What is PCIP?

The PCIP is the Pre-Existing Condition Insurance Plan. It is a program offering health insurance coverage to those who are otherwise considered uninsurable in California. PCIP is federally funded and is available for those who have not had any other forms of health coverage in the previous six-month period. He or she must also be a resident of California.

For the purposes of PCIP, a pre-existing condition must be shown through a denial of coverage through an insurance company within the previous 12 months or a letter within the same time period from a doctor, nurse practitioner, or physician’s assistance stating that the individual has a pre-existing condition. To qualify, you must not be enrolled in COBRA, Cal-COBRA, or Medicare Parts A and B, and you must be a U.S. citizen or national or be lawfully present in the U.S.

California’s PCIP plan works much like a group health insurance plan. Enrollees will enjoy the benefits of a basic PPO plan, paying copayments for visits to doctors and other services. A deductible will apply for both in-network and out-of-network services. Coinsurance may also apply for some services. Routine care, laboratory and X-ray services, gynecological and prenatal care, family planning services, newborn exams and well-baby care, certain immunizations, and disease management services are all covered. In-network preventative care is generally covered at no extra charge.

Premiums vary depending on your age and location. They are not based on income level. If you are in need of health coverage and cannot afford monthly premiums, consider applying instead for Medicaid or other means-based insurance programs. The first month’s premium is due at the time of application, and you must be able to prove your citizenship or immigration status.

Contact one of our experienced agents today to learn more about your options for affordable health care coverage.

Source: Health Insurance Los Angeles

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