Federal healthcare law includes health coverage for any person who is currently uninsured due to a denial for a pre-existing medical condition. This health insurance, called the Pre-Existing Condition Insurance Plan (PCIP), is available for anyone in the U.S., including Texas.

HCA Houston Specialty Hospital Medical Center understands the importance of having insurance to cover your medical needs and expenses. This is why we have made this information available for you to be informed.

Frequently asked questions

What is PCIP insurance?

The Pre-Existing Condition Insurance Plan was created as part of the nation's health insurance law, the Affordable Care Act, to make health insurance available to people if they have had a problem getting health insurance due to a pre-existing health condition. Different insurance companies indicate what qualifies as a pre-existing condition.

How do I know if I am eligible for coverage?

Eligible individuals must:

  • Be a U.S. citizen or a legal resident
  • Have a pre-existing medical condition
  • Not have been covered under health coverage for the previous six months before applying for coverage (proof of denial from insurance company will be needed)

Persons currently covered by a health plan, including employer insurance plans, Medicare, Medicaid and existing high-risk pool programs, are not eligible for the Pre-Existing Coverage Insurance Plan. PCIP coverage is only available to an eligible individual. There are no family plans or premium levels in PCIP.

How do I enroll?

You can enroll for the Pre-Existing Coverage Insurance Plan online at www.pcip.gov, or call the PCIP customer service department toll-free at (866) 717-5826 (TTY 1-866-561-1604) and ask for an application.

How much does PCIP cost me?

Monthly premium: Texas

Age Standard Option Extended Option HSA Option
0 to 18 $174 $234 $181
19 to 34 $261 $351 $271
35 to 44 $313 $422 $325
45 to 54 $400 $539 $416
55+ $557 $749 $578

This information is subject to change at any time. Please ensure that you visit PCIP’s website or contact them for the most up-to-date information.

What benefits do I receive under PCIP?

Covered in-network services include:

  • $1,000 to $3,000 annual deductible (except for preventive services, which have no copay or deductible), varies by plan option
  • Patient pays 20 percent of the cost of covered benefits
  • Out-of-pocket costs capped at $5,950 per year
  • No lifetime maximum
  • Preventive services include periodic health evaluations, screening services, well-child care and child and adult immunizations