Blue Cross Individual

With some Blue Cross Individual Insurance plans, pregnancy is a wavered condition. Blue Cross Individual Coverage excludes a waivered condition from charges and expenses incurred during the six-month period beginning as of the effective date of the coverage. A waivered condition under this kind of Blue Cross Individual Coverage only applies to a condition for which medical advice, diagnosis, care, or treatment (including prescription drugs) was recommended or received from a licensed health practitioner during the six months immediately preceding the effective date of coverage.

Therefore, under this sort of Blue Cross Individual Coverage, benefits for pregnancy and maternity services are not covered for the six-month period from the effective date of coverage, with the exception of services required to treat involuntary complications of pregnancy.

For example, under Access+Value HMO and Access+HMO Blue Cross Individual Coverage, pregnancy is a waivered condition. But for Vital Shield 2900, Active Start Plans 25 and 35, Essential plans, Balance plans, and Shield Spectrum PPO Savings Plan 4000/8000 Blue Cross Individual Coverage Plans, pregnancy and maternity benefits are not covered.

While this might or might not be something that people look for Blue Cross Individual Coverage, it is something they should certainly be aware of when shopping for insurance. However, there are other benefits to Blue Cross Individual Coverage. One great benefit is that you are covered while traveling. All Blue Cross health plans, whether Blue Cross Individual or Family, cover you with benefits anywhere in the world in the case of emergency. Blue Shield PPO members are also covered for care worldwide through the BlueCard program. Check your Blue Cross Individual Evidence of Coverage or Policy for specific provisions.

Something to keep in mind while shopping for individual health coverage is the difference between a PPO and an HMO. There can be several very important distinctions based on what your insurance needs are.

The main difference between a PPO and HMO is how you access care. If covered by a PPO Blue Cross Individual Plan, you may visit any licensed doctor. In an HMO Blue Cross Individual Plan, you need to receive non-emergency care through a designated Personal Physician to be covered. You can choose your own personal physician or one can be assigned to you.

If you are eligible for Medicare and not over the age of 65, approval for Blue Cross Individual Coverage will be based on your health history. If you do not qualify for a guaranteed issue plan, you will medically underwritten.

The Federal Health Insurance Portability and Accountability Act (HIPAA) makes it easier for people covered under existing group health plans to maintain coverage regardless of pre-existing conditions when they change jobs or are unemployed for brief periods of times. If you meet all specified conditions, you may be eligible for a guaranteed issue plan under Blue Cross Individual Coverage in accordance with the HIPAA and your application will be automatically accepted without underwriting.

It takes 4 to 6 weeks for an application for Blue Cross Individual Coverage to be looked over and accepted. Then Blue Cross Individual coverage begins.