What if you’re suddenly moving from the California state-run Pre-existing Condition Insurance Plan (PCIP) into the federal PCIP, and you’re a kidney transplant?
You’re in luck.
“Authorization is not required for cornea or kidney transplants,” according to a PCIP benefit transition summary posted on the website of the California Managed Risk Insurance Board (MRMIB).
If you are a patient who’s getting some other type of transplant, such as a lung transplant or a liver transplant, then plan authorization is now required for those types of transplants, according to the summary.
A patient in that situation should call an 800 number and ask to speak to a transplant nurse.
“The nurse will request contact information for your current transplant coordinator to initiate transplant plans,” according to the summary.
MRMIB officials have posted that summary, along with other PCIP-related items, including a collection of PCIP-transition-related call center scripts, in a collection of documents that could be discussed at a board meeting set to start at 11 a.m. PDT Wednesday.
Drafters of the Patient Protection and Affordable Care Act of 2010 (PPACA) included the provision that created PCIP (often pronounced “P-sip”) in an effort to provide temporary emergency access to affordable health coverage for people with health problems who could not qualify for conventional commercial coverage in states that have been insurers to use medical underwriting in the individual health insurance market.
PPACA calls for insurers to begin providing health coverage without use of health status information in the sale or pricing process starting Jan. 1, 2014.