Because of the overwhelming response to enroll in the program and the limited funding available, it was necessary to implement a waitlist for adultBasic. Here are a few commonly asked questions and answers about the waitlist:
How long will I be on the waitlist?
Unfortunately, there is not a simple answer to your question. There is currently a waitlist for low-cost adultBasic with more than 440,000 people, and available funding permits low-cost adultBasic coverage only for the people currently enrolled in low-cost adultBasic. There are no plans to make offers of enrollment into the low-cost adultBasic program. So at this time, there is no expectation that people on the adultBasic waitlist will be offered low-cost adultBasic coverage.
Should I apply for adultBasic even if there is a waitlist?
By law, the adultBasic program must continue to accept applications for low-cost adultBasic, although there are more than 440,000 people currently on the adultBasic waitlist. Available funding permits low-cost adultBasic coverage only for the people currently enrolled in low-cost adultBasic. Therefore, there are no plans to make offers of enrollment into the low-cost adultBasic program. If you apply and are found eligible, you will be added to the waitlist at the end of the waitlist. Anyone on the waitlist can purchase adultBasic coverage for $629 per month, which will be $636 per month effective January 1, 2011, as a result of a cost of living adjustment.
How will I know if I’m enrolled in the program, or placed on the waitlist?
You will receive a notice from the insurance company telling you if you are eligible or ineligible. If you are eligible, you will receive a notice stating you have been placed on the waitlist. The notice will also explain the option to purchase adultBasic benefits while on the waitlist.
Can I get coverage while I’m on the waitlist?
Available funding permits low-cost adultBasic coverage only for the people currently enrolled in low-cost adultBasic. Therefore, there are no plans to make offers of enrollment into the low-cost adultBasic program. However, anyone on the waitlist can purchase adultBasic coverage for $629 per month, which will be $636 per month effective January 1, 2011, as a result of a cost of living adjustment. If you purchase adultBasic coverage, the benefits you will receive are the same as those offered when enrolled in the low-cost program. In addition, whether or not you choose to purchase coverage does not affect your place on the waitlist.
What happens if I don’t respond to the offer when space becomes available to enroll in the program?
We understand that circumstances may change while you are on the waitlist. You have 30 days to respond and confirm whether or not you are still eligible and if you want to enroll in the program. If you are no longer eligible, or you do not respond within 30 days, your name will be removed from the waitlist and you will need to re-apply if you want to be placed back on the waitlist for coverage.
Is there a waitlist for the Children’s Health Insurance Program (CHIP)?
No! Applications and benefits for CHIP are not effected in any way by the waitlist for adultBasic. Uninsured children and teens (up to age 19) who are not eligible for Medical Assistance are eligible for CHIP. You can apply for CHIP by going. www.compass.state.pa.us.
How will I be told I can enroll?
You will receive a letter from the insurance company telling you that you applied with, and it will tell you that you have the opportunity to enroll in adultBasic. You will be asked to confirm that your circumstances have not changed, meaning that since the time your application was completed, your income is still the same and you will be without insurance on the day adultBasic coverage will start.You also will be asked to submit your monthly premium payment. When your updated information and payment is received, you will be enrolled in adultBasic.
Do I have a choice of insurance companies?
You may. Some counties have more than one insurance company offering services for adultBasic. The Pennsylvania Insurance Department has approved all participating adultBasic insurance companies, and does not endorse any company over another. Factors to consider in your decision about insurance should include whether your hospitals, doctors, nurse practitioners, or other health care providers participate with the company; what services and benefits are covered when you are away from home; and whether the insurance company is helpful in answering your questions.
If more than one insurance company is available in your county of residence, you may select the company you prefer. If you are already enrolled or on the waiting list, please contact your current insurance company and request the change.
Also, if you wish to stay with your current Primary Care Physician, please call your physician to be sure that he/she participates with the other adultBasic company.