PA Fair Care
View archived PA Fair Care information
UPDATE: PA Fair Care enrollees will be transitioning to the federal
Pre-Existing Condition Insurance Plan (PCIP) as of July 1, 2013.
For more information, please see the Frequently Asked Questions
The federal Centers for Medicare and Medicaid Services (CMS) have notified Pennsylvania that they can no longer provide 100 percent funding for PA Fair Care. As CMS can no longer keep their funding commitment, Pennsylvania has been directed by CMS to cease administering the program, and transition all enrollees to the federal PCIP.
After receiving a grant award from CMS in August of 2010, Pennsylvania created PA Fair Care to provide insurance coverage for those with pre-existing health conditions. The program was meant to be a bridge or temporary health program until 2014, when the new health exchanges are slated to begin operating. However, without the funding from CMS, we are not able to maintain the PA Fair Care program.
We are currently working with CMS to assure a smooth transition so that there are no lapses in coverage or care. Enrollees will need to act promptly once the enrollment letter from the federal PCIP during the month of June is received. This will include information about costs and how to activate coverage.
Initial indications from CMS are that enrollees may expect changes to benefits, treatment plans, deductibles and access to provider networks. Enrollees should watch their mail carefully for an enrollment letter and more information.
The state’s contract with Highmark for administering PA Fair Care coverage will end June 30, 2013. Highmark has also committed to work with the federal government for a smooth transition.
During the period of transition Highmark’s toll free number 888-767-7015 will be in operation from 8:30 a.m. until 4:30 p.m.
Enrollees may also use the federal PCIP points of contact: