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Federal Pre-Existing Condition Insurance Plan (PCIP)/Take Care Arkansas

Beginning Aug. 1, 2010, Arkansans will be able to apply for a new Federal Pre-Existing Condition Insurance Plan (PCIP)/Take Care Arkansas for people who have been uninsured for at least six months and denied coverage for pre-existing conditions.

Why PCIP Was Created

PCIP was created as a requirement of the Patient Protection and Affordable Care Act (PPACA) signed by President Barack Obama on March 23, 2010. Under the new law, the Secretary of the U.S. Department of Health and Human Services must create temporary federal high-risk pools in every state. These high-risk pools are administered either by the state, a non-profit entity or directly by the federal government. PCIP is the name of the coverage offered by this federal pool. Arkansas is one of 30 states that elected to administer its own pool through the Arkansas Comprehensive Health Insurance Pool (CHIP), which already provides similar risk pool plans to Arkansas residents. PCIP coverage will last until 2014, when similar coverage will be available through health insurance exchanges. Enrollment in PCIP/Take Care Arkansas is limited and on a first come first serve basis.

What Does PCIP Cover

PCIP offers many if not all of the same benefits you would get from a private health insurance plan.

This includes:
  • Prescription drug coverage
  • Care in medical offices for illness or injury
  • Emergency services
  • Inpatient and outpatient hospital services
  • Coverage for pregnancy
  • Certain transplants
  • Diabetes treatment, equipment and supplies
  • Home health care, skilled nursing and hospice care
  • Outpatient rehabilitative services
  • Wellness services and screening
  • Behavioral health services
  • Inpatient and outpatient mental health and substance abuse services
  • And more

Benefits

PCIP is an individual, comprehensive major medical policy with an annual deductible of $1,000. Your annual out-of-pocket maximum for services performed by network providers is $2,000. Prescription drug coverage has $10, $30 and $70 copayments based on the medical drug list (formulary).

Eligibility

To qualify for PCIP Coverage, you must:

  • Be a resident of Arkansas and either a U.S. Citizen, national or an alien lawfully present in the United States.
  • Have been uninsured for six months prior to submitting your application.
  • Within the past six months, have been denied coverage in Arkansas due to health conditions, or have been offered in Arkansas with a rider excluding certain health conditions. The plan will not deny any applicant coverage or benefits simply because of health status.

For more information, select the PCIP links below, e-mail Customer Service, or call Customer Service at 1-800-285-6477.

How to Apply

You may apply for PCIP directly by mailing an application to Federal Pre-Existing Insurance Plan, c/o CHIP, P. O. Box 1460, Little Rock, AR 72203. Please contact 1-800-285-6477 to request a paper application by mail. You also may contact a licensed insurance agent who can help you complete and submit an application.

Completed applications accepted by U.S. Mail only and are processed on a first-come, first-served basis. Applications cannot be accepted by fax, e-mail, hand delivery, or any other methods.

PCIP Application Information

Additional PCIP Forms and Information

Rates & Premiums

Schedule of Benefits

Pharmacy Program

Information for Agents

Additional Resource

CHIP Web site — http://www.chiparkansas.org
Take Care Arkansas Web site — http://www.takecarearkansas.org


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