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Home > Help > Pre-Existing Conditions
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Affordable Health Insurance for Pre-Existing Conditions: Fact or Fiction?

If you have been diagnosed with a pre-existing condition, we don't have to tell you how challenging it can be to find affordable health insurance. You have watched insurance company reps shake their head or offer you premium prices that nearly gave you another medical condition.


In many cases, people with pre-existing conditions who don't have access to affordable health insurance through their employer simply go without. This is an unfortunate decision – especially if you need regular maintenance medications that cost a small fortune. Perhaps you go without your essential but expensive medication as well, leaving you vulnerable to a hospital stay and an even bigger bill at the end.

It's enough to make your head spin, right? Who wants to live like that? Thanks to healthcare reform, you don't have to any longer!

One of the first provisions in the Affordable Care Act was designed to take care of people like you. People with pre-existing conditions who are getting punished by the insurance industry for being sick. People who need affordable health insurance even more than the rest of the healthy population.

Today, children with pre-existing conditions can no longer be denied coverage, thanks to healthcare reform. However, that provision will not be effective for adults until 2014. At that time, health insurance exchanges will offer affordable health insurance to all individuals, regardless of pre-existing conditions. Until then, the federal government is providing another option for adults in this situation, known as the Pre-Existing Condition Insurance Plan or PCIP.


About the PCIP

The PCIP is a new type of affordable health insurance that is available to adults with a pre-existing condition. The plan is available in every state, although coverage specifics may vary by state. States that do not offer coverage can help residents receive the affordable health insurance they need through the U.S. Department of Health and Human Services. The affordable health insurance will include the following:

• Coverage for a broad range of medical services, including primary and specialty care
• Coverage of hospitalizations and prescription drugs
• Coverage for everyone with a pre-existing condition, regardless of income
• Premiums in line with other affordable health insurance plans

This program will continue until 2014, when the health insurance exchanges will make affordable health insurance available to everyone and PCIP will no longer be needed.


Who is Eligible?

To be eligible for PCIP coverage, you must meet the following criteria:

• You have a pre-existing medical condition
• You have been denied affordable health insurance because of your condition
• You have been without affordable health insurance for six months or longer
• You are a U.S. citizen or residing here legally

If you are eligible for PCIP, the time to act is now. Find out if your state offers a PCIP program currently. This plan probably replaces the high-risk insurance pool offered by most states for individuals with medical conditions looking for insurance. If your state does not offer a PCIP program, check with the U.S. Department of Health and Human Services to find out if you qualify for the PCIP plan offered by the federal government.

Until 2014 arrives with health insurance exchanges for everyone, the PCIP is working to keep every American covered, no matter what their current medical condition might be. Don't go without affordable health insurance any longer. The right coverage will help you get the medical care you need to live a long and happy life, despite your current medical condition.

Visit the InsureMonkey homepage to start a health insurance quote.

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