The Major Risk Medical Insurance Plan (also known as “Mr. Mip”) is another option for people with conditions rendering them uninsurable. Unlike the PCIP program, MRMIP will allow you to join even if you had recent coverage. The only requirement along a MRMIP application is a letter from any insurance carrier stating you cannot qualify for their plans due to health conditions. The premiums are quite a bit higher than in the individual market, as collected funds need to cover higher risk clients.
MRMIP policy details:
- A choice of plans within your area, with an annual household deductible of $500 (this must be met prior to receiving benefits for anything other than preventive care)
- Maximum out of pocket for an individual is $2500 and $4000 for a family
- $75,000 annual policy benefit
- $750,000 lifetime policy benefit
- If you enroll on a PPO option you have a three month waiting period after your effective date prior to receiving care for any pre-existing condition
- If you enroll on an HMO, you will have a three month post-enrollment period during which you will receive no health benefits at all, but will not be required to pay premiums during this time
Based on the number of enrollment applications, there can often be a waiting period for applying. This can vary from a few weeks to several months, and you can get more information about the current waiting list by calling 1-800-289-6574. You must be able to show that you cannot obtain health insurance through a private insurer by means of a declination letter, provide an offer of alternate coverage from a private insurer with premiums higher than MRMIP, or prove involuntary termination of your current health plan. You must also be a resident of California, and ineligible for Medicare Part A and Part B.
While the premiums can be quite costlyMRMIP can be a great option for those with costly medical needs and a welcome choice until guaranteed coverage in 2014.If you are trying to enroll in MRMIP and need assistance, our agents can send you a quick decline form and assist you with any questions.
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