Like Ohio, Pennsylvania's now opened up their High Risk ObamaPool©. Called the PA Fair Care Plan, it's also built on what looks like an off-the-shelf PPO plan, with a few "tweaks." For example, only generic meds are covered (unless none's available). And, of course:
"Maternity and Newborn Care (31 days): 80% after deductible"
That is, "same as any illness." As we've mentioned before, this is a terribly expensive benefit (and completely inappropriate as an insured expense), and often (generally?) not available in the "regular" individual market without great cost and additional waiting periods. And, of course, pregnancy is one of the eligibility "triggers." As in Ohio, one must be uninsured for the prior 6 months (or longer); unlike Ohio's plan, coverage is not effective almost immediately:
"On average, it takes four to six weeks for an application to be processed after we receive your 1st monthly premium payment."
That's helpful to the extent that Pennsylvania's $160 million ObamaPool© funding may not run out quite as quickly as Ohio's. And speaking of funding, it's interesting to note that the premium is "about $283.00" per month. So is that a good deal, or a bad one? Depends on one's perspective, doesn't it?
One must provide either proof that one has been denied coverage (or offered coverage with one or more exclusions) or a letter from one's physician "stating that [one has] an existing medical condition that may result in denial of creditable coverage by a health insurance company." The Pennsylvania list of acceptable medical conditions is actually two-and-a-half times as long as Ohio's.
Medical Mutual is the insurer of choice for Ohio's Pool; Pennsylvania has selected its Blue Cross carrier, Highmark. One wonders who lost that particular bet.
In the event, all of these plans are due to "sunset" at the end of 2013; the so-called "Exchanges" are due to come on-line the first of January, 2014. We all await with bated breath.
[Hat Tip: FoIB Bob D]
"Maternity and Newborn Care (31 days): 80% after deductible"
That is, "same as any illness." As we've mentioned before, this is a terribly expensive benefit (and completely inappropriate as an insured expense), and often (generally?) not available in the "regular" individual market without great cost and additional waiting periods. And, of course, pregnancy is one of the eligibility "triggers." As in Ohio, one must be uninsured for the prior 6 months (or longer); unlike Ohio's plan, coverage is not effective almost immediately:
"On average, it takes four to six weeks for an application to be processed after we receive your 1st monthly premium payment."
That's helpful to the extent that Pennsylvania's $160 million ObamaPool© funding may not run out quite as quickly as Ohio's. And speaking of funding, it's interesting to note that the premium is "about $283.00" per month. So is that a good deal, or a bad one? Depends on one's perspective, doesn't it?
One must provide either proof that one has been denied coverage (or offered coverage with one or more exclusions) or a letter from one's physician "stating that [one has] an existing medical condition that may result in denial of creditable coverage by a health insurance company." The Pennsylvania list of acceptable medical conditions is actually two-and-a-half times as long as Ohio's.
Medical Mutual is the insurer of choice for Ohio's Pool; Pennsylvania has selected its Blue Cross carrier, Highmark. One wonders who lost that particular bet.
In the event, all of these plans are due to "sunset" at the end of 2013; the so-called "Exchanges" are due to come on-line the first of January, 2014. We all await with bated breath.
[Hat Tip: FoIB Bob D]
