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Pre-Existing Condition Insurance Plan: NY Bridge Plan

The health care reform law contains a provision for the establishment of a temporary statewide insurance pool for high risk individuals. Coverage through this program will be available until January 2014 when more health insurance coverage options become available through a Health Insurance Exchange.

This new program is called the Pre-Existing Condition Insurance Plan (PCIP) and will be available throughout the country. In New York State, the PCIP plan is called the NY Bridge Plan, and is administered by Group Health Incorporated (GHI), an EmblemHealth company.

To be eligible to apply, individuals must:

  • Be a legal U.S. resident;
  • Be a resident of New York State;
  • Have a pre-existing medical condition;
  • and not have had health care coverage for the last six months.

The NY Bridge Plan covers a broad range of services, including primary and specialty care, inpatient and outpatient hospital care, and prescription drugs, as well as assistance from professional nurses and caseworkers to help members manage chronic conditions and maintain overall health. Eligibility is not based on income. Coverage for a pre-existing condition begins right away, with no waiting period. Health insurance coverage under this program is more affordable than what is currently available in the individual market. Through the NY Bridge Plan, premiums will be $362/month for residents of upstate counties and $421/month for residents of downstate counties.

Applications are available beginning August 20, 2010, with coverage effective October 1, 2010. Enrollment is on a first-come, first-served basis. If the NY Bridge Plan reaches capacity, a waiting list will be established.

More information on the NY Bridge Plan, including the application and brochure, is available here.

If you need an application and brochure mailed to you, please call 1-877-444-9622.

Eligibility Specialists are available to answer your questions and to offer enrollment assistance. Call the NY Bridge Plan toll free from 8:30 am to 5:30 pm, Monday through Friday at 1-866-NY-EZ-APP (1-866-693-9277) TDD 1-877-448-4975.

Additional information on this program is available from the following sources: