The Pre-existing Condition Insurance Plan, also known as PCIP, is a new program available from the federal government to offer health insurance to individuals with existing medical conditions. There are no waiting periods or exclusions for pre-existing conditions under this plan. This program is designed to act as a “bridge” to 2014 when all individual health insurance policies are scheduled to become guaranteed-issue regardless of health. There are several qualifications that must be met (no exceptions) to qualify for coverage:
- You must have had no prior health insurance coverage within the past 6 months
- You must have been denied health insurance due to a pre-existing condition, OR ineligible for health insurance due to a pre-ex condition, OR been offered health insurance with an exclusion for a pre-ex condition
- You must be a US citizen or residing in the US legally (such as a visa or green card)
If you don’t meet one or more of these conditions, you are ineligible for the PCIP plan. Fortunately, there are other guaranteed-issue health insurance plans in Virginia available.
There are three different plans available through PCIP:
- Extended plan – $1,000 deductible, $5,950 out of pocket maximum
- Standard plan – $2,000 deductible, $5,950 out of pocket maximum
- HSA plan – $2,500 deductible, $5,950 out of pocket maximum. This plan is compatible with a health savings account.
Premiums for each plan in Virginia are as follows (per person, no family rates available):
Ages 0-18
Extended – $125/month
Standard – $93/month
HSA – $97/month
Ages 19-34
Extended – $188/month
Standard – $140/month
HSA – $145/month
Ages 35-44
Extended – $226/month
Standard – $168/month
HSA – $176/month
Ages 45-54
Extended – $288/month
Standard – $214/month
HSA – $222/month
Ages 55+
Extended – $401/month
Standard – $297/month
HSA – $309/month
If you are interested in applying for coverage under the PCIP program, please give us a call at 1-800-571-2980 or e-mail us at [email protected]. You can also click the banner at the top or bottom of the page to start comparing health insurance quotes instantly.