Pa. health plan costs skyrocket for people on wait list
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Some uninsured Pennsylvanians looking for a chance to enroll in the state's adultBasic health insurance program are learning the wait's about to get more expensive.
Beginning March 1, those who choose to pay an at-cost monthly premium for coverage while waiting for a spot to open for them in the much cheaper program will see their monthly premium go from an average of $330 to $600.
The rate hike affects about 3,000 people.
The 41,000 or so people who are in the adultBasic program will only see their monthly premiums go from $35 to $36. But their copayments will double and benefits that previously were offered at no charge, such as diabetic supplies, chemotherapy and home health care, will now carry a 10 percent coinsurance fee, up to $1,000 a year.
Melissa Fox, spokeswoman for the Pennsylvania Insurance Department, said funding for the program is fixed, with no increases budgeted, while use of the benefits has increased.
"That obviously affects the funds," she said. "In order to keep folks in the program, the benefit package was reduced and the premiums needed to increase -- those hit the hardest are the folks paying for coverage on the wait list."
The adultBasic program offers unlimited hospitalization, access to primary care physicians and specialists, emergency care, diagnostic tests such as X-rays and mammograms, maternity care and rehabilitation and skilled care.
About 369,000 people are on the wait list, up from about 200,000 in March. The insurance department Web site notes that more than 123,000 people on the waiting list were eventually offered a chance to enroll in adultBasic, but most "had been waiting a year or longer."
In July, the House voted to increase the number of Pennsylvanians eligible for adultBasic to about 130,000, but the bill died in the Senate.
The most recent insurance department survey, done in mid-2008, found that 878,000 adults in the state between 18 and 65 were without health insurance, and about 456,000 others had been without insurance for at least part of the previous year.
Of those who said they had no insurance, about 40 percent were eligible for the adultBasic plan.
The adultBasic program began in 2002 as a means to offer basic insurance coverage to the uninsured, and its popularity prompted the state to set up a wait list in February 2003.
More information on the program is available by clicking the Health Options link at www.insurance.pa.gov or by calling 1-800-GO-BASIC (1-800-462-2742).
First Published January 13, 2010 12:00 am
