As a result of the federal Affordable Care Act of 2010, California has a contract with the federal Department of Health and Human Services to establish a federally-funded high risk pool program called the California Pre-Existing Condition Insurance Plan (PCIP). The PCIP offers health coverage to medically-uninsurable individuals who live in California.

The program will last until December 31, 2013 when the national health reform is set to begin. After that date, there will no longer be a need for high risk pools because federal rules will not allow insurers to reject persons with pre-existing conditions or charge them higher rates than those without such conditions.

To be eligible for the PCIP Program:

• You must be California resident.
• You must have no health insurance coverage for the past 6 months, prior to application being received. This means in the last 6 months you were not enrolled in an individual or job-based health plan, including COBRA or Cal-COBRA, or enrolled in Medicare Part A and/or Part B, or in No-Cost Medicaid/No-Cost Medi-Cal.
• You must be a U.S. Citizen, U.S. National, or lawfully present individual.
• U.S. Citizens or U.S. Nationals must provide their Social Security Number.
• You must have been denied individual insurance coverage within the past 12 months, for a pre-existing condition as shown by:
  • Rejection letter from a health insurance company in the last 12 months, or 
  • Offered coverage with premiums higher than those of the Major Risk Medical Insurance Program (MRMIP) preferred provider organization (PPO) in the geographic region where the individual is seeking coverage.

The following individuals can apply:

• Person 18 years of age or older who are applying for coverage himself/herself;
• Parents (natural or adoptive);
• Legal Guardians;
• Stepparents;
• Foster parents;
• Caretaker relatives for a minor;
• Minor not living with persons listed above (i.e., emancipated minor)

For more information on the PCIP program, go to www.pcip.ca.gov.