On January 1, 2014, health insurance carriers will no longer be able to deny coverage for pre-existing health conditions. However, for many with pre-existing health conditions this is simply too long to wait to get California health insurance coverage. Perhaps, they are unable to qualify for group insurance and they would be denied if they applied for an individual health insurance plan. Help is on the way. As of this September 23, 2010, health insurance carriers will no longer be able to deny coverage to minors ages 18 and under. Also, for those 19 and above, states will be offering Pre-Existing Condition Insurance Plans beginning this August, 2010. This program will be run by MRMIB (the Managed Risk Medical Insurance Board).
Qualifications for Enrollment
In order to qualify for health insurance coverage with the Pre-Existing Condition Insurance Program, you must meet the following criterion:
• You must be a United States citizen or national or be lawfully present in the USA.
• You must have gone without health insurance for a minimum of six months before applying.
• Due to a pre-existing condition, you must have had a problem getting health insurance coverage.
This medical insurance coverage under the Pre-Existing Condition Insurance Plan covers a wide range of benefits. These health benefits include primary and specialty doctor visits, hospitalization, and prescription drug coverage. These medical benefits will be available to all on the Pre-existing Condition Insurance Plan regardless of whether the care is being received for new medical conditions or for conditions present on or before the time of enrollment. Thus approval will not be denied for pre-existing conditions nor will coverage be withheld to treat medical conditions that existed before enrollment.
Benefits & Pricing Example
The following example describes the type of coverage and pricing you might receive. A 50 year old living in San Francisco would be placed on a $1500 Deductible Plan with a $2,500 Out of Pocket Limit. The premium for this plan would be $575 a month.
How do I Apply?
Please send an email to FHRP@mrmib.ca.gov to request enrollment forms. In your email, be sure to include the following:
• your name
• your mailing address
Or, you may mail this information to the address below:
Pre-Existing Condition Insurance Plan
California Managed Risk Medical Insurance Board
P.O. Box 2769
Sacramento, CA 95812-2769
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