GREAT NEWS FOR PEOPLE WITH EATING DISORDERS WITHOUT INSURANCE! COVERAGE IS AVAILABLE IF YOU QUALIFY
If you do not have insurance because of a pre-existing illness - you can now apply for insurance that would cover eating disorder treatment. READ MORE!
The EDC is collaborating with the Office of Consumer Information and Insurance Oversight at the Department of Health and Human Services on the successful implementation of the health care reform law, the Patient Protection and Affordable Care Act (ACA). We want to connect people suffering from eating disorders who meet the eligibility requirements to a new insurance.
One provision of the ACA that is now in effect and has promise for people with eating disorders is the Pre-Existing Condition Insurance Plan (PCIP). The PCIP was created to make health insurance available to those who have been denied insurance due to a pre-existing condition. The Pre-Existing Condition Insurance Plan:
* Offers coverage of mental health services including eating disorders as a required benefit.
* Will cover a broad range of health benefits, including primary and specialty care, hospital care, in and out-patient services, and residential treatment.
* Doesn’t charge you a higher premium just because of your medical condition.
To be eligible for the Pre-Existing Condition Insurance Plan (PCIP):
1. You must be a citizen or national of the United States or lawfully present in the United States.
2. You must have been uninsured for at least the last six months.
3. You must have had a problem getting insurance due to a pre-existing condition.
To be approved, you must submit a complete application with all required documentation, including proof of citizenship and a copy of a health insurance denial notification dated within the last six months.
Some states are running their own PCIP while the others are run by the federal government. ALL PCIP’s are required through regulation to cover eating disorders as part of the mental health benefit. However, the state run programs have the option to put a lifetime cap on mental health services for PCIP enrollees. This will vary state by state. In addition, the scope of coverage for the mental health benefit varies by state.
Under the federal-run program, there is not an option to cap the mental health benefit. The following states are the federally run programs:
Alabama | Arizona | D.C. | Delaware | Florida | Georgia | Hawaii | Idaho | Indiana | Kentucky | Louisiana | Massachusetts | Minnesota | Mississippi | North Dakota | Nebraska | Nevada | South Carolina | Tennessee | Texas | Vermont | Virginia | West Virginia | Wyoming
For more information, rates, and application for the federal-run programs go to the Health and Human Services website at www.pcip.gov.
To apply for a state-run program go to: www.healthcare.gov and click on your state. At that point, state-specific contact information and coverage information (including rates) will appear.
Jeanine Cogan, Ph.D. Policy Director