Pre-Existing Condition Insurance Plan: West Virginia
Eligible residents of West Virginia can apply for coverage through the Pre-Existing Condition Insurance Plan program run by the U.S. Department of Health and Human Services.
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 or have been denied coverage because of your health condition.
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 if it’s to treat a preexisting condition.
Please note rates have changed as of July 1, 2011. The monthly premiums for your state are:
| Age | Standard Option | Extended Option | HSA Option |
|---|---|---|---|
| 0 to 18 | $119 | $160 | $124 |
| 19 to 34 | $178 | $240 | $185 |
| 35 to 44 | $214 | $287 | $222 |
| 45 to 54 | $273 | $367 | $284 |
| 55+ | $380 | $511 | $394 |
In addition to your monthly premium, you will pay other costs. In 2011, you will pay a $1,000 to $3,000 deductible, which varies by your plan option, for covered medical benefits (except for preventive services) before the plan starts to pay. A plan option may have a separate drug deductible. After you pay the deductible, you will pay a $25 copayment for doctor visits, $4 to $40 for most prescription drugs, and 20% of the costs of any other covered benefits you get. Your out-of-pocket costs cannot be more than $5,950 per year. These costs may be higher, if you go outside the plan’s network.
To apply for the PCIP plan, click here: https://www.pcip.gov/Apply.html