May 31, 2011: Following lower-than-expected enrollment numbers, the U.S. Department of Health and Human Services (HHS) has announced changes meant to facilitate enrollment in the Pre-existing Condition Insurance Plan (PCIP) national high-risk pool program. Key changes include the following:
- Individuals can now provide a doctor’s note indicating that they qualify for enrollment rather than having to provide evidence of denials of coverage.
- Brokers can now receive payments for successfully enrolling new PCIP members.
- Premiums have been reduced in 37 states.
Despite these changes, one significant barrier to enrollment remains: Applicants have to have been uninsured for six months in order to qualify for coverage.
In Minnesota: Is PCIP Worth the Wait?
Unlike PCIP, Minnesota’s existing state-run high-risk pool—Minnesota Comprehensive Health Association (MCHA)—does not have an uninsured waiting period; however, MCHA does have a pre-existing condition limitation for six months, and the premiums are significantly higher than those for the national pool. There are a number of presumptive conditions that allow an individual to waive the pre-existing condition exclusion; otherwise, individuals without immediate medical needs might see more financial advantage if they wait to become eligible for PCIP.