- 8,448
Some company named "GEHA" is administering the new Pre-Existing Condition Insurance Plan(PCIP)for Health and Human Services(HHS). It's a really nice website that's easy on the eyes and easy to navigate.
PCIP - Pre-existing Condition Insurance Plan - Home
But, as usual our government made a big mistake by allowing each state to decide if they wanted to administer the PCIP plan, or give it over to GEHA/HHS to administer. Why? Because if you sign up in a GEHA/HHS state and get sick or injured while visiting, or passing through one of the states that decided to administer the PCIP plan on a local level, you will be OUT OF NETWORK. I used the doctor/hospital finder at PCIPLAN.com to find medical providers in South Bend, Indiana. There are plenty. But, if you go across the state line to Chicago, Illinois, or north into the state of Michigan, you will find not a single doctor or hospital in the network.
Here is a link to the PCIP brochure for the GEHA/HHS product. https://www.pcip.gov/PCIP_ pamphlet_benefits_summary.pdf . Amazingly, it's only 4 pages long, but as you can see, out-of-network penalties are quite high.
Also, the brochure says that you pay a $25 Doctor Copay AFTER you meet the $2,500 deductible. Could this be a typo? The prescription benefits are the most complicated I've ever seen, but I suppose that's because the government designed this plan.
All in all though, the GEHA/HHS PCIP policy is less expensive and more benefit rich than our local Illinois CHIP policy for those who are uninsurable via private coverage. But GEHA/HHS should have not given states the option to administer their own PCIP...essentially creating multiple networks with no reciprocity. Not yet anyway.
-A.C.
PCIP - Pre-existing Condition Insurance Plan - Home
But, as usual our government made a big mistake by allowing each state to decide if they wanted to administer the PCIP plan, or give it over to GEHA/HHS to administer. Why? Because if you sign up in a GEHA/HHS state and get sick or injured while visiting, or passing through one of the states that decided to administer the PCIP plan on a local level, you will be OUT OF NETWORK. I used the doctor/hospital finder at PCIPLAN.com to find medical providers in South Bend, Indiana. There are plenty. But, if you go across the state line to Chicago, Illinois, or north into the state of Michigan, you will find not a single doctor or hospital in the network.
Here is a link to the PCIP brochure for the GEHA/HHS product. https://www.pcip.gov/PCIP_ pamphlet_benefits_summary.pdf . Amazingly, it's only 4 pages long, but as you can see, out-of-network penalties are quite high.
Also, the brochure says that you pay a $25 Doctor Copay AFTER you meet the $2,500 deductible. Could this be a typo? The prescription benefits are the most complicated I've ever seen, but I suppose that's because the government designed this plan.
All in all though, the GEHA/HHS PCIP policy is less expensive and more benefit rich than our local Illinois CHIP policy for those who are uninsurable via private coverage. But GEHA/HHS should have not given states the option to administer their own PCIP...essentially creating multiple networks with no reciprocity. Not yet anyway.
-A.C.
