2010-09-03 / Top Stories

Pre-Existing Condition Insurance Plan Is Ready

Governor David A. Paterson today announced that New York State’s Pre-existing Condition Insurance Program is ready to take applications now. The program, called NY Bridge Plan, is available to people with pre-existing conditions — that is, who are already ill — and who currently do not have health insurance. It will provide coverage starting October 1. The program is expected to enroll about 15,000 New Yorkers.

NY Bridge Plan will provide immediate coverage to individuals for medical expenses, including those related to the pre-existing condition. In addition, the program will be affordable. Currently, an individual buying health insurance will pay about $1,000 a month. NY Bridge Plan will cost $362 per month in upstate New York counties and $421 per month in downstate counties. Physician services are subject to a $20 co-payment and there are no deductibles.

The Federal Patient Protection and Affordable Care Act makes $5 billion available over the next three and a half years, of which New York is expected to receive about $297 million. The Federal government has guaranteed that no financial responsibility for this program will be shifted to the states. The temporary program is designed to help individuals who are uninsured and have preexisting health conditions. The program will end in 2014 when individuals will be able to purchase insurance through State health insurance exchanges.

To be eligible to apply, an individual must be a legal U.S. resident, a resident of New York State, have one or more pre-existing medical conditions and not have had health care coverage for the last six months.

Enrollment is on a first-come, first-serve basis. Once the program is full, a waiting list will be established. For additional information, call 1-877-444-9622 or go to www.nybridgeplan.com.

The NY Bridge Plan covers a broad range of services, including primary and specialty care, inpatient and outpatient hospital care, and prescription drugs, as well as assistance from professional nurses and caseworkers to help members manage chronic conditions and maintain overall health. The NY Bridge Plan is an Exclusive Provider Option (EPO), which means that participants must use doctors and health care providers who are in the network, except in cases of emergency or when care is not available through a participating provider.

New York requested that Group Health Incorporated (GHI) serve as the designated nonprofit contractor to operate the pre-existing health insurance program on behalf of the State. By Federal rules, only a nonprofit can serve in this role.

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