The health reform law created the Pre-Existing Condition Insurance Plan (PCIP). These plans are for people who have been denied health insurance because they have a health condition or illness that they were previously diagnosed with or treated for. You are eligible for one of these plans if you meet all of the following 3 criteria:
- You have not had health insurance for at least six months
- You have a pre-existing health condition or have been denied health insurance because of your health condition
- You are a U.S. citizen or legally reside in the U.S
If you are in a health insurance plan, but it does not cover your pre-existing condition, you are not eligible for this plan.
The PCIP covers doctors visits, specialty care, hospital care and prescription drugs.
These PCIPs are either administered by the state or federal government. Check with your state to find out what plan options are offered in your area.
How you apply for these PCIPs depends on if your state has a federal or state run program.
If the PCIP in your state is run by the state, you should check with the state to find out how you can apply.
If the PCIP in your state is run by the federal government, you will need to provide one of following documents in order to apply.
- A denial you got in the past 6 months from an insurance company in your state.
- A letter from an insurance agent stating that you are not eligible because of your medical condition.
- An offer of health insurance coverage within the past 6 months that shows that your condition is excluded. If your condition is excluded, it means that you will not be able to get coverage for the condition from the plan which is offering you health insurance.
For information about premiums and copays you should contact the plan directly.