Pre-Existing Condition Insurance Plan Changes Are Important to People With Disabilities, Reports Allsup

Share Article

Reduced premiums, improved access can benefit people with disabilities; PCIP is an option for those without health insurance seeking Social Security disability benefits

“In order to receive Social Security Disability Insurance benefits, it’s critical to have the support of a treating physician—but lack of health insurance can be a barrier to receiving treatment.”

It is now easier for people to enroll in the federally administered Pre-Existing Condition Insurance Plan (PCIP), providing an important option for people with disabilities who do not have health coverage, according to Allsup, which has helped tens of thousands of people to receive their Social Security Disability Insurance (SSDI) benefits.

Program changes made by the U.S. Department of Health and Human Services (HHS) include the new option for applicants to provide a letter from a physician, a nurse practitioner or a physician assistant dated within the past 12 months stating that they have had a medical condition, disability or illness. Previously, applicants had to provide a coverage denial letter from an insurance company.

“Having health coverage is absolutely critical for people with disabilities, so it’s incredibly beneficial that this federal program for people with pre-existing conditions is easier to join,” said Paul Gada, personal financial planning director for Allsup’s Disability Life Planning Center.

In addition, the HHS announced many PCIP premiums have been reduced, and the program now pays insurance agents for helping people to join the plan. The Pre-Existing Condition Insurance Plan was created under the Affordable Care Act to serve as a bridge to 2014, when insurers can no longer deny coverage to people with pre-existing conditions.

Requirements and stipulations vary depending on the state where someone lives. In 23 states and the District of Columbia, the PCIP is federally administered using the same requirements across those states. The other 27 states run their own programs and requirements vary. Some states will accept a letter from a provider while others may still require proof that someone was denied insurance. Find more information online:

“Allsup disability experts help many people with disabilities who can no longer work and, as a result, no longer have health insurance,” Gada said. “In order to receive Social Security Disability Insurance benefits, it’s critical to have the support of a treating physician—but lack of health insurance can be a barrier to receiving treatment.”

Social Security Disability Insurance is a federally mandated disability insurance program overseen by the Social Security Administration that operates separately from the retirement and Supplemental Security Income (SSI) programs. SSDI provides monthly benefits to more than 8.5 million individuals under full retirement age (age 65 or older) who can no longer work because of a serious illness or injury expected to last more than 12 months, or that is terminal. Individuals must have paid FICA payroll taxes to be eligible. Nearly 153 million workers are insured under the SSDI program. More details are provided in the SSDI Overview at

Social Security Disability & Medicare Help
Individuals with a severe or permanent disability making them unable to work should consider applying for Social Security Disability Insurance benefits. Financial aspects of applying for SSDI include increased monthly income, the potential to extend COBRA health coverage, medical benefits through Medicare, protected retirement benefits, dependent benefits and return-to-work incentives.

Find more resources for people with disabilities, and answers to questions about Social Security disability benefits at If you think you may be eligible for Social Security disability benefits, contact Allsup’s Disability Evaluation Center at (800) 678-3276.

Find answers to Medicare questions by contacting the Allsup Medicare Advisor®, which works one-on-one with individuals to help them choose the Medicare plan that best meets their needs. You can visit or call (866) 521-7655.

Allsup is a nationwide provider of Social Security disability, Medicare and Medicare Secondary Payer compliance services for individuals, employers and insurance carriers. Founded in 1984, Allsup employs nearly 800 professionals who deliver specialized services supporting people with disabilities and seniors so they may lead lives that are as financially secure and as healthy as possible. The company is based in Belleville, Ill., near St. Louis. For more information, go to

# # #

Share article on social media or email:

View article via:

Pdf Print

Contact Author

Rebecca Ray
(800) 854-1418, ext. 5065
Email >

Mary Jung
(773) 429-0940
Email >
Visit website