Pre-existing Condition Insurance Plan (PCIP)

Affordable Healthcare Insurance

The Pre-Existing Condition Insurance Plan makes health insurance available to people who have had a problem getting insurance due to a pre-existing condition.

The Pre-Existing Condition Insurance Plan:

• Covers a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs.
• Does not charge you a higher premium just because of your medical condition.
• Does not base eligibility on income.

To be eligible for the Pre-Existing Condition Insurance Plan:

• You must be a citizen or national of the United States or reside in the U.S. legally.
• You must have been without health coverage for at least the last six months. Please note that if you currently have insurance coverage that doesn’t cover your medical condition or are enrolled in a state high risk pool, you are not eligible for the Pre-Existing Condition Insurance Plan.
• You must have a pre-existing condition or have been denied coverage because of your health condition.

Florida PCIP offers a choice of plan options to fit your needs (different levels of premiums, calendar year deductibles, prescription deductibles and prescription copays) at more affordable premiums.


Follow these links for more PCIP FAQs and information on the Affordable Care Act.

Florida KidCare health insurance

Child Health Insurance
You Can Afford

Through Florida KidCare, the state of Florida offers health insurance for children from birth through age 18, even if one or both parents are working. It includes four different parts. When you apply for the insurance, Florida KidCare will check which part your child may qualify for based on age and family income.

• MEDIKIDS: children ages 1 through 4.
• HEALTHY KIDS: children ages 5 through 18.
• CHILDREN’S MEDICAL SERVICES NETWORK: children birth through 18 who have special health care needs.
• MEDICAID: children birth through 18. A child who has other health insurance may still qualify for Medicaid.

Some of the services Florida KidCare covers are:

 

• Doctor visits
• Check-ups and shots
• Hospital
• Surgery
• Prescriptions
• Emergencies
• Vision and hearing
• Dental
• Mental health 

Follow this link for information on eligibility and cost.

There are several ways to apply for Florida KidCare:

• Apply online   or 

• Print an Application and Instructions

 If  you've applied for Florida KidCare before, call 1-888-540-5437 to update your information by telephone.

Pre-Existing Condition Insurance in Florida

Help for Getting Medical Insurance with a Pre-Existing Condition in Florida

As of July 1, eligible residents of Florida are able to apply for coverage through the state’s Pre-Existing Condition Insurance Plan program run by the U.S. Department of Health and Human Services.

To qualify for coverage:

• You must be a citizen or national of the United States or lawfully present in the United States.
• You must have been uninsured for at least the last six months before you apply.
• You must have had a problem getting insurance due to a pre-existing condition.

PCIP will cover a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs. All covered benefits are available for you, even if it’s to treat a preexisting condition.

Below are the monthly PCIP premium rates for Florida by the age of an enrollee.

Ages 0 to 34: $363

Ages 35 to 44: $435

Ages 45 to 54: $556

Ages 55+: $773

In addition to your monthly premium, you will pay other costs. You will pay a $2,500 deductible for covered benefits (except for preventive services) before the plan starts to pay. After you pay the deductible, you will pay a $25 co-payment for doctor visits, $4 to $30 for most prescription drugs, and 20% of the costs of any other covered benefits you get. Your out-of-pocket costs cannot be more than $5,950 per year. These costs may be higher, if you go outside the plan’s network.

You can apply here (it can take a while for this page to load).

This was originally posted at the HealthCare.gov site here.

Health Reform in Florida

Health reform has passed both the House of Representatives and the Senate. However, there are differences between the Senate version of the bill and the House version of the bill. Both chambers will elect members to convene a conference to reconcile differences between the two versions of the bill. The new version of the bill that emerges from the conference must then be voted on again by each chamber. If the bill is approved by both chambers, the president may sign the final version turning it into law.

To answer how the bill will affect Floridians, the government web site, www.healthreform.gov has listed several elements from both bills that benefit individuals and families in Florida, such as:

• Insurance companies will no longer be able to place lifetime limits on the coverage they provide, use of annual limits will be restricted, and they will not be able to arbitrarily drop coverage.
• 10 percent of people in Florida have diabetes, and 28 percent have high blood pressure – two conditions that insurance companies could use as a reason to deny health insurance coverage. Reform will establish a high-risk pool to enable people who cannot get insurance today to find an affordable health plan.
• Roughly 565,000 Medicare beneficiaries in Florida hit the “doughnut hole,” or gap in Medicare Part D drug coverage that can cost some seniors an average of $4,080 per year. Reform legislation will provide a 50 percent discount for brand-name drugs in this coverage gap.
• Without reform, individuals and families in Florida will spend increasing amounts of money out-of-pocket to cover premiums, deductibles, and co-payments, from $19.4 billion today to up to $35.4 billion in 2019. Through health insurance reform, 2.5 million Florida residents could be eligible for premium credits to ease the burden of these high costs.
• Health insurance reform will create a new voluntary long-term care services insurance program, which will provide a cash benefit to help seniors and people with disabilities obtain services and supports that will enable them to remain in their homes and communities.

Since both versions of the bill have yet to be reconciled, some of these elements may increase or decrease.  To see the full list for Florida, visit the healthreform.gov site, here.

Below is a message about health reform from the Secretary of Health & Human Services, Kathleen Sebelius.