IMPORTANT: The instructions on this page apply ONLY to people who live in states served by the federally-run PCIP.
If you do not reside in a federally-run PCIP state, click here to find PCIP coverage in your area.
The PCIP will cover you no matter what health condition you have. You can’t be charged more because of your condition or turned down based on your income.
All covered benefits are available when your coverage starts, even if it’s to treat a pre-existing condition — there are no waiting periods.
PCIP Plan Options for 2012
The federally-run PCIP offers three plan options:
- Standard Plan
- Extended Plan
- Health Savings Account (HSA) Plan
Each plan has different levels of premiums, calendar year deductibles, prescription deductibles and prescription copays. The HSA Plan Option lets you open a Health Savings Account, a tax-exempt account where you can deposit funds for eligible medical expenses.
After you pay the deductible, you’ll pay 20% of medical costs in-network. All covered services — both in-network and out-of-network — will count toward your catastrophic maximum. This means the maximum you'll pay for covered benefits (not including your monthly premium) in 2012 is $7,000. The maximum is even less if you use only in-network providers. There’s no lifetime maximum or cap on the amount the plan pays for your care.
PCIP Premium Rates
Premiums vary depending on your age, the state you live in, and which health plan you choose. See premium rates for your state.
Learn more about your premium payment options.
What’s Covered
The PCIP covers a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs. All covered benefits are available for you, even to treat a pre-existing condition.
All three PCIP plan options provide preventive care (paid at 100%, with no deductible) when you see an in-network doctor and the doctor indicates preventive diagnosis. Included are annual physicals, flu shots, routine mammograms and cancer screenings.
You might like to compare the three plan options. For a basic overview of each one, including premiums, benefits, and cost-sharing, take a look at the Benefits Summary 
. To get more detail on benefits, exclusions, limitations, and maximums, click here for the Benefits Brochure .
PCIP Provider Networks
The PCIP has provider networks that include a full range of services and specialists. For information on PCIP providers, search for participating providers online, or call the GEHA benefits administrator at 1-877-745-7198 between 8:00 a.m. and 6:30 p.m. EST, Monday - Friday.
Help With Costs
There are no discounts or waivers for PCIP monthly premiums.
If you have limited income and resources, you may be eligible for other coverage programs like Medicaid and the Children’s Health Insurance Program.
