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How to Apply

IMPORTANT: The instructions on this page apply ONLY to people who live in states served by the federally-run PCIP.

If you do not reside in a federally-run PCIP state, click here to find PCIP coverage in your area.

Note: On February 16, 2013, the federally-run Pre-Existing Condition Insurance Plan (PCIP) suspended acceptance of new enrollment applications until further notice. The suspension also became effective in the state-based PCIPs on March 2. This will help ensure that funds are available through 2013 to continuously cover people currently enrolled in PCIP. PCIP continues to provide coverage to more than 100,000 people currently enrolled nationwide. We encourage you to visit http://finder.healthcare.gov Exit Disclaimer Icon to explore your other health care options.

Note: If you lost PCIP coverage during the past 6 months because you moved out of state, you may be eligible to re-enroll in PCIP in your new state of residence. Please call 1-866-717-5826 (TTY: 1-866-561-1604), Monday – Friday, 9 a.m. to 5 p.m. EST, if you believe you are eligible.


Apply Online

  1. Fill out the online application. It's easy, and should take only 10-15 minutes to complete.
  2. Electronically sign the application on the "E-Signature" page.
  3. Mail in any required documents listed on the "Confirmation" page. Include the "e-form" number shown on the Confirmation page on each of your documents before mailing them.

  4. What happens next?

Apply by Mail

  1. Download a PDF version of the enrollment application:
    • Application is unavailable
  2. Follow the instructions to fill out the application.
  3. Mail in your application, along with a copy of the documentation showing you’re eligible.

  4. What happens next?

Apply by Phone

  1. Call 1-866-717-5826 on Monday - Friday, 8 a.m. to 11 p.m. EST. TTY users call 1-866-561-1604.
  2. Mail in a copy of the documentation showing you’re eligible.
  3. Eligibility documentation

  4. What happens next?

Mailing Required Documents

If your application was submitted online through this web site, you have 10 days to mail in all of your supporting documents before your application is considered incomplete. Your application will be cancelled 21 days after it is marked incomplete, or by the end of the calendar month, whichever is later. If your application is cancelled for this reason, you may re-apply immediately.

Applications sent by mail without proper documentation are considered incomplete. You’ll get a letter in the mail that explains what information is missing, and gives instructions for mailing the required documents before the application is cancelled.

Please mail all eligibility documentation to the National Finance Center:

  • National Finance Center
  • Pre-Existing Condition Insurance Plan
  • P.O. Box 60017
  • New Orleans, LA 70160-0017

 
Department of Health and Human Services