Frequently Asked Questions

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.

Does 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. View the federal pool's current 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.

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Apply for MHIP Coverage

Applications accepted until 11-15-13.

It's easy to apply for MHIP coverage. We've put together a simple checklist to help you get all your information in order.

Go to the Apply Now Checklist Page for information and helpful links.

Download the MHIP Application.

Need help with your application?
Call us at 800-821-2231.

Appeals and Grievances

Appeals and Grievances should be filed in accordance with State Pool Certificate of Coverage (page 45).

State Pool Certificate of Coverage