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

Feb 4, 2011

Social workers should be aware of an important component of the Affordable Care Act, which can provide immediate coverage for Individuals with pre-existing health care conditions.

The Federal Pre-Existing Condition Insurance Plan (PCIP) is a transitional program that will be in effect until 2014, when the new Health Insurance Exchanges become operational. The PCIP offers comprehensive benefits including physician’s services, hospital care, inpatient and outpatient mental health and substance abuse treatment, home care, hospice and prescription drug coverage. Premiums and deductibles vary by state.

To qualify, individuals must: be a US citizen or legal resident; have been uninsured for at least 6 months; and have a pre-existing condition or have been denied insurance coverage because of a medical condition.

Consumers can find more information at www.pcip.gov. Under, “select your state,” consumers should click on their state of residence on the interactive map. Information is also available on a toll-free line: 1-866-717-5826 (TTY 1-866-561-1604). The Call Center is open 8 A.M. to 11 P.M. Eastern Time.

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