PCIP is an alternative for those who have a pre-existing condition or have been denied coverage because of poor health. Government sponsored, it is limited to US Citizens, or those living here legally. Applicants must be without health coverage for at least six months prior to applying. The plan offers individual coverage only, so a spouse and children must apply individually.
PCIP enrolless can choose from three plan options with different levels of premiums, calendar year deductibles, prescription deductibles and prescription co-pays. There is also an option in which an enrollee can open a tax exempt Health Savings Account where funds can be deposited and then withdrawn for medical expenses.
All three PCIP options pay for preventative care at 100%, so there is no deductible for routine preventative care which includes physicals, flu shots, mammograms and cancer screenings. For other medical services, there is a reasonable deductible. After reaching one of the deductibles offered in the three plans, members pay 20% of medical costs in network. The maximum members pay out of pocket for covered expenses is $5,950 in network and $7,000 out of network. There is no lifetime maximum cap on the amount the plan pays for member care.
I recently discovered this plan when I became guardian for someone who had been without health insurance for many years. She was in the hospital with cancer. No regular health insurance plan would cover her. The PCIP program must cover her so long as she pays the monthly premium. In comparison to many individual plans, the monthly premium is reasonable.
To lear more about theis Pre-Existing Condition Plan call 1-800-220-7898. For information on the internet type: www.healthcare.gov or www.pciplan.com.