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California PCIP (Federal Risk Pool)

MRMIB has published the final document for PCIP (Pre-existing Condition Insurance Program) which includes both rates and plan summary of benefits.

Rates are reasonable and benefits fairly rich.

PCIP Summary


  1. Yes, this plan looks great -- if you haven't had insurance for the last 6 months. I've been paying $$$ for a HIPAA guaranteed issuance plan because of pre-existing condition that makes me unable to get an individual plan. Because of that, I am not eligible for PCIP. I guess I should just stop paying for my HIPAA plan, hope for the best for six months, and then apply for this new plan, which costs half as much as seems to offer twice the benefits.

    I feel like I'm being punished for holding onto my health insurance (even though the exorbitant rates put me in debt) while the people who didn't shell out for coverage are being rewarded with access to a much nicer plan at a much more reasonable rate.

  2. 18 Nov. 2010

    I agree with Sara that the requirement that one be uninsured for six months before applying for PCIP coverage is unfair and discriminatory. I have been buying individual health insurance for my son since he was 10 years old. He will turn 30 in a few months, and has a pre-existing condition. The premium for his policy is supposed to go up to $800 a months when turns 30. Due to his "pre-existing condition", we cannot purchase any other policy for him.

    We have paid a lot of money for 20 years to maintain my son's health insurance. Now that a reasonably priced policy is available that would give us some relief, my son is not eligible, because he already has insurance.

    People with pre-existing conditions who currently have coverage are often being gouged by the for profit, private health insurance industry, and have no other options for obtaining coverage. It is discriminatory and unfair to exclude them from applying to the PCIP program, because they have been responsible, and paid high premiums for individual coverage, with no other insurance options.

    I, too, feel that responsible behavior, and personal sacrifice, are being punished by the requirement that one be uninsured for six months before applying for PCIP coverage.


  3. I agree with Sara and Connie.
    I had the misfortune to be diagnosed at age 37 with severe Osteoarthritis. I was told I had the knees of an 80 year old, and that it was a genetic predisposition, as I never had an injury, nor was I ever overweight. I lived in pain for 11 years. I had to finally have a Total Knee replacement 4 years ago. Then I became divorced. When my COBRA ran out I was led to believe I could purchase an individual plan. NOT!! After being treated like dirt , despite being American and paying taxes. I was finally granted the right to purchase a HIPPA plan. I pay 1
    $1000 dollars a month with a $ 5000 deductible. Nothing is covered other than a GYN visit and a 1 physical a year. I am unable to work as I had been hit by a car as a pedestrian and broke the fall with my hand, as a result I now have end stage osteoarthritis in my Thumb joint and have limited use of my hands. Despite being in otherwise excellent health, I am forced to pay out close to 15,000 dollars a year for the privilege of having really crappy insurance not even covering the routine tests recommended for a person my age. The 6 month uninsured waiting policy is a blatant and disgusting act of the worst form of legal discrimination in this country. This waiting period was likely put into place to as a means to allow the insurance companies to still gauge us , and yes to further punish and disenfranchise American citizens with illness and disability. The fact that because we were responsible by purchasing these overpriced policies , which now openly exclude us from gaining the benefits of PCIP and the right to be charged fairly; hardly seems legal.
    Now our taxes will pay for everyone but us to benefit from PCIP, Our taxes pay for many illegals to get free medical care here in California.
    I find myself wondering what reason I have to be patriotic to a country whose elected officials seem to think it is okay for millions of Americans to play Russian roulette with their lives. It is most certainly a depressing struggle to kept from going into debt over medical insurance or abandoning our homes.
    I have been blindsided by all of this and wish there was a group or organization we could all form to stop this discrimination against millions of useful productive americans being treated as outcasts in our society. The only answer I saw was a politician defending the waiting period since it was already signed into statute Hypocrisy?


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