Frequently Asked Questions

Below are some details about the federal pool. MHIP has been granted the contract to operate this pool by the U.S. Department of Health and Human Services. Funding for the pool is made available by the federal Patient Protection and Affordable Care Act, signed by President Barack Obama in March 2010. The federal program funding high-risk pools is known as the Pre-existing Condition Insurance Plan (PCIP). MHIP has also run a state high-risk pool since 1991.

How can I determine whether I am eligible?

Applicants must:

• Be a citizen or national of the United States or lawfully present in the United States.
• Have been uninsured for at least the past six months.
• Have had a problem getting insurance due to a pre-existing condition.
• Be a Missouri resident

How do I apply?

Download the application at www.mhip.org/Documents/MHIPApplication.pdf, print and mail it to the address as shown. You can also call the Missouri Health Insurance Pool (MHIP) office at 800-821-2231, and the application will be mailed to you. Applications can also be requested from and should be mailed directly to the enrollment department at RightCHOICE Benefit Administrators.

What is a pre-existing condition?

A pre-existing condition is a condition, disability or illness (either physical or mental) that you have before you enrolled in a health plan.

Will the plan cover my pre-existing condition?

Yes. Under federal law, the plan may not make any limitation, restriction or exclusion on coverage of pre-existing medical conditions.

What are the premiums?

Premiums vary depending on your age. Click here for the federal pool's 2011 premiums.

What are the deductibles and out-of-pocket costs?

The federal pool program has three plans with annual deductibles of $1,000, $2,500 and $5,000 for medical. All three plans have a separate annual deductible of $100 for prescription drugs. The maximum out-of-pocket cost for all plans, including pharmacy coverage, is $5,950 per year. After reaching your deductible, you pay 20 percent of the cost of covered medical services and supplies. Once your out-of-pocket maximum is reached, the plan pays 100 percent for covered services and supplies.