Update: Federal Pre-Existing Condition Insurance Plan (PCIP) for Mass. Residents

In a recent blog post we suggested that the Federal Pre-Existing Condition Insurance Plan (PCIP) was a health insurance option for Mass. residents currently locked out of the private health insurance market. We have received additional information from our partners at CMS that we’d like to share with our readers. Please forward this information far and wide and contact our HelpLine, 1-800-272-4232, with questions or concerns.

Clarification has been given to us as to how a Mass. resident goes about applying for and enrolling in a PCIP plan. Persons that have been uninsured for six months or more and cannot get health insurance through our private health insurance market due to it being closed for enrollment may be eligible for a plan through the PCIP. The applicant must provide obtaining a letter from a doctor, physician assistant, or nurse practitioner dated within the past 12 months stating that the individual has or had a medical condition, disability, or illness. The letter must also include the applicant’s name and medical condition, disability, or illness and the name, license number, state of licensure, and signature of the doctor, physician assistant, or nurse practitioner. People can apply for a PCIP plan at http://www.pcip.gov or by calling 866-717-5826.

Also, CMS has issued this consumer alert regarding an unauthorized website:

The Centers for Medicare and Medicaid Services: Consumer Alert – October 9, 2011

Website Warned on Suggesting Linkage to Government Agency – Could Mislead Consumers

The Centers for Medicare and Medicaid Services (CMS) has recently become aware of a website that has the appearance of being an official government website for the Pre-Existing Condition Insurance Plan.

This new website – preexistingconditioninsuranceplan.com – is not maintained by any government programs and consumers are strongly urged not to submit any personal information requested by this website under the assumption that it is a government website.

CMS is taking the appropriate steps to protect consumers from being misled.

The Pre-Existing Condition Insurance Plan made available through the Affordable Care Act makes health insurance available to people who have had a problem getting insurance due to a pre-existing condition.

The Pre-Existing Condition Insurance Plan:

  • Covers a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs.
  • Does not charge you a higher premium just because of your medical condition.
  • Does not base eligibility on income.

Individuals interested in this new federally backed program should visit: www.pcip.gov or call 866-717-5826.

-Kate Bicego

About HCFA

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One Response to Update: Federal Pre-Existing Condition Insurance Plan (PCIP) for Mass. Residents

  1. Thank you for the information and the update. It is also worth noting that effective September 2010, children (below age 19) with pre-existing conditions may not be denied access to their parents’ health plan and insurance companies will no longer be allowed to insure a child, but exclude treatments for that child’s pre-existing condition.

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