PCIP-WA

PCIP-WA
PO BOX 1090
Great Bend, KS 67530
1-877-505-0514

Login

Need a login?
Click Here to request your enrollee login to check claims and benefits, change address or send a question to Customer Service.














Image

About PCIP-WA

In March of 2010, Congress passed and President Obama signed the Affordable Care Act—the new health law. The law creates a new program – the Pre-Existing Condition Insurance Plan - to make health coverage available to individuals with pre-existing conditions who have been uninsured for at least six months.  The new plan, funded by the federal government, is temporary and will end January 1, 2014, when full health reform takes effect and people cannot be denied insurance due to a pre-existing medical condition.

States could choose to let the federal government run the plan or choose to run the plan themselves. Washington State chose to run the plan itself.  The plan will be operated alongside the existing state high risk pool operated by the Washington State Health Insurance Pool (WSHIP). 

The plan is called “Pre-existing Condition Insurance Plan–Washington State (PCIP-WA).”  It will be administered by the same third party administrator (Benefit Management Inc.), provider network (First Choice Health), pharmacy benefit manager (Medco) and care management company (Health Integrated) who administer the WSHIP program. 

There are five key differences between PCIP-WA (the federal plan) and WSHIP (the state high risk pool):

  • You must be uninsured for at least six months to be eligible for the federal plan, and WSHIP has no such requirement.
  • The federal plan has no waiting period for pre-existing conditions, and WSHIP has a six month pre-existing waiting period (which is waived if you have had prior continuous coverage).
  • The federal plan includes a list of pre-existing conditions that automatically qualify you for the federal plan. To qualify for WSHIP, you must be rejected for individual coverage.
  • The federal plan has no lifetime maximum, and WSHIP's is $2 million.
  • The federal plan is funded by premiums and federal dollars. WSHIP is funded by premiums and an assessment on the health insurers in Washington State.

If you do not qualify for PCIP-WA, you may be eligible for WSHIP, the state high risk pool for individuals rejected for coverage due to medical reasons.

New-PCIP-WA Brochure