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How to Apply for the Pre-Existing Condition Insurance Plan

If you have a medical condition that makes it difficult to get affordable health insurance -- or any insurance at all -- you may be eligible for the high-risk insurance pool funded by the U.S. government. Here's what you need to know.


  • Step 1: Go through your records: you'll need a copy of a letter from an insurance company or health plan -- dated within 6 months of your application -- showing that you have been denied individual coverage because of a pre-existing condition, or you were offered coverage but were denied certain benefits because of your condition.
  • Step 2: Apply as soon as possible. The federal funds set aside are not unlimited, and there's no guarantee that additional funds will be allotted to the program if the money runs out.
  • FACT: The Affordable Care Act, passed in March 2010, is intended to help the approximately 32 million Americans who either couldn't get or afford health insurance.
  • TIP: If your state's program is being run by the federal government, go to "": to apply, or call 1-866-717-5826.
  • Step 3: Find out who's running the Pre-Existing Condition Insurance Plan where you reside. Some states opted to oversee their own program, while others elected to have the federal government manage theirs. Go to to find out who's running the show in your state.
  • Step 4: Determine your eligibility. To qualify, you must be a U.S. citizen or legal resident, you must have been uninsured for at least 6 months, and you must be able to prove that you've been denied coverage due to a pre-existing condition.
  • TIP: Eligibility requirements vary from state to state. Some states consider being offered a policy at an exorbitant rate as being equivalent to being denied coverage.
  • Step 5: Know what the Pre-Existing Condition Insurance Plan is -- a federally funded program that makes health insurance available to people who have been denied coverage because of a medical condition, disability, or illness, either physical or mental. It's intended to help people until affordable health insurance is available to everyone in 2014, per the 2010 Affordable Care Act.

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