Frequently Asked Questions - Individuals
Health Frequently Asked Questions
Frequently Asked Questions
- When is Open Enrollment?
- How can I apply outside of Open Enrollment?
- When will coverage end?
- How will my premium be determined?
- How long does it take to enroll in a plan?
- What happens if Blue Cross declines to issue a contract?
- Do I need to send payment with the application?
- If I make a payment during enrollment, when will it be processed?
- What happens if I move out of Alabama?
- May I cover my family members when I apply for the plan?
- May I add a spouse or child after I have obtained coverage under the plan?
- Can I apply for coverage for my dependent only?
- What happens if I or one of my covered dependents later becomes covered under some other group or individual health plan?
- May I change from one Blue Cross individual or family plan to another?
- What happens if I or one of my covered dependents later becomes eligible for or entitled to coverage under Medicare?
- May my employer endorse or sponsor the plan?
Open Enrollment begins November 1, 2018, and ends December 15, 2018. You may enroll anytime during Open Enrollment. If you apply between:
- November 1 and December 15, 2018, coverage will begin on January 1, 2019.
The effective dates apply assuming you pay your premium in full.
In order to apply for a plan outside of Open Enrollment, you must have a qualifying life event that results in a special enrollment period. Most Special Enrollment Periods last 60 days from the date of the qualifying event. Find out when you are eligible to enroll in health insurance coverage. Qualifying life events that create a Special Enrollment Period include:
- Adoption/Foster Child
- Placement for Adoption
- Permanent move into Alabama
- Loss of health insurance coverage due to death
Note: Please call the Customer Service number on the back of your ID card if this applies to you.
- Loss of health insurance coverage
Note: This does not include loss of a short-term plan or loss of minimum essential coverage due to non-payment of premiums.
- No longer eligible for subsidy
- Gain of citizenship or nationality
- American Indians or Alaskan Natives
If you are currently a Blue Cross member and need to add a dependent to your plan, please call the Customer Service number located on the back of your ID card. If you purchased a plan through the health insurance marketplace, please visit Healthcare.gov or call 1-800-318-2596.
Plan coverage ends for you and your dependents when one of the following happens:
- You fail to pay all applicable fees for coverage within the first 30 days following the effective date of your coverage, in which case coverage for you and your dependents will be canceled as of the effective date of coverage;
- You fail to pay subsequent fees for coverage within your applicable grace period.
- You are no longer a resident of Alabama;
- For spouses, the first day of the month following divorce or other termination of marriage;
- For children, the first day of the month following the date a child ceases to be a dependent;
- For all covered dependents, the first day of the month following the date of a subscriber's death unless proper documentation is received within 30 days from the date of death to allow coverage to continue (we will not notify the subscriber's dependents upon the date of death of his/her options to continue coverage);
- For any member, the date of his or her death;
- Upon discovery of fraud or intentional misrepresentation or omission of a material fact; or
- Upon termination of the plan.
Each person on the contract will be rated based on their age, their tobacco usage, and the county in which the contract holder lives. Once each member has been rated, then all amounts will be added together to get the family rate. For children age 20 and under, the oldest three children will be individually rated and included in the family premium amount, and any additional children will be free. All dependent children, age 21 and older, will be individually rated and included in the family premium amount.
The enrollment process generally takes between 15 and 30 minutes.
If we decline to issue a contract, we will refund any fees paid with respect to the application. You will receive a denial letter in the mail.
If payment is not received with the application, a bill is automatically generated. This will not delay the application process; however, if payment is not received by the effective date of coverage, the contract will cancel. You can make a one-time payment online through myBlueCross.
- If you make an initial, one-time credit card payment, your card will usually be charged within 48 hours.
- If you make an initial one-time payment with an eCheck, your account will usually be charged within 48 hours.
- If you make a payment with a check, it will be processed upon receipt.
- If your application is denied after payment has been processed, we will refund the applicant.
Your contract will cancel; coverage is for Alabama residents only.
When you first apply for the plan, you will be given the option to cover eligible family members.
Your spouse can be covered under the plan if he or she is a resident of the state of Alabama.
Your married or unmarried child may likewise be covered if, at the time of your application, he or she is under the age of 26 and is a resident of the state of Alabama. In addition, the child must be your natural child, stepchild, legally adopted child, child placed for adoption or eligible foster child. An eligible foster child is a child that is placed with you by an authorized placement agency or by court order.
You may cover your grandchild only if you are eligible to claim your grandchild as a dependent on your federal income tax return.
If you qualify for a Special Enrollment Period, you may add a spouse or dependent to your plan. Otherwise, you may add a spouse or child during Open Enrollment. See, "How can I apply outside of Open Enrollment?" for more information.
If you obtain coverage under some other group or individual health policy or plan, you may still keep this plan. Blue Cross coordinates benefits under this plan with other group and non-group plans. For more information, please review the Coordination of Benefits section of the benefit booklet.
Yes, you may change plans during Open Enrollment or during a special enrollment period.
If you are a member on one of our Individual plans and become enrolled in any part of Medicare (Parts A, B or D) you will have minimal or no benefits under this plan without any reduction in premiums. This is because our individual plans do not pay primary, secondary nor supplemental to Medicare. Because of this, we strongly encourage you to cancel your coverage under this plan when you become enrolled for Medicare.
You must notify Blue Cross immediately when you or someone on your contract becomes enrolled for any part of Medicare (Parts A, B or D). Please call Blue Cross at 1-888-543-9212 or visit us at www.bcbsalmedicare.com to learn about options available to those who are Medicare eligible.
No, because this plan is individual insurance and is not designed to satisfy the rules for group insurance.