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.