Government lowers health insurance premiums to increase participation

Nevadans who have been denied health insurance because of pre-existing conditions were given a helping hand last year, extended to them by the federal government.

But only 147 people out of the thousands eligible have enrolled in the Pre-Existing Condition Insurance Plan.

The year-old program is now reaching even further, reducing its premiums by 38 percent for all Nevadans, regardless of age, according to a Tuesday announcement by the U.S. Centers for Medicare and Medicaid Services.

The price decrease takes effect in July and means those up to age 18 will pay $113 per month. Premiums increase with age. Those 45-54 will pay $260, and anyone older than 54 pays $362 per month.

"Only 147 people is unacceptable," said David Sayen, regional administrator for Nevada for Medicare and Medicaid. "We expect there to now be a great deal more."

Sayen said the government couldn’t predict the imminent increase in enrollment because those ineligible might be unemployed and still unable to pay the premiums despite the decrease.

The program is meant to fill the gap until 2014, when it becomes illegal for companies to deny someone coverage based on a pre-existing condition.

"One of the main purposes of health-insurance reform was to rein in abusive practices by insurance companies," said Senate Majority Leader Harry Reid of Nevada. "It’s not right for a woman to be denied quality health insurance because she is a breast cancer survivor.

"Now, tens of thousands of Nevadans with pre-existing conditions are eligible to obtain coverage."

The change also simplifies the process. Nevadans only need to provide a letter from a doctor, physician’s assistant or nurse within the past 12 months stating their condition.

Approved applicants can choose from three plan options, with different levels of premiums, calendar-year deductibles, prescription deductibles and prescription co-pays.

The maximum a patient will pay out-of-pocket for services in a calendar year is $5,950 in-network or $7,000 out-of-network. And there’s no lifetime maximum or cap on the amount the plan pays.

See pcip.gov for more information.

Contact reporter Trevon Milliard at tmilliard@review journal.com or 702-383-0279.