A health plan for high risk people

    If you have a medical condition that makes it hard to find insurance coverage, you may be eligible for Pennsylvania’s new subsidized health plan.

    If you have a medical condition that makes it hard to find insurance coverage, you may be eligible for Pennsylvania’s new subsidized health plan.

    The federal health law provides funding to states that establish affordable coverage for people with pre-existing conditions, such as diabetes or arthritis. The program will be first-come, first-served and only people who’ve been without coverage for six months are eligible.

    Ann Torregrossa leads Pennsylvania’s Office of Health Care Reform.

    Torregrossa:
    There’s a real tension to have it be comprehensive enough so that it can meet the needs of people who have a condition, yet doesn’t price it out of existence for them.

    Pennsylvania’s proposal for the high risk pool includes coverage for mental health care and prescription drugs.

    The cost for patients would be about $470 a month. Torregrossa wants to offer an even deeper discount for very low-income people. Their premium would be about $170 a month.

    Pennsylvania has enough federal funding to enroll about 5,100 people.

    Shelley Bain is with the state Insurance Department.

    She says lots of Pennsylvanians are looking for a better-priced plan, but the new high-risk pool is only for people who have no insurance now.

    Bain:
    It’s a requirement under the federal law that they not have had insurance for the last six months. To get the money, that’s what we had to do, that’s how we had to set up the program.

    The state submitted a benefits and cost proposal for the program last week and expects a decision from federal regulators in July.

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