Health Care Reform, Insurance and Employee Benefits

Everything you need to know about health insurance

State-by-State Guide to PCIP (Federal Health Insurance Risk Pool)

Note: None of this should be taken as legal or tax advice.

In July, 2010, the health reform bill created the Pre-Existing Condition Exclusion Plan (PCIP) to provide health insurance coverage to uninsurable citizens. Currently, 24 states (including District of Columbia) administer their own PCIP program. The federal government and HHS run the program on behalf of the remaining states.

Eligibility for PCIP is based on the following criteria:
  • Legal citizen of the United States
  • Uninsured for 6-months prior to application
  • Denied an individual health insurance plan due to a pre-existing condition

A state-by-state summary is provided below for your convenience. Please add questions and suggestions via the comment section.


State Federal or State Run? State Program Name (if applicable) Additional PCIP Notes*
Alabama Federal N/A
Alaska State ACHIA-FED $1500 deductible plan, rates from $468/mo (25 yr old) to $1310/mo (55 yr old)
Arizona Federal N/A
Arkansas State CHIP
California State California PCIP
$1500 deductible plan, rates from $180/mo (25 yr old) to $564/mo (55 yr old)
Colorado State GettingUSCovered $2500 deductible plan, rates from $184/mo (25 yr old) to $486/mo (55 yr old)
Connecticut State CT PCIP Plan $1250 deductible plan, rates from $285/mo (25 yr old) to $628/mo (55 yr old)  
Delaware Federal N/A
District of Columbia Federal N/A  
Florida Federal N/A
Georgia Federal N/A
Hawaii Federal N/A  
Idaho Federal N/A
Illinois State IPXP $2000 deductible plan, rates from $135/mo (25 yr old) to $368/mo (55 yr old)  
Indiana Federal N/A
Iowa State HIPIOWA-FED $1000 deductible plan, rates from $261/mo (25 yr old) to $435/mo (55 yr old)  
Kansas State PCIP-KS $2500 deductible plan, rates available via phone at 1-877-505-0511
Kentucky Federal N/A
Louisiana Federal N/A
Maine State DirigoChoice Choice of three deductible amounts from $1250 - $2500
Maryland State MHIP $1500 deductible plan, rates from $141/mo (under 30) to $354/mo (65 and over)  
Massachusetts Federal N/A
Michigan State HIP Michigan $1000 deductible plan, rates from $241/mo (25 yr old) to $563/mo (55 yr old)  
Minnesota Federal N/A
Mississippi Federal N/A
Missouri State MHIP Choice of three deductible amounts from $1000 - $5000 with plan rates from $271/mo (25 yr old) to $570/mo (55 yr old)
Montana State MAC Plan $2500 deductible plan, rates from $219/mo (25 yr old) to $516/mo (55 yr old)  
Nebraska Federal N/A
Nevada Federal N/A
New Hampshire State NHHP-FED $1000, $2000, and $2500 deductible plan options, rates from $159/mo (25 yr old) to $520/mo (55 yr old)  
New Jersey State NJ Protect Several plan options with plan rates from $252/mo (25 yr old) to $440/mo (55 yr old)
New Mexico State NMMIP $500, $1000, and $2000 deductible plan options, rates from $168/mo (25 yr old) to $409/mo (55 yr old) 
New York State NY Bridge Plan Zero deductible plan with standardized premium rates ranging from $362/mo to $421/mo, depending on geographic location
North Carolina State Inclusive Health Choice of four deductible amounts from $1000 - $4500 with plan rates from $109/mo (25 yr old) to $276/mo (55 yr old)
North Dakota Federal N/A
Ohio State Ohio Risk Pool Choice of $1500 or $2500 deductible amounts with plan rates from $130/mo (25 yr old) to $358/mo (55 yr old), depending on geographic location
Oklahoma State OHRP $2000 deductible plan, rates from $137/mo (25 yr old) to $395/mo (55 yr old)  
Oregon State Oregon Medical Insurance Pool Choice of four deductible amounts from $500 - $1500 with plan rates from $266/mo (25 yr old) to $557/mo (55 yr old)
Pennsylvania State PA Fair Care $1000 deductible plan, with average rate of $283/mo 
Rhode Island State PCIPRI $1000 deductible plan, with plan rates from $231/mo (25 yr old) to $520/mo (55 yr old)
South Carolina Federal N/A
South Dakota State SD Federal Risk Pool $2000 deductible plan, with plan rates from $231/mo (25 yr old) to $535/mo (55 yr old)
Tennessee Federal N/A
Texas Federal N/A
Utah State Federal HIPUtah Choice of four deductible amounts from $500 - $5000 with plan rates from $137/mo (25 yr old) to $271/mo (55 yr old)
Vermont Federal N/A
Virginia Federal N/A  
Washington State PCIP-WA Choice of $500 or $2500 deductible amounts with plan rates from $221/mo (25 yr old) to $606/mo (55 yr old)
West Virginia Federal N/A
Wisconsin State HIRSP-Federal Choice of four deductible amounts from $500 - $3500 with plan rates from $113/mo (25 yr old) to $340/mo (55 yr old)
Wyoming Federal N/A
  
SRC:  Pre-Existing Condition Insurance Plan Website
*Monthly premium rates are estimates, please obtain unique individual quote based on your needs 


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