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Career Transitions: Health Insurance Coverage FAQs

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Whether foreseen or unforeseen, a career transition brings can reveal hidden opportunities. But until your better future arrives, you'll need to make one decision today — how to handle your health care.

Will you cover my preexisting conditions?

BCBSM nongroup coverage requires a 180-day preexisting exclusion period.  If you had a medical condition for which medical advice, care or treatment was recommended or received 180 days before the enrollment date, any services to treat that condition within the first 180 days after enrollment will not be paid by BCBSM.  You will be responsible for paying for those services.

Are there any exceptions to BCBSM's preexisting exclusion?

You may be eligible to receive credit for prior health coverage if you meet all of the following criteria:

  • Had at least 18 months of coverage with no more than a 62-day break.  Coverage may include group health plans, individual health insurance, Medicare, Medicaid, public health plans, military or federal benefit programs, Indian Health Service, or other health plans.  Freestanding benefit programs, such as dental and vision coverage, cannot be counted as prior health care coverage
  • Had the most recent health coverage through an employer group policy.  Enrollment in Associations and Chambers, one-subscriber groups and sole proprietorships is considered individual coverage, not group. 
  • Are a Michigan resident
  • Do not currently have health coverage from Medicare, Medicaid or any other health insurance carrier
  • Did not have your last coverage terminated due to premium nonpayment or fraud

The member will not have to meet the 180-day preexisting exclusion period if he or she:

  • Meets all the criteria listed above
  • Presents a “certificate of coverage” as proof of prior coverage, including COBRA documentation, if applicable.

I can't afford COBRA.  What happens if I don't take COBRA and choose a MyBlue option?

If you experience a buyout situation and do not elect to take COBRA, you can enroll in any of the MyBlue options.  The preexisting condition period will apply.

I'm already on COBRA, but want to switch to an individual plan without exhausting my COBRA. Can I do that? Will I receive a higher rate or be subject to a preexisting waiting period?

You can switch to a MyBlue product option that best fits your needs and budget at any time.  The preexisting condition period will apply.

Why are some of the group conversion rates more expensive than the nongroup conversion rates?

Based on our historical claims experience, our MyBlue products are rated differently.

How do I coordinate my effective date with my employer's health contract termination date?

For individuals and families transferring from a BCBSM-qualified, employer-sponsored group health plan, coverage will be effective on the beginning date of the first billing cycle following the expected termination date of the employer's coverage.  There are two different schedules:

  • 1st of the month
  • 15th of the month

Individual applications submitted online may be effective the first cycle date available following 14 days from the receipt of a completed and approved application.  All other applicants will be effective with the first cycle date 30 days following receipt of a completed and approved application.

How soon will my coverage become effective?

Coverage is effective as of your effective date, which is approximately 14 days after BCBSM receives the application for coverage.  However, benefits will not be paid unless payment has been received by BCBSM.  For example, if your effective date is April 1, covered services will be paid as of that date.   However, no ID card will be generated and should no premium payment be received by BCBSM, all claims will be your responsibility.

I've met a portion of my current deductible (under an employer-sponsored policy).  Will my deductibles be applied to my individual policy when I transfer to a MyBlue product?

No. The money put toward your current employer's plan deductible will not transfer over to the new individual plan when you enroll in a MyBlue product option.

Do I need to send payment in with my application?

If you apply online:  You may choose to pay your first two months' premium with a credit card during the enrollment process.  For ongoing payments, you may also choose automatic bank withdrawal.  You may also select to be billed at a later date. 

If you apply by mail:  Once approved for coverage, you will be billed for the premium amount due.  

We're losing our dental coverage.  What dental options do you have available?

We have three dental products available for individuals.

Personal Blue Dental covers preventive, basic restorative and major restorative services. Members select a dentist from our PPO network. This plan gives members:

  • Quality dental care
  • Large dental network
  • Freedom to choose your dentist from our network
  • Discounts on non-covered services
  • Blues ID card

Personal Blue Dental Plus covers preventive, basic restorative and major restorative services. Members have the freedom to choose any dentist. Other valued added benefits are:

  • Quality dental care
  • Freedom to choose your dentist
  • Discounts on non-covered services
  • Blues ID card

Flexible Blue Dental can be purchased with Flexible Blue medical and/or Individual Care Blue Plus medical. It is a comprehensive dental product that covers preventive and restorative services. The other value-added benefits are:

  • Quality dental care
  • Largest dental network
  • Freedom to choose your dentist from our network
  • Discounts on noncovered services
  • Blues ID card

I'm switching coverage from a different carrier. How do I make sure that my doctor is in your network?

It's easy. Search our network. You can also call us at 888-MI-BCBSM.

What happens if I get a new job and am currently enrolled in an individual product? 

You will need to disenroll from your current individual MyBlue product.  You will need to submit a Change of Status Form (PDF) to us.  The address information is also located on the form.

Why am I ineligible for an individual policy if my employer offers to contribute towards part or all of my premium?

If your employer contributes toward an individual's health policy, then you are not eligible for a MyBlue individual health care product.

How does the Affinity Rx program work?

Affinity Rx is our free prescription drug discount program.  Eligible members simply present their ID card to receive discounts on prescription drugs.

There is not a standard discount through the Affinity Rx program, but you can use our pricing calculator to help estimate your savings.

If I've chosen a Flexible Blue or IC Blue plan, will I have to pay for office visits after I've exhausted my two office visit benefit?

Once the two office visit benefit has been exhausted and the deductible has been met, you are responsible for any additional office visits.

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