PATIENT FAQ
The New Federal Healthcare Law includes health coverage for any person who is currently uninsured due to a denial for a pre-existing medical condition. This new health insurance, called the Pre-Existing Condition Insurance Plan (PCIP), is available now and will remain in place until new health insurance options become available in January 2014.
What is the Pre-Existing Condition Insurance Plan?
The Pre-Existing Condition Insurance Plan was created as part of the nation's new health insurance law, the Affordable Care Act, to make health insurance available to people if they have had a problem getting health insurance due to a pre-existing condition.
How do I know if I am eligible for coverage through PCIP?*
Eligible individuals must:
- Be a U.S. citizen or a legal resident: U.S. Citizens or U.S. Nationals must provide their Social Security Number.
- Have a pre-existing medical condition
- Not have been covered under health coverage for the previous 6 months before applying for coverage (proof of denial from insurance company will be needed)
How do I enroll?
Download application at http://www.mhip.org/apply. Include 2 forms of Missouri residency and mail to:
MHIP Enrollment
471 Siemers Drive
Cape Girardeau, MO 63701
When will my PCIP coverage be effective?
Once the PCIP application and accompanying documentation is reviewed by the marketing/underwriting department of the administering carrier, the applicant will receive written notification that they have been accepted under the MHIP or the MHIP-PCIP program. The effective date will be either the first day or the 15th day of the month following the date the application was received.
How much does the Pre-Existing Coverage Insurance Plan cost me?**
Monthly Premium:
|
Age |
00-17 |
18-29 |
30-39 |
40-44 |
45-49 |
50-54 |
55-59 |
60-64 |
|
|
$243 |
$370 |
$447 |
$501 |
$579 |
$680 |
$779 |
$972 |
What benefits do I receive under PCIP?
Covered In-Network Services:
- $1,000 annual deductible (except for preventive services, which have no copay or deductible)
- Patient pays 20% of the cost of covered benefits
- Preventive services include: periodic health evaluations (ie. annual physicals), screening services (ie. cancer screenings, cardiac screenings, and mammograms), well-child care, and child and adult immunizations.
- Yearly Out-of-pocket max at $5,950
*Persons currently covered by a health plan, including employer plans, Medicare, Medicaid and existing high-risk pool programs, are not eligible for PCIP. Coverage is only available to an eligible individual. There are no family plans or premium levels in PCIP.
**Premiums may be subject to changes made by PCIP.