The Pre-existing Condition Insurance Plan, also known as PCIP, is a new program available from the federal government to offer health insurance to individuals with existing medical conditions.  There are no waiting periods or exclusions for pre-existing conditions under this plan.  This program is designed to act as a “bridge” to 2014 when all individual health insurance policies are scheduled to become guaranteed-issue regardless of health.  There are several qualifications that must be met (no exceptions) to qualify for coverage:

  • You must have had no prior health insurance coverage within the past 6 months
  • You must have been denied health insurance due to a pre-existing condition, OR ineligible for health insurance due to a pre-ex condition, OR been offered health insurance with an exclusion for a pre-ex condition
  • You must be a US citizen or residing in the US legally (such as a visa or green card)

If you don’t meet one or more of these conditions, you are ineligible for the PCIP plan.  Fortunately, there are other guaranteed-issue health insurance plans in Virginia available.

There are three different plans available through PCIP:

  • Extended plan – $1,000 deductible, $5,950 out of pocket maximum
  • Standard plan – $2,000 deductible, $5,950 out of pocket maximum
  • HSA plan – $2,500 deductible, $5,950 out of pocket maximum.  This plan is compatible with a health savings account.

Premiums for each plan in Virginia are as follows (per person, no family rates available):

Ages 0-18
Extended  – $125/month
Standard – $93/month
HSA – $97/month

Ages 19-34
Extended  – $188/month
Standard – $140/month
HSA – $145/month

Ages 35-44

Extended  – $226/month
Standard – $168/month
HSA – $176/month

Ages 45-54
Extended  – $288/month
Standard – $214/month
HSA – $222/month

Ages 55+

Extended  – $401/month
Standard – $297/month
HSA – $309/month

If you are interested in applying for coverage under the PCIP program, please give us a call at 1-800-571-2980 or e-mail us at Info@terminsurancebrokers.com.  You can also click the banner at the top or bottom of the page to start comparing health insurance quotes instantly.