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Learn About the Affordable Care Act

I Have a Pre-existing Condition

The ACA has made it easier for people to get health insurance, even if they have a known health problem. This also is known as a pre-existing condition.

  • Today, health insurers cannot deny coverage to children under 19 with a known health problem.
  • In 2014, health insurers cannot deny coverage to anyone with a known health problem.

If you haven't been able to get insurance for at least six months due to this reason, you may be able to get it through the:

Pre-Existing Condition Insurance Plan (PCIP)

The new PCIP is now offered in each state. The State of Ohio runs the PCIP in Ohio. The federal government runs the PCIPs in Kentucky and Indiana. To qualify for a PCIP, you must:

  • Be a US citizen or live here legally
  • Have been uninsured for at least six months; AND
  • Have a pre-existing condition OR been turned down for health insurance because of your health.

To find out how to apply:

How much the plan costs depends on your state and your benefits. For example, in Ohio, the premium for a non-smoker ranges from $189 to $545 each month, based on the medical and drug deductibles chosen.

If you are interested in enrolling in a PCIP, act soon. Some states may stop covering more people because of limited funds or preparing for the opening of the health insurance marketplace in October 2013.

These plans will exist until 2014. After 2014, you will have other affordable health insurance choices through your state's health insurance marketplace. In the marketplace, insurers will have to cover you, even if you have a pre-existing condition.

State High-Risk Pools

Thirty-five states have their own high-risk insurance for people with pre-existing conditions. These are run in addition to the state's PCIP program.

High-risk pools and PCIPs are not the same. They offer different benefits and charge different premiums. If you are thinking of getting this coverage, you will have to look at the exactly what is offered in your area.

  • For Kentucky's state high risk pool, click here.
  • For Indiana's state high risk pool, click here.
  • Ohio does not run a separate state high-risk pool.

For other states use the Find Insurance Options tool on healthcare.gov.

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