times Free Press, P.O. Box 1447, Chattanooga, TN 37401-1447, or by e-mailing him at

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TedSchmidt said...

The Health Care Reform Act, if it is fully implemented in 2014, will allow persons with un-insurable, pre-existing conditions to get health insurance. Until it is full implemented, the Federal government has set up Pools for persons with pre-existing conditions. These pools are either administered by the State or Federal government.

In most cases, in order to be covered, the applicant must have been declined for insurance due to a health issue, AND not be covered with health insurance for the previous 6 months. In Tennessee, the premium for someone over 55 years old currently starts at $520.

We represent most of the major medical carriers for individual and group coverage. We also represent a number of guaranteed acceptance health benefit plans which accept persons with pre-existing conditions. These plans are not part of the government pool. They range in price from $195 to $370 per month. Please call us if you would like further information.

Ted Schmidt Independent Insurance Broker Individual and Group Health Insurance Life Insurance & Annuities 1-800-972-1108

February 17, 2011 at 6:54 a.m.
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