Blue Cross Blue Shield Arizona Guidelines
Here is an outline of underwriting guidelines for Blue Cross Blue Shield Arizona, acceptable weight ranges, and non-insurable conditions.
Pre-existing conditions?
Rules governing pre-existing conditions are still in effect until 2014 for adults.
Effective 10/01/2010, the Blue Cross Blue Shield Arizona guidelines will no longer issue individual and family policies with waivers excluding certain pre-existing conditions from coverage. Instead, the applicant may choose coverage at an adjusted rate, effectively buying coverage for the pre-existing condition. (Non-insurable conditions may still cause denial of coverage.) The rate-up percentage, depending on the number and/or seriousness of the insurable pre-existing conditions will be 15%, 35%, or 80%. At any time the member may request reconsideration of their policy premium. As an example, a member may have started exercising regularly, lost weight, quit smoking, and as a result their doctor took them off of a cholesterol medication. It is likely that BCBSAZ will look kindly on this development and lower the premium. It is a win-win situation for everyone involved. Blue Cross Blue Shield Arizona guidelines will also give month for month credit toward the waiting period for pre-existing conditions so long as there has not been a lapse in prior coverage of more than 63 days.
Blue Cross Blue Shield Arizona Guidelines
You may wonder why there are Blue Cross Blue Shield Arizona guidelines for pre-existing conditions. Arizona Health insurance companies impose pre-existing condition exclusion periods to discourage people from waiting until they become ill before purchasing health insurance. The Blue Cross Blue Shield Arizona guidelines, along with all other Arizona health insurance companies, will have to change this long-standing underwriting practice if and when Obamacare is fully implemented in 2014. At that time insurers will not be allowed to deny coverage or exclude certain pre-existing conditions. In a perfect world this sounds great. Unfortunately we do not live in a perfect world. If the underwriting practice of having waiting periods or denial of coverage no longer available to insurers there will be nothing stopping applicants from purchasing Arizona health insurance only when needed, such as when a claim occurs.
If you have a medical problem that exists when you enroll in or purchase your health insurance, the medical insurance company will deny all claims pertaining to this medical problem for a certain period of time. Blue Cross Blue Shield of Arizona will now cover these waiver-able conditions on individual and family plans for an additional premium. As mentioned, there may or may not be a waiting period, depending on whether there was prior coverage in place, group or individual coverage, before purchasing a BCBSAZ policy. The Blue Cross Blue Shield Arizona guidelines are in fact very fair with over half of all applicants qualifying for the lowest premium rate offered.
Blue Cross Blue Shield Arizona Guidelines
Underwriting
All health insurance companies, including Blue Cross Blue Shield Arizona guidelines, use a process called underwriting when someone applies for individual health insurance. Age, sex, and health history are scrutinized before health insurance companies determine whether they will cover the individual and how much it will cost to provide coverage. Not until 2014 must an insurer accept all applicants no matter their medical condition. This is the law now for children. All insurers that offer child-only coverage must accept all applicants. Unfortunately, due to this new law which is part of ObamaCare, Blue Cross Blue Shield Arizona guidelines will no longer offer child-only coverage effective 10/01/2010. To insure a child an adult must be on the policy now. Short-term health insurance policies will insure just children, no parent necessary, Here.
Acceptable Weight Ranges
The Blue Cross Blue Shield Arizona guidelines, just like those of all health insurance companies in Arizona, have guidelines regarding acceptable weight ranges for individuals and children. If an individual is overweight or obese, Blue Cross Blue Shield Arizona guidelines may offer insurance at a higher premium rate or refuse to insure the individual. As mentioned previously, the premium will likely be higher than most, but there is also an incentive to lose weight, namely the possiblity of a lower premium because of the weight loss. The opposite condition also applies. If an applicant is 25% or more underweight the Arizona health insurance company may deny coverage until weight gain has occured. As a non-profit organization, the Blue Cross Blue Shield Arizona guidelines allow for more individuals to be insured due to higher allowable weight ranges than many other carriers.
Blue Cross Blue Shield Arizona Guidelines
Non Insurable Medical Conditions
There are several medical conditions that may cause the Blue Cross Blue Shield Arizona guidelines to automatically deny coverage to an individual. Many of the conditions that insurers consider uninsurable are the same throughout the Arizona health insurance industry. But there are differences, and an applicant will be best served if they use a qualified broker to point the applicant in the right direction. Simply because one Arizona health insurance company has denied coverage to an applicant does not mean that all Arizona health insurers will deny coverage. Blue Cross Blue Shield Arizona guidelines for non-insurable conditions are listed here.
Since each application is different, Michael Higgins recommends that you give him a call to discuss the general underwriting guidelines. If you have any questions regarding Arizona health insurance policies, please call Michael Higgins at 602.405.8769. For your convenience he is available anytime, seven days a week.