Blue cross blue shield pre existing condition waiting period

Can I still get coverage if I have a preexisting condition?

Since the Affordable Care Act (ACA) was passed in 2010, everyone can get a health plan now, no matter what their health history is. Preexisting conditions will no longer apply for qualified health plans issued under the ACA.

You can buy one of the health plans, even if you are sick or have had health problems in the past. Everyone who applies for health insurance can get coverage. Once you have a health plan, your coverage cannot be canceled if you have a health problem. If you use tobacco, you’ll pay more for your health plan.

When can I sign up for a health plan?

If you get coverage through your employer, you’ll sign up for coverage as a new employee and then make changes during their yearly Open Enrollment period. If you’re not sure when your company’s Open Enrollment is, get in touch with someone in Human Resources.

Each year, from November 1 through January 15, you can shop for plans during open enrollment. This is the only time all year you can buy plans for the upcoming year unless you have certain life events like:

  • Losing other coverage
  • Getting married
  • Moving
  • Having a baby or
  • Your income is near the federal poverty level and changes frequently

Any of these situations may make you eligible for a special enrollment period. To find out more, click here.

When does coverage start?

If you didn’t make a payment when you applied for coverage, you’ll need to make your payment in full before your coverage will start. Look for a payment letter and a bill in the mail.

It takes up to 10 days to process your payment. If your payment is still processing when your coverage takes effect and you need care right away, there will be a few extra steps to verify your payment and coverage first.

800-352-2583
http://www.floridablue.com/paynow

You can pay with a credit card, a debit card or by electronic funds transfer (EFT). Follow the prompts and select the option ‘Make a Payment.’

You’ll need:

  • Member Number
  • Social Security Number
  • Zip Code
  • Birthdate
  • Bank or credit card information

Yes. Under the Affordable Care Act, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts. They also can’t charge women more than men.

The only exception to the pre-existing coverage rule is for grandfathered individual health insurance plans -- the kind you buy yourself, not through an employer. They don’t have to cover pre-existing conditions.

Learn more about what this means for you.

Content created by Digital Communications Division (DCD)
Content last reviewed August 4, 2017

Looking to find answers to your billing, claim forms, and other questions? Use our frequently asked questions to find answers.

Where do I file a claim for medical care received outside the United States?

If you are eligible for the Federal Employee Program (your member ID starts with the letter R immediately followed by numbers), your overseas claim form and instructions can be found here.

If you are eligible for the Blue Cross Blue Shield Global Core program, enter the first three letters or numbers of your member ID here to access your international claim form and instructions.

Otherwise, contact your Blue Cross and Blue Shield company for assistance.

Whom do I contact when I have billing questions, get claim forms or talk to if a claim has been rejected?

How often is your BlueCard Doctor and Hospital Finder updated?

Each one of our Blue Cross and Blue Shield independent licensees (our member companies) collect and provide information for our PPO finder via different timetables and methods. While we make every effort to keep the Provider Finder "up-to-date," it is always best to confirm any provider information you select from this utility with your local Blue Cross and Blue Shield representatives.

What is a Primary Care Physician (PCP)?

A physician or other medical professional who serves as a group member's first contact with a company's health care system. Also known as a primary care provider, personal care physician or personal care provider.

What is an HMO?

HMO stands for Health Maintenance Organization, a health care system that assumes or shares both the financial risks and the delivery risks associated with providing comprehensive medical services to a voluntarily enrolled population in a particular geographic area, usually in return for a fixed, prepaid fee.

For more insurance terms and definitions, please see our Glossary.

What is a PPO?

A Preferred Provider Organization (PPO) is an arrangement designed to supply health care services at a discounted cost by providing incentives for members to use designated health providers (who contract with the PPO at a discount), but which also provides coverage for services rendered by health care providers who are not part of the PPO network.

I was denied coverage, a claim, or received erroneous charged on my EOB, whom do I contact?

To access specific information about your coverage and claims related to your individual or group health insurance, please contact the customer service number on the back of your member card. Otherwise, you can find your local BCBS company online. BCBS.com does not maintain member information.

I am a member but I do not see where I can log in on this website. Where do I find access to my member benefits, coverage, etc?

Bcbs.com is the Blue Cross and Blue Shield Association website. The Blue Cross and Blue Shield Association does not have access to member information. We regulate the brand and licenses to all 36 Blue Cross and Blue Shield local companies.

To access specific information about your coverage, EOBs, prescriptions, paying a bill, or any other questions related to your individual or group health insurance, please contact the customer service number on the back of your member card. You can also find your local BCBS company on BCBS.com. 

How can I find out information about coverage that is supplemental to Medicare?

There are lots of Medicare choices, including Medicare+Choice, medical savings accounts and private fee-for-service plans. For plans available to you, use our Medicare guide. You can also view a listing of Blue Cross and Blue Shield companies who participate in Medicare Advantage and Prescription Drug choices. Contact your local BlueCross and Blue Shield representative for details regarding claims or coverage. Not sure which Blue company you belong to? You can find out by typing your home or work ZIP code in our Plan Finder.

How can I get information on purchasing health insurance?

The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies.

Is there a waiting period for pre

No. There are no waiting periods for medical plans, including for pre-existing conditions. When choosing a health plan, consider your medical needs.

Can pre

Health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer, as well as pregnancy. They cannot limit benefits for that condition either.

Does Blue Cross Blue Shield NC cover pre

Most employer groups require a 12-month waiting period for pre-existing conditions. However, the waiting period for pre-existing conditions is reduced by the amount of time spent on prior coverage if your prior coverage was terminated within 63 days of your new enrollment date.

What does insurance consider a pre

A health problem, like asthma, diabetes, or cancer, you had before the date that new health coverage starts. Insurance companies can't refuse to cover treatment for your pre-existing condition or charge you more.

Does Blue Cross Blue Shield of Michigan cover pre

Your Blue Cross Blue Shield of Michigan individual certificate includes a 180-day pre-existing exclusion period during which coverage for pre-existing medical conditions is not available.