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North Carolina Pre-Existing Condition Insurance Plan (PCIP)
The New Federal Healthcare Law includes health coverage for any person who is currently uninsured due to a denial for a pre-existing medical condition. This new health insurance, called the Pre-Existing Condition Insurance Plan (PCIP), is available now and will remain in place until new health insurance options become available in January 2014.
What is the Pre-Existing Condition Insurance Plan?
The Pre-Existing Condition Insurance Plan was created as part of the nation's new health insurance law, the Affordable Care Act, to make health insurance available to people if they have had a problem getting health insurance due to a pre-existing condition.
How do I know if I am eligible for coverage through PCIP?*
Eligible individuals must:
- Be a U.S. citizen or a legal resident
- Have a pre-existing medical condition
- Not have been covered under health coverage for the previous six months before applying for coverage (proof of denial from insurance company will be needed)
How do I enroll for the Pre-Existing Condition Insurance Plan?
Apply Online: https://www.benefitinfocenter.com/ncnrp/Login.aspx
Contact a local Agent/Broker
Print a copy of the 2010 Application: http://www.inclusivehealth.org/federaloption/forms/IH_Fed_App.pdf
Call Inclusive Health 1-866-665-2117
How much does the Pre-Existing Coverage Insurance Plan cost me?**
$183 to $729 per month depending on age, plan type, and smoker vs. non-smoker.
What benefits do I receive under PCIP?
Covered In-Network Services:
$1,000 - $4,500 annual deductible (except for preventive services) depending on plan type.
Patient pays 20% of the cost of covered benefits
Out-of-pocket costs capped at $5,950 per year
No lifetime maximum
Preventive services include: periodic health evaluations (ie. annual physicals), screening services (ie. cancer screenings, cardiac screenings, and mammograms), well-child care, and child and adult immunizations.
*Persons currently covered by a health plan, including employer insurance plans, Medicare, Medicaid and existing high-risk pool programs, are not eligible for the Pre-Existing Coverage Insurance Plan. PCIP coverage is only available to an eligible individual. There are no family plans or premium levels in PCIP.
**Premiums may be subject to changes made by PCIP.