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Making Medicare make sense
Insurance for those with pre-existing conditions

Q: I've heard about the Pre-Existing Condition Insurance Plan currently available through the Affordable Care Act for anyone who does not have health insurance because of a pre-existing condition. Can you tell me about Kansas' program?

A: Kansans who have had difficulty finding health coverage because of a pre-existing condition can now more easily get affordable coverage. The Pre-Existing Condition Insurance Plan was created under the Affordable Care Act to help uninsured people with a pre-existing condition get high-quality care at affordable prices. It serves as a bridge to the year 2014, when insurers may no longer deny coverage to people with any pre-existing condition, such as cancer, diabetes, or asthma.

This health coverage program is administered at the state level in 27 states and by the federal government in 23 states and the District of Columbia. Kansas has elected to run its program. Eligible Kansans may apply for coverage through the state's plan, which is run by the Kansas Health Insurance Association. To qualify for coverage:

  • You must be a citizen or national of the United States or residing in the United States legally.
  • You must have been uninsured for at least the past six months before you apply.
  • You must have a pre-existing condition or have been denied coverage because of your health condition.

The Pre-Existing Condition Insurance Plan will cover a range of health benefits, including primary and specialty care, hospital care, and prescription drugs. All covered benefits are available for you, even to treat the pre-existing condition.

Premiums vary based on age. For example, age 50 non-smoker rates range from $349 to $385. The deductible is $2,500 and the out-of-pocket limit is $5,950.

To learn more about this program, call 877-505-0511 or visit www.khiastatepool.com/KHIA-FED.

To learn about the Pre-Existing Condition Insurance Plan in another state, visit www.pcip.gov and click "Find Your State." Then select the state from a map of the United States or from the drop-down menu.

The program's call center is open from 7:00 a.m. to 10:00 p.m. Central Time; call toll-free 866-717-5826 (TTY 866-561-1604).

Information provided by the Centers for Medicare & Medicaid Services; www.medicare.gov; 800-633-4227, TTY 877-486-2048.