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November 2010
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Pre-Existing Condition Insurance Plans (PCIPs): Is There An Easier Way to Qualify?

If you have tried to apply for your state’s Pre-Existing Condition Insurance Plan (PCIP) and had difficulty qualifying, this tip may really be able to help you as you put together your application for the pool.

The PCIPs may be designed to provide affordable health insurance benefits to Americans with pre-existing conditions, but there’s are a couple of catches to qualifying. First, it’s only open to Americans who have been without health insurance for at least six months, so if you’ve been laid off and lost your health insurance recently, been dropped from your health insurance or are about to see your COBRA health insurance expire, you won’t qualify immediately. Even if you have a pre-existing condition which precludes other health insurance, you will have to wait six months until you can qualify for your state’s PCIP.

However, in addition to the six month rule, most states are also requiring that you prove that you’ve been denied health insurance based on your pre-existing condition. It’s a hefty task if you haven’t been keeping track of your health insurance application denials. And really who wants to memorialize the fact that they’ve been turned down for health insurance?

Well, thankfully, about half the states have started pre-existing condition lists which can help applicants get around the health insurance denial. 23 of the 27 states that are running their own PCIPs have started lists of pre-existing conditions which will determine automatic eligibility for the states pools. (None of the federally-run PCIPs currently have pre-existing condition lists).

Although most lists include the obvious conditions such as AIDS/HIV+, diabetes and Parkinson’s disease, the lists can vary wildly from state to state. Alaska’s pre-existing condition list includes 60 conditions including anorexia nervosa, morbid obesity and rheumatoid arthritis, while Colorado’s pre-existing condition list includes alcohol/drug abuse and obsessive compulsive disorder. Even cancer is not uniformly listed. Some states only list metastatic cancer (i.e. cancer that has spread to other parts of the body) while others require that the applicant have had a tumor within the last four years.

Still, it’s a step in the right direction if you have had difficulty applying to your state PCIP!

If you are interested in joining a PCIP, more information is available at the government website

Have you applied to a PCIP? Tell us about it!

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Related posts:

  1. Enrollment Trickles Into the Pre-Existing Condition Insurance Plans (PCIPs), Are the Health Insurance Premiums Too High?
  2. Healthcare Reform: Just 1,200 Accepted For Interim High-Risk Health Insurance Pools (Pre-Existing Condition Insurance Plans) So Far
  3. 1 in 7 Denied Health Insurance based on Pre-Existing Conditions
  4. Michigan Pre-Existing Insurance Condition Plan (PCIP) Gets a New Website:
  5. Healthcare Reform: Applying for the New Interim High-Risk Health Insurance Pool for Americans with Pre-Existing Conditions

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