For Consumers

State's Pre-Existing Condition Insurance Plan (PCIP) is closing; Members can transfer to the federal high-risk pool

Contact Public Affairs: 360-725-7055

May 31, 2013

OLYMPIA, Wash. - After three years, a temporary federal high-risk health insurance program in Washington state is ending June 30, due to a proposed cap on federal support for such programs.

 

The approximately 1,100 members of Washington’s Pre-Existing Condition Insurance Plan (PCIP-WA) will be able to transition to a federally run program. Notices to members were sent out on Thursday.

 

PCIP-WA was formed in 2010 to help provide insurance to people with significant pre-existing medical conditions who had been uninsured for at least six months. It was intended to serve as a temporary safety net for individuals who had been denied health coverage due to their medical status. Under federal health care reform, after Jan. 1, 2014, health insurers can no longer deny coverage or set an individual’s rates based on pre-existing medical conditions.

 

Washington is one of 17 states transitioning their PCIP members to the federally run PCIP. The total number of enrollees affected nationally is more than 40,000.

 

Enrollees do not need to apply to the federally run PCIP to qualify. Payment of their premium to the federally run PCIP activates their coverage. Federal notices to enrollees are expected about June 10, and new ID cards for the program will be issued by July 1.

 

The federally run PCIP has different benefits, premiums, cost-sharing and participating providers than PCIP-WA. Cost and benefit details are available at www.pcip.gov, www.pciplan.com, or by calling 866-717-5826. The Washington State Insurance Commissioner’s Office, at 800-562-6900, can also help consumers explore their options for health coverage.

 

The changes do not affect members of the state’s largest high-risk pool, the Washington State Health Insurance Pool.