LANSING – The Office of Financial and Insurance Regulation (OFIR) announced yesterday that an agreement has been reached that will offer coverage to uninsured Michigan citizens who have been unable to obtain health coverage because of a pre-existing health condition. Coverage will be offered through Michigan-based HMO Physicians Health Plan of Mid-Michigan (PHP).  PHP has contracted directly with the U.S. Department of Health and Human Services (HHS) to administer this program.

OFIR will have regulatory oversight over the state-implemented pool, which will be funded entirely by subscriber premiums and an estimated $141 million in federal subsidies. The temporary pool will operate until January 1, 2014, when federal law requires all insurers to accept individuals regardless of pre-existing conditions.   Coverage provided by the pool will be more comprehensive and the offerings will be, in many cases, less expensive compared to products currently available in the individual market.   Enrollment is scheduled to begin August 31, 2010 and coverage is scheduled to start October 1, 2010.

Information for Consumers: Michigan residents with pre-existing conditions who have been uninsured for the previous six months will be eligible to enroll. Consumers interested in this program should begin collecting the documents that will be required for enrollment, including:

• Proof of U.S. citizenship (i.e. birth certificate) and Michigan residency (i.e. state driver’s license).
• Certification by a physician (i.e. doctor’s letter), issued within the past six months, demonstrating that the individual suffers from a medical condition found in the pool’s list of pre-existing conditions, OR
• Evidence that, for health reasons, a carrier has refused to issue coverage to the individual within the previous six months (i.e. health insurance company denial letter).

For a list of the pool’s pre-existing conditions, visit: http://www.michigan.gov/documents/dleg/Pre-Ex_330602_7.pdf Michigan consumers interested in detailed enrollment, benefit and eligibility information should contact PHP weekdays from 9:00 am – 5:00 pm EST at 877-459-3113.

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