PCIP Transition - Questions

1. When will the Inclusive Health - Federal Option premium, benefits and administration transition to the federal government?

Starting July 1, 2024, Inclusive health will no longer offer PCIP health coverage. As of that date, the federal government will provide coverage to current PCIP members through the federally run PCIP program. You will be automatically enrolled in this program by July 1, 2013.

2. Why is the Inclusive Health no longer offering Federal Option coverage?

The contract between Inclusive Health and the federal government is ending as of June 30, 2013. As of July 1, 2013, the PCIP program in NC will be administered by the federal government.

3. How do I get more information on the premium rates, benefit plan, out-of-pocket costs and provider network that will take effect July 1, 2013?

More information is available on the PCIP website at www.pcip.gov. You can also contact the PCIP Customer Service Hotline at (866) 717-5826 with additional questions.

4. How do I enroll in the new federal PCIP coverage?

You will receive a letter from the National Finance Center on or around June 10th explaining how to activate your new federal PCIP coverage. You will not need to complete a new application to qualify for the federally-run PCIP. To activate your new coverage on July 1, and receive your PCIP health plan ID card by that date, you must pay your first month's premium by the Enrollment Letter's deadline of 30 days from the date of that letter. If you choose to do that, you will be a member of the federally-run PCIP program. You'll be enrolled in the new plan and have a new benefits administrator.

5. What will happen with the AIDS Drug Assistance Program/PCIP members?

ADAP/ PCIP members will go back to the ADAP assistance program as of July 1st with drug coverage available though the Walgreen's mail order program.

ADAP/ PCIP members will have the option to purchase the PCIP coverage through the federal government, but ADAP will not continue to pay for the coverage.

For more information on the ADAP program, ADAP/ PCIP members may contact:

1. Their local ADAP case manager
2. The ADAP program hotline - 1-877-466-2232
3. The ADAP website - http://epi.publichealth.nc.gov/cd/hiv/adap.html

6. What if I am currently receiving ongoing treatment?

If you're currently getting ongoing treatment, don't worry. You'll receive guidance about that when you receive the Enrollment Letter from the National Finance Center on or around June 10th. You or your provider must get "pre-authorization" or approval for certain services before PCIP will pay for it-even if you were already authorized under the state's plan. The letter will explain what you need to do if you're already getting certain types of services and who to call with questions about your care.