Re: More on Pre-existing Conditions
Jim DeWees
Description
Collection
Title:
Re: More on Pre-existing Conditions
Creator:
Jim DeWees
Date:
2/25/2013
Text:
Hello Everyone,
This entire deal about the PCIP program is really amazing. MOST states, if
not all of the 50 states, have had some kind of plan or program for the
so-called un-insurable people. In Indiana, for example, we still have the
ICHIA program (Indiana Comprehensive Health Insurance Association) where
people can get a policy, which is about the same policy that a professor at
the university will get....with either a $500 or $1000 deductible (the
patient can select what plan they want) and is also an Anthem policy, giving
the patients access to the entire Anthem network. The prices of this plan
are reasonable, and less than what I pay for my individual family policy
that I have for my family.
NOW we also have the PCIP plan to check into. They claim now that FINALLY
there is a plan or program for those who have been denied this kind of
insurance for many years, or forever, or whatever they are saying to make
this sound like something new and great.
The state plan has been solvent for many years, and has helped many Hoosiers
to have insurance, which has a reasonable deductible as well.
The PCIP is expensive (in my view anyway), and also has a HUGE deductible (I
think the best one for my state is a $2000 deductible, and then I think is
only 50% for DME, including O&P.) And, now we have heard in the media that
this PCIP program is broke! They are OUT of money, and are NOT taking any
new applications starting in Mid March or on April 1. I am not sure what
the actual date is.
They are SO proud that they have over 12,000 enrollees in this PCIP now!!
Well, out of the 37 million uninsured that they all talked about when this
Affordable Care Act was passed, the 12,000 new enrollees is just a drop in
the bucket! That is 0.032 % (3 hundredths of ONE percent ) of these
uninsured Americans have signed up for the PCIP, and that has totally
financially wiped them out already...and Obamacare hasn't really officially
been totally implemented yet.
This is a real problem....and we are NOT hearing this on any national news
yet......
So yes, I agree, IF you have any patient coming to your facility for a new
prosthetic device, or any services, I would really urge everyone to beware
of this, and be warned that the funds are exhausted at this point according
to several sources. Make sure you have all the proper documentation (equal
to what Medicare requires, like the physician's notes, the Rx, etc.) so that
they cannot deny the payment for services on some technicality or paperwork
issue.....and also try to get some straight answer from United Healthcare
about IF there are funds left to pay for this service BEFORE you spend the
time, and all the money to pay for the components, and then to only get a
notification that YOU will NOT be paid, AND the patient gets to keep the
device and cannot be held financially liable for anything.
This is a big mess, and I am afraid just the BEGINNING of what we are going
to be dealing with for a long time.....and hopefully we will survive this.
I know there are some facilities that have not survived already, and others
who are really struggling.
Well, Happy Monday everyone....sorry to be so negative. But this is the
straight, and it hurts.
Jim DeWees, CP
-----Original Message-----
From: James Fenton
Sent: Friday, February 22, 2013 2:21 PM
To: <Email Address Redacted>
Subject: [OANDP-L] More on Pre-existing Conditions
Following is more information about the Pre-existing Conditions Insurance
Program (PCIP). It was one of the responses to yesterday's post.
Jim Fenton, LPO
Miami, FL
Check out this site from the US Government. Straight from the Horses Mouth.
I cannot believe this:
1. Click this weblink:
<URL Redacted>
2. Click on pcip.gov link in the middle pragraph
3. A notification pops up and explains why they stopped enrollment and
further explains the high cost of expenses and limited funds from Congress.
Typical Lies from our own Government. FRAUD and just as bad as Medicare RAC
audits. No Oversite.
PLEASE pass this information along so everyone can see the actual proof!
This entire deal about the PCIP program is really amazing. MOST states, if
not all of the 50 states, have had some kind of plan or program for the
so-called un-insurable people. In Indiana, for example, we still have the
ICHIA program (Indiana Comprehensive Health Insurance Association) where
people can get a policy, which is about the same policy that a professor at
the university will get....with either a $500 or $1000 deductible (the
patient can select what plan they want) and is also an Anthem policy, giving
the patients access to the entire Anthem network. The prices of this plan
are reasonable, and less than what I pay for my individual family policy
that I have for my family.
NOW we also have the PCIP plan to check into. They claim now that FINALLY
there is a plan or program for those who have been denied this kind of
insurance for many years, or forever, or whatever they are saying to make
this sound like something new and great.
The state plan has been solvent for many years, and has helped many Hoosiers
to have insurance, which has a reasonable deductible as well.
The PCIP is expensive (in my view anyway), and also has a HUGE deductible (I
think the best one for my state is a $2000 deductible, and then I think is
only 50% for DME, including O&P.) And, now we have heard in the media that
this PCIP program is broke! They are OUT of money, and are NOT taking any
new applications starting in Mid March or on April 1. I am not sure what
the actual date is.
They are SO proud that they have over 12,000 enrollees in this PCIP now!!
Well, out of the 37 million uninsured that they all talked about when this
Affordable Care Act was passed, the 12,000 new enrollees is just a drop in
the bucket! That is 0.032 % (3 hundredths of ONE percent ) of these
uninsured Americans have signed up for the PCIP, and that has totally
financially wiped them out already...and Obamacare hasn't really officially
been totally implemented yet.
This is a real problem....and we are NOT hearing this on any national news
yet......
So yes, I agree, IF you have any patient coming to your facility for a new
prosthetic device, or any services, I would really urge everyone to beware
of this, and be warned that the funds are exhausted at this point according
to several sources. Make sure you have all the proper documentation (equal
to what Medicare requires, like the physician's notes, the Rx, etc.) so that
they cannot deny the payment for services on some technicality or paperwork
issue.....and also try to get some straight answer from United Healthcare
about IF there are funds left to pay for this service BEFORE you spend the
time, and all the money to pay for the components, and then to only get a
notification that YOU will NOT be paid, AND the patient gets to keep the
device and cannot be held financially liable for anything.
This is a big mess, and I am afraid just the BEGINNING of what we are going
to be dealing with for a long time.....and hopefully we will survive this.
I know there are some facilities that have not survived already, and others
who are really struggling.
Well, Happy Monday everyone....sorry to be so negative. But this is the
straight, and it hurts.
Jim DeWees, CP
-----Original Message-----
From: James Fenton
Sent: Friday, February 22, 2013 2:21 PM
To: <Email Address Redacted>
Subject: [OANDP-L] More on Pre-existing Conditions
Following is more information about the Pre-existing Conditions Insurance
Program (PCIP). It was one of the responses to yesterday's post.
Jim Fenton, LPO
Miami, FL
Check out this site from the US Government. Straight from the Horses Mouth.
I cannot believe this:
1. Click this weblink:
<URL Redacted>
2. Click on pcip.gov link in the middle pragraph
3. A notification pops up and explains why they stopped enrollment and
further explains the high cost of expenses and limited funds from Congress.
Typical Lies from our own Government. FRAUD and just as bad as Medicare RAC
audits. No Oversite.
PLEASE pass this information along so everyone can see the actual proof!
Citation
Jim DeWees, “Re: More on Pre-existing Conditions,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/234706.
