Pre-Existing Condition Insurance Plan: California
Eligible residents of California can apply for coverage through the state’s Pre-Existing Condition Insurance Plan program run by the Managed Risk Medical Insurance Board.
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 a pre-existing condition, have been denied individual health insurance coverage within the past 12 months, or have been offered individual health insurance coverage at a premium rates higher than the California Major Risk Medical Insurance Program (MRMIP) preferred provider organization (PPO) within the last 12 months.
The Pre-Existing Condition Insurance Plan 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 pre-existing condition. Premiums are based on subscriber age and region of residence in California.
Monthly Premium: | $428 for a 50 year old subscriber in San Francisco |
Annual Deductible: | |
• Medical | • $1,500 in-network / $3,000 out-of-network |
• Brand Name Prescription Drugs | • $500 in-network / $500 out-of network |
Annual Out of Pocket Maximum: | $2,500 in-network / no maximum out-of-network |
Apply for Coverage in Your State
For more information please call 1-877-428-5060 Monday-Friday, 8 a.m. to 8 p.m. or, on Saturday, 8 a.m. to 5 p.m. or go to www.pcip.ca.gov.