VIRGINIA’S PRE-EXISTING CONDITION INSURANCE PLAN

Eligible residents of Virginia can apply for health insurance coverage through the Pre-Existing Condition Insurance Plan (PCIP) program run by the U.S. Department of Health and Human Services.
Congress created the temporary PCIP program as part of the Affordable Care Act to help uninsured Americans with a variety of medical conditions get affordable coverage rather than be locked out of the system by insurance companies. In 2014 and beyond, insurers will be prohibited from denying coverage to anyone with a pre-existing condition and new competitive marketplaces called Health Insurance Exchanges will give people the opportunity to shop for the policy that best suits their needs. Millions of Americans also will receive tax credits to help make coverage affordable.
PCIP provides Americans living with such conditions as cancer, diabetes, or heart disease the opportunity to obtain insurance coverage. The program covers a broad range of health benefits and is designed as a bridge for people with pre-existing conditions who cannot obtain health insurance coverage in today’s private insurance market.
To qualify for PCIP coverage:

• You must be a citizen or national of the U.S. or lawfully present in the U.S.

• You must have been uninsured for at least the last six months before you apply.

• You must have a pre-existing condition or have been denied coverage because of your health condition. Starting July 1, 2011, you can simply provide a letter from a doctor, physician assistant, or nurse practitioner dated within the past 12 months stating that you have or, at any time in the past, had a medical condition, disability, or illness. A denial from an insurance company is not needed!
PCIP covers a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs. All covered benefits are available for you, even if it’s to treat a preexisting condition.

New Virginia Premium Rates (July 1, 2011) are lower and much more affordable

Age Standard Option Extended Option HSA Option
0 to 18 $93 $125 $97

19 to 34 $140 $188 $145

35 to 44 $168 $226 $174

45 to 54 $214 $288 $222

55+ $297 $401 $309

In addition to your monthly premium, you will pay other costs. Before most medical benefits are covered, you must first pay a deductible, which varies by your plan option. (see below). But, there is no deductible for preventive services, which can start right away. You will also pay copayments (e.g. $25 for doctor visits; $4 to $40 for most prescription drugs), and 20% of the costs of any other covered benefits you get. Your out-of-pocket costs cannot be more than $5,950 per year. These costs may be higher, if you go outside the plan’s network.

2011 Standard Plan - The 2011 Standard Plan now has two separate deductibles -- a $2,000 medical deductible and $500 drug deductible. The reduced pharmacy deductible is particularly helpful for people who take one or more maintenance medications.

2011 Extended Plan - The Extended Plan has a $1,000 medical deductible and $250 drug deductible plan. Like the Standard Plan, separating the drug and medical deductibles makes this option more valuable for enrollees with one or more maintenance medications.

Health Savings Account Option - The HSA Option has a $2,500 deductible and is eligible to receive favorable tax treatment by the federal government when used with a Health Savings Account (HSA).

Child-Only Rate -To ensure that children have more affordable access to coverage, HHS has established premiums targeted for covering children under PCIP, creating a child-only rate for PCIP enrollees between 0-18 years of age.
For more information, including eligibility, plan benefits and rates, as well as information on how to apply, visit www.pcip.gov and click on “Find Your State.” Then select Virginia from the map or drop-down menu. The PCIP Call Center is open from 8 a.m. to 11 p.m. Eastern Time. Call toll-free 1-866-717-5826 (TTY 1-866-561-1604).

Health Care Information

In your work/discussions about health reform and ways to address the federal deficit without decimating federal health programs, here are some “home grown” resources that may be useful to you and your networks.


John McInerney’s (Commonwealth Institute) Op Ed regarding the importance of the federal “Maintenance of Effort Requirement” to protect current Medicaid and FAMIS eligibility.

http://www2.timesdispatch.com/news/2011/may/19/TDOPIN02-mcinerney-budgeted-savings-would-mean-los-ar-1048613

My Op Ed on health reform and its impact/implementation in Virginia.

http://www2.timesdispatch.com/news/2011/jun/05/TDCOMM03-health-care-reform-brings-home-many-benef-ar-1084400



The Op Ed is a much abbreviated version of my commentary on the Affordable Care Act, which appears in the current issue of the Virginia News Letter, published by the University of Virginia's Weldon Cooper Center for Public Service.



www.coopercenter.org/publications/VANsltr0518

Diaper Drive

Help Anthem HealthKeepers Plus meet this challenge! Your workplace can collect diapers - or funds - and Anthem staff will arrange to come by your office to pick up your donation!


Next time you shop - pick up a pack of diapers........it can change a baby's life!

For more information, please contact Tresserlyn Jones, Health Promotions Consultant at (757) 875-5785 or email tresserlyn.jones2@anthem.com

The Minnesota Department of Health is pleased to announce the launch of a new, free, online training. The training was developed as part of an EPA grant and is titled, Reducing Environmental Triggers of Asthma in the Home, or RETA-Home. This training is designed for public health nurses (PHNs) and certified asthma educators (AE-Cs) and takes about 40 minutes to complete. It teaches about the triggers of asthma found in the home and suggests simple, realistic interventions that helps limit or eliminate exposure to these triggers.

The program also features a resource section that can be accessed after the training has been completed.

To view this training program, please go to: www.retahome.org
Please feel free to contact me if you have any questions.
Kathy
Kathleen Norlien, M.S., CPH
Research Scientist
Asthma Program, MDH
85 E. 7th Place
PO. Box 64882
St. Paul, MN 55164-0882
Phone: (651) 201-4613
FAX: (651) 201-5898
Kathleen.Norlien@state.mn.us

Asthma survey

The Asthma and Allergy Foundation of America (AAFA) is conducting a brief online survey among all types of public health professionals as part of a CDC funded asthma project in order to better understand the role of certain public health services regarding asthma.

• The survey is conducted via Survey Monkey™ and is completely anonymous.

• Click on the following link to take the survey: https://www.surveymonkey.com/s/TMSYCVC

Please forward this email freely to all of your public health colleagues, not just those in asthma – the more responses we get, the better our results!

If you have any questions, don’t hesitate to contact me for more information. Thank you in advance for taking and sharing our short survey!
Best Regards,

Jacqui Vok

jacqui@aafa.org

Moms Matter Gala

My name is Lilly Smith, the Loving Steps Resource Mothers program coordinator at Eastern Virginia Medical School. The Loving Steps program is a federally funded community-based program to lower infant mortality and improve the health of mothers and babies. And one of the steps is to improve the self esteem of these low-income, struggling mothers and mothers-to-be.
For the past five years in May, the Loving Steps program celebrated motherhood by inviting the families to what we call the, "Moms Matter Gala". Last year we partnered with members of the community to provide each woman attending who desired one with an after five/semi-formal outfit. This project was such a success, it was decided that it would be worth repeating.
I am requesting your help to make this possible by donating your gently used semi-formal/after five dresses. The event is scheduled for May 24, 2011. Please help us put smiles on pretty faces, and show your support. We are requesting the dresses be turned in by May 16, 2011. If you are interested in making a donation, please contact me at 757-683-9173.

A2 Nurse Update - Congratulations

Congratulations to our newest nationally certified asthma educator (AE-C) and CINCH Asthma & Allergy School Nurse Expert, Debbie Barnes with Portsmouth Public Schools! Portsmouth Public Schools will benefit greatly from your expertise and commitment to improve asthma management across the school system. We appreciate both Debbie’s effort and commitment and the commitment of the school system to participate in this ground-breaking program – the first of its kind in the country.
That makes seven school nurses in Hampton Roads that are now nationally certified asthma educators! 100% pass rate (68% pass rate nationally)!

Liz Ayers, Chesapeake
Michelle Prescott, Chesapeake
Joanie Haury, Gloucester
Janet Duey, Hampton
Jennifer Rashid, Newport News
Monica White, Newport News
Debbie Barnes, Portsmouth
We are grateful to our CINCH Respiratory Health Work Group for their development and support of this project, and our funders past (Virginia Asthma Coalition/Virginia Department of Health’s Asthma Control Project) and present (American Lung Association Asthma Friendly Schools Initiative and Eastern Virginia Medical School Department of Pediatrics) for making this program possible. We look forward to many more nurses in our region becoming nationally certified.
Thank you all for your support and participation, and congrats again to Debbie and Liz, our two newest AE-C’s! This has been a good week for kids with asthma in Hampton Roads, indeed.