How do I Apply?

To apply for PCIP Online

1. Click the APPLY NOW button above
2. Complete both the PCIP Supplemental Application and Major Risk Medical Insurance Program (MRMIP) Applications Online
3. Submit one month’s premium along with the necessary citizenship or immigration forms
4. Click Submit

It's that easy!

Application Downloads for Manual Submission

• PCIP Supplemental Application and Plan Comparison (PDF; 455KB)
   The PCIP Supplemental Application includes a checklist of important steps for completing both the PCIP Supplemental Application and MRMIP Application.
• Complete MRMIP Handbook (PDF; 879KB)
  The MRMIP Handbook is about 26 pages and includes the four-page MRMIP application. Open an Acrobat version of the handbook.
• MRMIP Application Only (PDF; 474KB)
  You can open an Adobe Acrobat version (.pdf) of the application and print it from the computer.

You will be enrolled in the plan that you qualify for but you should send the premium amount listed in the PCIP Cost sheet.

The PCIP Supplemental Application contains a Checklist. The Checklist is helpful for you to have when filling out your application. It tells you each step you need to complete. The Checklist explains the supporting documents and monthly premium you need to send with your application.

All questions on both forms must be answered and submitted on our site along with the amount for your first month’s premium.

All application forms & necessary citizen or immigration documents should be sent to:
Cantbeturnddown.com - PCIP Applications
578 Washington Blvd., #801
Marina Del Rey, CA 90292
Or
Email: info@cantbeturneddown.com
Or
Fax: 310-574-4045 – Attn: PCIP

If you have questions when you fill out the applications, please give us a call at 1-800-250-9646, Monday - Friday, from 9 a.m. to 5 p.m. (PST) Or on send an email at any time to: info@cantbeturneddown.com