What is Pre-existing Condition Insurance Plan (PCIP)?

July 13, 2018

If you have a pre-existing condition, you know how hard it is to get insurance. At least, that’s the way it used to be. You would either have to opt for insurance that excluded your condition or go without insurance. Either way, you generally paid a lot more money for the premiums than those that didn’t have a condition already existing.

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The Affordable Care Act created the Pre-Existing Condition Insurance Plan to solve this problem. The plan was created for those that didn’t have insurance for the last six months and have some type of pre-existing condition that made it hard to get insurance coverage.

The End of the Pre-Existing Condition Insurance Plan

As of 2014, the PCIP no longer exists. The Healthcare Marketplace took its place. In the Marketplace, anyone has access to insurance, regardless of a pre-existing condition. In the Marketplace:

  • Insurance companies cannot deny you because of a pre-existing condition
  • Once you have insurance, the insurance company cannot raise your rates because of your health conditions alone
  • Pregnancy is covered by the plan no matter how pregnant you are when you start on the new insurance

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The Exception to the Rule

There is one way an insurance company can exclude your pre-existing condition. That’s if you have a grandfathered plan. These plans are those you enrolled in prior to March 23, 2010, and that still exist today. They are called ‘grandfathered plans.’

These plans can continue to exclude your pre-existing condition until the insured switches over to the Marketplace. Since the condition would be excluded, it typically makes sense to switch over to the Marketplace though.

The Pre-Existing Condition Insurance Plan was the start of the way to help those with pre-existing conditions. It helps people get the proper medical care while not having to pay for the expenses out of pocket. Today, the Marketplace helps to achieve the same goal – helping people comfortably afford their medical care.

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