Back in March, Congress and President Obama enacted the Patient Protection and Affordable Care Act, a major health care reform bill that will drastically change the U.S. health care system over the next four years. As part of the reform bill, a new high risk pool plan is being created to help cover people with pre-existing medical conditions. It is called the Pre-Existing Condition Insurance Plan (PCIP).
In Arizona, the new plan is run by the U.S. Department of Health and Human Services. (In some states, the plan is run by the state itself.)
Because so many details of the new plan have not yet been released (including the monthly premiums, the full explanation of benefits, and the list of providers), it is hard for us to give a full endorsement of this plan just yet. However, if you are not able to qualify for a major medical health insurance plan, this new PCIP plan is probably your best option.
If you are not able to qualify for the new plan, click here to request a complete Arizona health insurance quote.
Here are the basic details of the new plan, including qualification requirements and the link to apply.
Arizona Pre-Existing Condition Health Insurance Plan
- How do I qualify for the plan?
You are not eligible for the plan unless you have been without health insurance for the past 6 months. You also must have been denied for individual health insurance due to a pre-existing condition, or, you must have had some benefits denied due to a pre-existing condition. For example, if you applied for Blue Cross Blue Shield of Arizona and they issued a rider on your pre-existing condition, then you are eligible for the new plan.
- How much does the PCIP plan cost?
The exact monthly premiums for the Arizona plan won’t be announced until July 15th. If you apply before the 15th of July, you’ll receive a bill in the mail letting you know the monthly premium. So far, all that has been announced about the price is this: “The estimated premium for a 50 year old will be between $491 and $600.” For someone with major pre-existing conditions, it’s a very good rate.
- When does coverage begin?
The coverage will begin on August 1st. If you apply on or before the 15th of the month, your coverage will begin on the 1st of the following month.
- What doctors and hospitals will accept the new plan?
The provider network in Arizona for the new plan has not yet been announced, but has been described as including “a full range of services and specialists.”
- What is covered?
The new plan has a broad range of benefits that includes hospitalization, doctor visits and prescription drugs. The comprehensive list of benefits has not yet been released.
- What if I can’t afford the monthly cost?
If you can’t afford the plan, you may be able to qualify for Arizona’s low income Medicaid plan, called AHCCCS.
- How do I apply for the new PCIP plan?
You can apply for the plan beginning on July 1st, 2010, by clicking here.
- What if I can’t qualify for the PCIP plan or AHCCCS?
If you can’t qualify for the Pre-Existing Condition Plan or AHCCCS, click here to compare plans and prices for your various Arizona health insurance options.
*** Update 7/16/2010 ***
The monthly premiums for Arizona’s Pre-Existing Condition Insurance Plan have now been released. They are as follows:
Age 0-34: $323 a month
Age 35-44: $387 a month
Age 45-54: $495 a month
Age 55+: $688 a month
The plan has a $2,500 deductible for all care except preventive services. Once you meet your deductible, there is a $25 co-pay for office visits, $4 to $30+ charge for the first two prescription drugs you purchase. After the first two drugs, you pay 50% of the cost of drugs. The plan has a maximum out-of-pocket cost of $5,950. See pcip.gov for more information.
