The Pre-Existing Condition Insurance Plan (PCIP) is a program created by the Affordable Care Act of March 2010. It makes health insurance available to those denied coverage by private insurance companies due to pre-existing conditions. You qualify for the program if you meet the following requirements:

  • You have been without health coverage for at least six months (if you have Medicare or TRICARE, you shouldn’t apply);
  • You have a pre-existing condition or have been denied health coverage due to a health condition; and
  • You are a U.S. citizen or reside here legally.

If you are uninsured and have been told that you may be eligible for other coverage programs like Medicaid, you should check out those programs first as they may better meet your needs.

PCIP covers a broad range of health benefits and all are available on your coverage effective date even to cover pre-existing conditions – there are no waiting periods. The benefits include primary and specialty care, hospital care, and prescription drugs. Premiums do not increase because of pre-existing conditions and eligibility is not based on income.

Arizona is using the federally-administered PCIP program that offers three plan options: the Standard Plan, the Extended Plan, and the HSA Plan.  These plans have different levels of premiums, yearly deductibles, prescription deductibles and prescription co-pays.

For more information and to apply, visit the PCIP-Arizona website. If you need help, call Keogh Health Connection at 602-266-0397.