Eligibility
The MHIP now operates two separate high risk pool programs. Eligibility for each of these programs is different. Please review the basic eligibility criteria for each program below to determine your eligibility.
MHIP State High Risk Pool Program Eligibility:
Any resident of Missouri who provides evidence of any one of the following:
- A refusal by two insurers to issue health insurance except at a rate exceeding the plan rate for substantially similar health insurance; OR
- A federally defined eligible individual who has not experienced a significant break in coverage; OR
- A trade act eligible individual; OR
- Any resident dependent of a person who is eligible for plan coverage; OR
- Any person, regardless of age, that can be claimed as a dependent of a trade act eligible individual on such trade act eligible individual's tax filing; OR
- Any person whose health insurance coverage is involuntarily terminated for any reason other than nonpayment of premium or fraud, and who is not otherwise ineligible for this program; OR
- Any person whose premiums for health insurance coverage have increased above the 300% of standard and are otherwise eligible for this program; OR
- Any person currently insured who would have qualified as a federally defined eligible individual or a trade act eligible individual between the effective date of the federal Health Insurance Portability and Accountability Act OF 1996.
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MHIP-PCIP Federal High Risk Pool Program Eligibility:
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 last six months.
- Have had a problem getting insurance due to a pre-existing condition.
- Be a resident of the state of Missouri
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