Premium rates for people covered under THIRP
are based on age, sex, and smoker/nonsmoker status. These premium rates are substantially higher than the standard market rates found in Texas.
Elements of the Pre-existing Condition Insurance Plan To be eligible for the program, a person must meet the following criteria:
• Be a citizen or otherwise legally residing in the United States.
• Be uninsured for at least the last 6 months. Per- sons currently insured or enrolled in THIRP are not eligible.
• Have a preexisting condition, as determined by HHS or have been denied coverage because of a preexisting condition.
People covered under PCIP will not be subject to
preexisting condition exclusions. Premium rates for people covered under PCIP are based only on the age of the insured person. These premium rates are con- sidered standard market rates. For more information on the Texas High Risk Insur-
ance Pool, call (888) 398-3927, or log on to www
.txhealthpool.org. Additional information about the Pre-existing Con- dition Insurance Plan can be obtained by calling (866) 717-5826 or logging on to
www.pcip.gov.
Most HIV positive persons had previous visits to a medical facility where they were not tested for HIV.
Routine HIV testing is an opportunity for earlier diagnosis and treatment.
Warren Cooper is TMA’s director of health care delivery systems. Learn more at
Editor’s Note: This is the latest in a continuing series by TMA staff experts on what the new health system reform law means to physicians and patients.
www.testtexashiv.org
CDC. Missed Opportunities for Earlier Diagnosis of HIV Infection --- South Carolina, 1997—2005. MMWR 2006; 55(47);1269-1272
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