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Life Health > Health Insurance > Your Practice

PCIP: Iowa Lists Pre-Qualifying Conditions

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This is one of the rare times when being an uninsured Iowa resident who has had a lobotomy may be helpful.

A new Iowa health insurance program for residents with health problems, the Health Insurance Plan of Iowa – The Federal High Risk Pool, has included having had a lobotomy on the list of conditions that qualify an individual for a streamlined risk pool application process.

Iowa set up the Iowa HIPIOWA-FED program to implement its portion of the federal Pre-existing Condition Insurance Plan (PCIP) program.

Congress created the PCIP program to tide uninsured people with health problems over until 2014, when provisions in the Patient Protection and Affordable Care Act (PPACA) are supposed to ban use of health status information in insurer efforts to sell and price health insurance. PCIP programs will provide coverage for people with serious health problems at standard rates.

To make limited PCIP funding stretch as far as possible and reduce the possibility of the program crowding out private coverage, Congress has required PCIP program enrollees to be uninsurable and to have gone without health coverage for at least 6 months.

Iowa normally will require HIPIOWA-FED applicants to submit declination letters from insurers to prove that they are uninsurable.

To help applicants who clearly cannot qualify for individually underwritten healthinsurance, Iowa has established a list of conditions that can help an applicant qualify for HIPIOWA-FED coverage without getting a declination letter.

The list does not include hypertension, obesity or pneumonia, The list does include relatively common, well-known conditions such as juvenile diabetes, angina pectoris, lupus and cystic fibrosis.

The list also includes conditions such as metastatic cancer, kidney failure requiring dialysis, lead poisoning with cerebral involvement, and psychotic disorders.

The simplified application process also is available to applicants who have had either lobotomies or topectomies.


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