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

pcip by stateIn 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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