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Pre-Exisiting Condition Insurance Plan (PCIP) Program discontinued in California

Following Federal direction received on February 15, 2013, California PCIP has suspended new enrollments for applications received after March 2, 2013. This comes to a surprise, and one wonders will this also happen to the State Exchanges, when they realize what the cost will be to offer everyone insurance without medical underwriting and give subsidies to lower income families.

 The PCIP program has a limited amount of funding from Congress. Based on national experience and trends since the program began, PCIP subscribers have serious and expensive illnesses with significant and immediate health care needs. This enrollment suspension will help ensure that funds are available for existing PCIP subscribers.

 PCIP/MRMIP Applications received after March 2, 2013 for the PCIP program will no longer be enrolled unless they meet exception criterion (see below). Instead, the PCIP/MRMIP Applications will be processed for the California’s high risk pool, Major Risk Medical Insurance Plan (MRMIP)eligibility. The MRMIP is still open for exception criterion and new enrollment and available for individuals with a pre-existing condition, if eligible. The PCIP/MRMIP Application is currently used for both PCIP and MRMIP.

PCIP/MRMIP Applications that were received on or before March 2, 2013 with missing information, PCIP will continue to process the applications for PCIP eligibility for enrollment, provided the applicant sends in the missing information timely.

PCIP subscribers moving to California from another State can still apply and transfer their eligibility for enrollment to California PCIP. To successfully transfer eligibility, former PCIP subscribers need to apply to the California’s PCIP within six (6) months after disenrollment from their previous PCIP program by submitting a complete PCIP/MRMIP Application. If an application is incomplete and/or missing documentation, the approval process will be delayed and coverage may be denied. For additional information go to www.pcip.ca.gov/PCIP_Program/PCIP_Eligibility_When_Moving_From_Another_State.aspx

Current PCIP subscribers are not affected by this change. However, subscribers need to pay their monthly PCIP premiums by the due date and continue to meet all eligibility requirements.  PCIP Subscribers who are disenrolled cannot be re-enrolled back into the program.

Contact us to find ways to to find affordable health insurance in the transition phase to the California healh insurance exchange.

 

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