Pre-Existing Condition Insurance Plan Coverage...

By: Taylor

As part of the Affordable Car Act, the United States government started a program commonly known as the PCIP program. PCIP is an acronym for Pre-Existing Condition Insurance Plan. The program was designed to allow those who had a pre-existing condition and had been previously denied insurance because of the condition to have insurance. One other requirement for enrollees was that they must have been without medical insurance for a period of six months or more.

The PCIP program is run by the United States Department of Health and Human Services and was not available in every state. Open enrollment in the PCIP program was suspended in February of 2013 for fear that there wouldn’t be enough funds to adequately cover those already enrolled in the program through the 2013 calendar year.

Those currently enrolled in the PCIP program will have their health insurance coverage ending as of December 31, 2013 and will have to enroll in a new medical plan. For more information on this, see our page on PCIP Coverage Ends on Dec 31, 2013.

What the PCIP Covers
The Pre-Existing Condition Insurance Plan covers many health benefits, including primary and specialty care, hospital care, and prescription drugs. It also provides preventive care with no deductible if a preventive diagnosis is needed. It also offers coverage for annual physical examinations, flu shots, routine mammograms and cancer screenings.

PCIP Coverage Ends on Dec 31, 2013
Two provisions within the Affordable Care Act will be enacted as of January 1, 2014. These two provisions make the PCIP coverage no longer necessary to offer as a separate type of insurance and they are:

The Individual Mandate: Which requires every legal citizen of the United States not covered under employer sponsored health plan, Medicaid, Medicare or other public insurance program to secure a pre-approved private insurance policy. This goes into effect on January 1, 2014. Exempt from this mandate are those members of a recognized religious sect exempted by the Internal Revenue Service, or waived in case of financial hardship. All others will pay a penalty if they are without insurance as of 1/1/2014.
Guaranteed Issue: Insurance policies must be issued to any consumer enrolling, regardless of pre-existing medical conditions and without charging additional premiums.
Because every citizen must have insurance, and every insurer is barred from precluding any person from a health policy based on a pre-existing condition, the PCIP Program is no longer needed and will no longer be funded.

Your Options

If you are currently enrolled in the PCIP program, you will need to get insurance from a different source. For more information on your options, see our page: PCIP Coverage Ends on Dec 31, 2013

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