Missouri Pre-Existing Condition Insurance Plan (PCIP) 
Do you have a pre-existing conditionPATIENT 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:

  1. Be a U.S. citizen or a legal resident: U.S. Citizens or U.S. Nationals must provide their Social Security Number.
  2. Have a pre-existing medical condition
  3. 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.