Pre-Existing Condition Insurance Plan- New Health Coverage Option for the Uninsured

If you are a Minnesotan who has had difficulty finding health coverage because of a medical condition, you should know about the Pre-Existing Condition Insurance Plan (PCIP). Created in 2010 under the Health Reform Law, this program offers uninsured people with pre-existing conditions health coverage without charging them more for their coverage or denying them coverage of their pre-existing condition.

The Pre-Existing Condition Insurance Plan is providing eligible adults and children with comprehensive benefits until 2014, when insurers will no longer be allowed to deny coverage to people with any pre-existing condition. At that time, people enrolled in PCIP will have a choice of health plans. Until then, this program is available in every state and the District of Columbia; and administered at the state level or by the Federal government. In Minnesota, the program is administered by the Federal government.

Reduced premiums and simplified eligibility could make PCIP the right option for you. In 2011, premium prices for Minnesotans enrolled in PCIP were reduced by 38.3% and remain at those levels. For more information on premiums, please visit www.pcip.gov.

In Minnesota, and in other states where PCIP is federally administered, you can fill out a PCIP application online at www.pcip.gov. Watch a short video first on the How To Apply page to get prepared to apply online. You can also call 1-866-717-5826 (TTY 1-866-561-1604). To prove that you have a pre-existing condition, simply mail in a letter from a doctor, physician assistant, or nurse practitioner dated within the past 12 months stating that you have or, at any time in the past, had a medical condition, disability, or illness. To qualify, you must be a U.S. citizen or reside in the U.S. legally and have been without health coverage for at least six months.

When you apply, you can choose among three plan options. Each plan covers 100% of preventive care (with no deductible), which includes annual physicals, flu shots, routine mammograms and cancer screenings. For other care, you will pay a deductible before PCIP pays for your health care and prescription drugs. There is no lifetime maximum on the amount PCIP pays for care, and you can receive benefits at any qualified provider.

With PCIP, all covered benefits are available for you, beginning on your coverage effective date, even if it’s to treat a pre-existing condition - there are no waiting periods.

For more information, including eligibility, plan benefits and rates, and how to apply, visit www.pcip.gov and click on “Find Your State.” Then select Minnesota from the drop-down menu. The PCIP Call Center is open from 8 a.m. to 11 p.m. Eastern Time. Call toll-free 1-866-717-5826 (TTY 1-866-561-1604).