The U.S. Department of Health and Human Services (HHS) announced on July 1 the establishment of a new Pre-existing Condition Insurance Plan (PCIP) that will offer coverage to uninsured Americans who have been unable to obtain health coverage because of a pre-existing health condition.
The Pre-Existing Condition Insurance Plan, which will be administered either by a state or by the Department of Health and Human Services, will provide a new health coverage option for Americans who have been uninsured for at least six months, have been unable to get health coverage because of a health condition, and are a U.S. citizen or are residing in the United States legally.
Created under the Affordable Care Act, the Pre-Existing Condition Insurance Plan is a transitional program until 2014, when insurers will be banned from discriminating against adults with pre-existing conditions, and individuals and small businesses will have access to more affordable private insurance choices through new competitive Exchanges. In 2014, Members of Congress will also purchase their insurance through Exchanges.
“For too long, Americans with pre-existing conditions have been locked out of our health insurance market,” said Secretary Kathleen Sebelius. “Today, the Pre-Existing Condition Insurance Plan gives them a new option – the same insurance coverage as a healthy individual if they’ve been uninsured for at least six months because of a medical condition. This program will provide people the help they need as the nation transitions to a more competitive and fair market place in 2014.”
The Affordable Care Act provides $5 billion in federal funding to support Pre-Existing Condition Insurance Plans in every state. Some states have requested that the U.S. Department of Health and Human Services run their Pre-Existing Condition Insurance Plan. Other states have requested that they run the program themselves. For more information about how the plan is being administered where you live, please visit HHS’ new consumer website, www.HealthCare.gov.
“Health coverage for Americans with pre-existing conditions has historically been unobtainable or failed to cover the very conditions for which they need medical care,” said Jay Angoff, Director of the Office of Consumer Information and Insurance Oversight (OCIIO) which is overseeing the program. “The Pre-Existing Condition Insurance Plan is designed to address these challenges by offering comprehensive coverage at a reasonable cost. We modeled the program on the highly successful Children’s Health Insurance Program, also known as CHIP, so states would have maximum flexibility to meet the needs of their citizens.”
In order to give states the flexibility to best meet their needs, HHS provided states with the option of running the Pre-Existing Condition Insurance Plan themselves or having HHS run the plan. Twenty-one states have elected to have HHS administer the plans, while 29 states and the District of Columbia have chosen to run their own programs.
Starting today, the national Pre-Existing Condition Insurance Plan will be open to applicants in the 21 states where HHS is operating the program.
All states which are operating their own Pre-Existing Condition Insurance Plans will begin enrollment by the end of the summer, with many beginning enrollment today.
“The Pre-Existing Condition Insurance Plan is an important next step in the overall implementation of the Affordable Care Act,” said Richard Popper, Director of Insurance Programs at OCIIO. “We have been working closely with the states and other stakeholders to make sure this program reaches uninsured Americans struggling to find coverage due to a pre-existing condition.”
The Pre-Existing Condition Insurance Plan will cover a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs. The Pre-Existing Condition Insurance Plan does not base eligibility on income and does not charge a higher premium because of a medical condition. Participants will pay a premium that is not more than the standard individual health insurance premium in their state for insurance that covers major medical and prescription drug expenses with some cost-sharing.
Like the popular Children’s Health Insurance Program (CHIP), the Pre-Existing Condition Plan provides states flexibility in how they run their program as long as basic requirements are met. Federal law establishes general eligibility, but state programs can vary on cost, benefits, and determination of pre-existing condition. Funding for states is based on the same allocation formula as CHIP, and it will be reallocated if unspent by the states. Unlike CHIP, there is no state matching requirement and the federal government will cover the entire cost of the Pre-Existing Condition Plan. While it took more than 6 months for a small number of states to establish their CHIP programs, we anticipate that every state will begin enrolling individuals in the Pre-Existing Condition Plan by the end of August.
Information on how to apply for the Pre-Existing Condition Insurance Plan is available at www.HealthCare.gov. Americans who live in a state where the U.S. Department of Health and Human Services is running the Pre-Existing Condition Plan will be linked directly to the federal application page. Those living in states running their own programs will also find information on how and where to apply on www.HealthCare.gov.
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Showing posts with label affordable. Show all posts
Showing posts with label affordable. Show all posts
Sunday, July 04, 2010
Thursday, June 03, 2010
HHS Announces Availability of $60 Million in Affordable Care Act Grants to Help People Navigate their Health and Long-term Care Options
HHS Secretary Kathleen Sebelius announced the availability of $60 million in Affordable Care Act grants to states and communities to help individuals and their caregivers better understand and navigate their health and long-term care options.
Through this opportunity made possible by the Affordable Care Act HHS' Administration on Aging (AoA) and the Centers for Medicare & Medicaid Services (CMS) will work collaboratively to award funds for an integrated approach that focuses on the unique needs of seniors, disabled Americans and their caregivers as they seek health care and long-term care.
"The Affordable Care Act seeks to lower health care costs, improve the quality of health care and perhaps most importantly give people more control over their own care. These new grants, authorized under the new law, will help seniors, individuals with disabilities and their families get better quality care and more control. We've also streamlined the process for states and people who rely on these funds," said Secretary Sebelius.
"We know how difficult it can be for caregivers and patients to try and deal with a sudden illness or chronic disease while at the same time trying to navigate through a complex health care system to figure out where you can get help. These new funds that we have bundled together will help promote better opportunities for coordination of health and long-term supports," said Sebelius.
The purpose of this new grant program authorized by the Affordable Care Act is to create streamlined, coordinated statewide systems of information, counseling, and access that will help people find consumer-friendly answers they seek to meet their health and long-term care needs. AoA and CMS will administer the funding through separate announcements, but will coordinate implementation and monitoring through a single process.
Some specific areas of focus will include assisting individuals who are under-served and hard to reach with information about their Medicare and Medicaid benefits, helping older adults and individuals with disabilities live at home or in settings of their choosing with the right supports, assisting people transition from hospital or nursing home stays back into the community, and strengthening linkages between the medical and social service systems.
"When it comes to long-term health care, each patient has a unique mix of complex medical and social needs that must be considered when seeking care," said Marilyn Tavenner, acting CMS administrator. "Our health care system can offer many options to meeting those needs from traditional nursing home care to home and community-based services. Making patients and their families aware of these options will help them make inherently difficult decisions about long-term care. This integrated program will help families make informed choices and make sure patients have more control over their own care."
AoA and CMS have provided grants to states for several years to develop person-centered systems of information, counseling and access to make it easier for individuals to learn about and access their health and long-term services and support options. This grant program through the Affordable Care Act strengthens and enhances the ability of states to truly integrate the medical and social services care models.
"AoA's national network of community-based organizations has long served as the central place for individuals and families seeking information and help to address health and long term care challenges. This collaborative opportunity between AoA and CMS will further strengthen the network's capacity to help people in a more coordinated and comprehensive way in the communities where they live," said Kathy Greenlee, assistant secretary for aging.
Funds will be available to states, area agencies on aging (aaa's), State Health Insurance Assistance Programs (SHIPs) and Aging and Disability Resource Centers (ADRCs). Through the grant program, states and local aging and disability programs will receive funds to:
* provide outreach and assistance to Medicare beneficiaries on their Medicare benefits including prevention;
* use additional funds through a competitive process to provide Options Counseling on health and long-term care through ADRCs;
* use additional funds through a competitive process to strengthen the ADRCs role in Money follows the Person program and support state Medicaid agencies as they transition individuals from nursing homes to community-based care; and
* coordinate and continue to embed tested Care Transition models that integrate the medical and social service systems to help older individuals and those with disabilities remain in their own homes and communities after a hospital, rehabilitation or skilled nursing facility visit.
"CMS and AoA share a long-standing goal of expanding access to community-based care for the elderly and individuals with disabilities. The Affordable Care Act provides significant resources for state Medicaid agencies and providers to balance the nation's long-term care systems and assure that individuals have a choice of where and how they receive their services," said Cindy Mann, director of CMS's Center for Medicaid, CHIP, and Survey and Certification.
The announcement combines funding opportunities from several provisions in the Affordable Care Act signed into law by President Obama on March 23, 2010, including the Role of Public Programs (Title II, Sections 2403 - Money Follows the Person and 2405 - Funding for Aging and Disability Resource Centers) and Improving the Quality and Efficiency of Health Care (Title III. Section 3306 - Funding for Outreach and Assistance for Low-Income Programs).
These grants also complement President Obama's "Year of Community Living Initiative," which focuses on better serving those individuals with disabilities who need ongoing services and support programs in the community such as those provided by AoA, CMS and other HHS agencies.
The deadline for applications is: Monday, July 30, 2010. Grants will be awarded in September 2010. For more information about this grant opportunity, please visit http://www.aoa.gov/AoARoot/Grants/Funding/index.aspx or www.grants.gov.
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Through this opportunity made possible by the Affordable Care Act HHS' Administration on Aging (AoA) and the Centers for Medicare & Medicaid Services (CMS) will work collaboratively to award funds for an integrated approach that focuses on the unique needs of seniors, disabled Americans and their caregivers as they seek health care and long-term care.
"The Affordable Care Act seeks to lower health care costs, improve the quality of health care and perhaps most importantly give people more control over their own care. These new grants, authorized under the new law, will help seniors, individuals with disabilities and their families get better quality care and more control. We've also streamlined the process for states and people who rely on these funds," said Secretary Sebelius.
"We know how difficult it can be for caregivers and patients to try and deal with a sudden illness or chronic disease while at the same time trying to navigate through a complex health care system to figure out where you can get help. These new funds that we have bundled together will help promote better opportunities for coordination of health and long-term supports," said Sebelius.
The purpose of this new grant program authorized by the Affordable Care Act is to create streamlined, coordinated statewide systems of information, counseling, and access that will help people find consumer-friendly answers they seek to meet their health and long-term care needs. AoA and CMS will administer the funding through separate announcements, but will coordinate implementation and monitoring through a single process.
Some specific areas of focus will include assisting individuals who are under-served and hard to reach with information about their Medicare and Medicaid benefits, helping older adults and individuals with disabilities live at home or in settings of their choosing with the right supports, assisting people transition from hospital or nursing home stays back into the community, and strengthening linkages between the medical and social service systems.
"When it comes to long-term health care, each patient has a unique mix of complex medical and social needs that must be considered when seeking care," said Marilyn Tavenner, acting CMS administrator. "Our health care system can offer many options to meeting those needs from traditional nursing home care to home and community-based services. Making patients and their families aware of these options will help them make inherently difficult decisions about long-term care. This integrated program will help families make informed choices and make sure patients have more control over their own care."
AoA and CMS have provided grants to states for several years to develop person-centered systems of information, counseling and access to make it easier for individuals to learn about and access their health and long-term services and support options. This grant program through the Affordable Care Act strengthens and enhances the ability of states to truly integrate the medical and social services care models.
"AoA's national network of community-based organizations has long served as the central place for individuals and families seeking information and help to address health and long term care challenges. This collaborative opportunity between AoA and CMS will further strengthen the network's capacity to help people in a more coordinated and comprehensive way in the communities where they live," said Kathy Greenlee, assistant secretary for aging.
Funds will be available to states, area agencies on aging (aaa's), State Health Insurance Assistance Programs (SHIPs) and Aging and Disability Resource Centers (ADRCs). Through the grant program, states and local aging and disability programs will receive funds to:
* provide outreach and assistance to Medicare beneficiaries on their Medicare benefits including prevention;
* use additional funds through a competitive process to provide Options Counseling on health and long-term care through ADRCs;
* use additional funds through a competitive process to strengthen the ADRCs role in Money follows the Person program and support state Medicaid agencies as they transition individuals from nursing homes to community-based care; and
* coordinate and continue to embed tested Care Transition models that integrate the medical and social service systems to help older individuals and those with disabilities remain in their own homes and communities after a hospital, rehabilitation or skilled nursing facility visit.
"CMS and AoA share a long-standing goal of expanding access to community-based care for the elderly and individuals with disabilities. The Affordable Care Act provides significant resources for state Medicaid agencies and providers to balance the nation's long-term care systems and assure that individuals have a choice of where and how they receive their services," said Cindy Mann, director of CMS's Center for Medicaid, CHIP, and Survey and Certification.
The announcement combines funding opportunities from several provisions in the Affordable Care Act signed into law by President Obama on March 23, 2010, including the Role of Public Programs (Title II, Sections 2403 - Money Follows the Person and 2405 - Funding for Aging and Disability Resource Centers) and Improving the Quality and Efficiency of Health Care (Title III. Section 3306 - Funding for Outreach and Assistance for Low-Income Programs).
These grants also complement President Obama's "Year of Community Living Initiative," which focuses on better serving those individuals with disabilities who need ongoing services and support programs in the community such as those provided by AoA, CMS and other HHS agencies.
The deadline for applications is: Monday, July 30, 2010. Grants will be awarded in September 2010. For more information about this grant opportunity, please visit http://www.aoa.gov/AoARoot/Grants/Funding/index.aspx or www.grants.gov.
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Thursday, November 05, 2009
AARP Endorses Affordable Health Care for America Act
/PRNewswire/ -- Today AARP announced its endorsement of the Affordable Health Care for America Act (H.R. 3962) and the accompanying Medicare Physician Payment Reform Act (H.R. 3961). The Association's support follows nearly two years of work with lawmakers on both sides of the aisle to craft a health care reform plan that meets the needs of AARP's nearly 40 million members and all older Americans. Among those needs are reforms that strictly curb insurance companies' discrimination against older Americans and Medicare improvements that strengthen benefits while protecting the program for future generations.
"We started this debate more than two years ago with the twin goals of making coverage affordable to our younger members and protecting Medicare for seniors," said Jim Wordelman, State Director for AARP in Idaho. "We've read the Affordable Health Care for America Act and we can say with confidence that it meets those goals with improved benefits for people in Medicare and needed health insurance market reforms to help ensure every American can purchase affordable health coverage."
Today's endorsement marks the first time in this legislative battle that AARP has put its full weight behind a comprehensive health care reform package. In the coming days, AARP will be educating its members about the health care reform package through its publications, paid advertising and more than five million calls and e-mails to its grassroots activists.
The Affordable Health Care for America Act and the Medicare Physician Payment Reform Act contain critical components AARP has been fighting for on behalf of its members and all older Americans to improve health care for them and their families. They include:
-- Protecting and strengthening Medicare for today's seniors and future
generations of retirees;
-- Ensuring seniors can see the doctor of their choice or find a doctor
if they need one by improving Medicare's payments to doctors;
-- Lowering drug costs for seniors by closing the Medicare Part D
"doughnut hole" and allowing Medicare to negotiate with drug makers
for lower drug prices;
-- Taking steps to reduce waste, fraud, abuse and inefficiency in the
Medicare program;
-- Requiring Medicare and insurance companies to provide for important
preventive services like screenings for diabetes, cancer and
osteoporosis free of charge;
-- Stopping insurance companies from denying you affordable coverage
because of your age;
-- Preventing insurance companies from denying you coverage if you have a
pre-existing condition or dropping your coverage if you get sick;
-- Limiting how much your insurance company can make you pay
out-of-pocket;
-- Providing affordable health insurance options for those who don't have
insurance; and
-- Providing benefits to help seniors and people with disabilities live
in their own homes and communities by establishing the Community
Living Assistance Services and Supports (CLASS) program.
Wordelman added: "We cannot continue to let insurers price older Americans out of the market, just as we cannot stand idle while millions of seniors are forced to choose between their groceries and their prescriptions. AARP is proud to endorse the Affordable Health Care for America Act and the Medicare Physician Payment Reform Act, and we urge members of the House to pass this critical package in the coming days to help fix our broken health care system."
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"We started this debate more than two years ago with the twin goals of making coverage affordable to our younger members and protecting Medicare for seniors," said Jim Wordelman, State Director for AARP in Idaho. "We've read the Affordable Health Care for America Act and we can say with confidence that it meets those goals with improved benefits for people in Medicare and needed health insurance market reforms to help ensure every American can purchase affordable health coverage."
Today's endorsement marks the first time in this legislative battle that AARP has put its full weight behind a comprehensive health care reform package. In the coming days, AARP will be educating its members about the health care reform package through its publications, paid advertising and more than five million calls and e-mails to its grassroots activists.
The Affordable Health Care for America Act and the Medicare Physician Payment Reform Act contain critical components AARP has been fighting for on behalf of its members and all older Americans to improve health care for them and their families. They include:
-- Protecting and strengthening Medicare for today's seniors and future
generations of retirees;
-- Ensuring seniors can see the doctor of their choice or find a doctor
if they need one by improving Medicare's payments to doctors;
-- Lowering drug costs for seniors by closing the Medicare Part D
"doughnut hole" and allowing Medicare to negotiate with drug makers
for lower drug prices;
-- Taking steps to reduce waste, fraud, abuse and inefficiency in the
Medicare program;
-- Requiring Medicare and insurance companies to provide for important
preventive services like screenings for diabetes, cancer and
osteoporosis free of charge;
-- Stopping insurance companies from denying you affordable coverage
because of your age;
-- Preventing insurance companies from denying you coverage if you have a
pre-existing condition or dropping your coverage if you get sick;
-- Limiting how much your insurance company can make you pay
out-of-pocket;
-- Providing affordable health insurance options for those who don't have
insurance; and
-- Providing benefits to help seniors and people with disabilities live
in their own homes and communities by establishing the Community
Living Assistance Services and Supports (CLASS) program.
Wordelman added: "We cannot continue to let insurers price older Americans out of the market, just as we cannot stand idle while millions of seniors are forced to choose between their groceries and their prescriptions. AARP is proud to endorse the Affordable Health Care for America Act and the Medicare Physician Payment Reform Act, and we urge members of the House to pass this critical package in the coming days to help fix our broken health care system."
-----
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