Blue Cross Blue Shield Pre-Existing Condition Waiting Period

This article will discuss the waiting periods for these medical conditions under BCBS. But before starting our discussion, let’s first clarify a pre-existing medical condition.

What is Blue Cross Blue Shield Pre-Existing Condition Waiting Period?

Most insurers in the U.S. impose pre-existing condition waiting periods.

Blue Cross Blue Shield is among the firms with these guidelines. If you want details on the company’s waiting period, you’ve come to the right place.

  • Understanding a Pre-existing Condition

A medical or mental issue typically advised or treated within a specific time frame before an individual’s first enrollment is referred to as a pre-existing condition.

Medical counsel, diagnosis, care, prescription, or therapy are a few examples.

Some pre-existing conditions include diabetes, chronic obstructive pulmonary disease (COPD), cancer, and sleep apnea. As previously stated, many health plans in the country feature exclusions for pre-existing diseases.

One of these exclusions outlines a waiting period after which the new plan will not pay for services related to this treatment type.

It is critical to note that under the Affordable Care Act, insurers are not permitted to refuse to pay for treatment of these types of ailments or to charge you more.

Blue Cross Blue Sheild Pre-existing Condition Waiting Period

The waiting period for these conditions covered by BCBS is one of the many concerns of patients. Before paying attention to this insurance company’s waiting period, you should know a few things.

A waiting period for this type of medical condition is a clause in health insurance that temporarily holds or eliminates benefits.

This decision is predicated on the policyholder’s prior medical condition preceding health plan enrollment. Currently, there is a 12-month waiting time for pre-existing conditions with BCBS.

Additionally, the business offers a very advantageous pre-existing condition exception.

BCBS often credits the time a member was covered by a previous qualifying health plan against the one-year waiting period for the exclusion of these health conditions.

By offering this exception, the company complies with the requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Does the waiting period get shorter sometimes?

Can BCBS shorten the waiting period for pre-existing conditions? The response is. The waiting period for these conditions may be shortened for any member with complete medical/surgical insurance coverage.

We are speaking of coverage that either remained active or was canceled within sixty-three days of the individual’s original enrollment.

The waiting period for such conditions will be shortened by at least the time the previous plan constantly covered you. However, you must present documentation as a Certificate of Creditable Coverage from your prior health insurance provider.

The Workings of the BCBS Pre-existing Condition Waiting Period

Understanding the operation of the exclusion period is essential before attempting to obtain coverage from BCBS for a medical condition. Such information will enable you to assess whether you’re moving in the correct direction.

As stated earlier, an insurer’s obligation to offer benefits for some medical issues is frequently restricted by a waiting period for pre-existing conditions. These restrictions do not, however, apply to medical benefits provided by BCBS or other health insurance policies.

What Effect Might the Waiting Period for a Pre-Existing Condition Have on My BCBS Health Coverage?

Not at all. The waiting period won’t affect any health services unrelated to the disease. Your waiting period can be shortened if you had health insurance before joining BCBS.

On the other hand, late enrollees will be referred to as special enrollees. In that scenario, the coverage’s effective date will be postponed by 90 days following the application’s signature date.

In what way does BCBS determine pre-existing conditions?

Knowing the determining tool for these conditions at this insurance firm is also essential.

If not for any significant reason, you’ll better understand what you’re getting into. That said, most insurance plans, including BCBS, determine the nature of sickness.

Medical conditions that are termed medically essential are often classified as pre-existing conditions.

As pointed out earlier, some of these illnesses include cancer, chronic obstructive pulmonary disease (COPD), diabetes, and sleep apnea.

Is it Possible to Be Denied Health Insurance Because of a Pre-Existing Condition?

No, that’s the answer. Your insurer is not allowed by law to deny coverage or raise your premiums if you have been enrolled in a plan since 2010.

According to the Affordable Care Act, passed in 2010, insurers are now illegally refusing coverage or charging exorbitant premiums for these diseases.

Furthermore, your insurer is not permitted to inflate your rates if your health changes, you become a member of a health plan, or you acquire a chronic illness. Annual premium hikes, however, can apply to your plan for different reasons.

If you sign up for a plan that began before 2010, your coverage can only be discontinued or your premiums increased. Therefore, staying informed about prospective changes to healthcare laws is crucial while investigating your coverage options.

Doing this will help ensure that nothing affects the coverage of health conditions.

Procedure for Getting a Certificate of Creditable Coverage

Throughout our conversation, we mentioned using this certification as evidence that your issue is medically essential. How can I obtain the Credible Coverage Certificate, though?

It’s relatively easy. You can obtain this certificate from your prior health plan. You should receive this information from your original insurance provider.

Therefore, to get such a document, call your customer service department.

But remember that these conditions have restrictions. A newborn child will not be subject to these restrictions if they are added to your plan within the time frames mentioned in your plan.

The same holds if a kid under the age of 18 who has been adopted or who has been put in the member’s care for adoption is added to coverage within the time frames your plan specifies.

We have a lot to discuss regarding the waiting period for Blue Cross Blue Shield. But we need more time to process everything. On the other hand, the maximum waiting time for BCBS pre-existing conditions is visible.

Should the scheduled time listed above be too much for you, you may be eligible for a reduction. You can always return to this website for more details about this topic.