Most Recently Answered Questions
Questions 1 - 11 of
11 (Page 1 of 1)
Submitted by Holly Stewart from Matthews NC
Q: Is there a quaranteed issue plan from Blue Cross Blue Shield of NC for people with pre existing conditions?
Answered 04/15/08 09:31:49 by Scott Ashcraft
A: Yes, Blue Advantage from BCBSNC is "guaranteed issue". This means that nobody will be turned down because of health conditions. If one has had a gap in medical coverage for over 63 days, then one may not be covered for those medical conditions that they currently have.
Submitted by Jan from Cary NC
Q: We have BCBS with my husband's current employer. He's starting a new job on Monday, and the new company also offers BCBS after 90 days, so we'll be without health insurance for 60 days. Will I be faced with any pre-existing clauses? I'm disabled and have alot of medical issues. We live in NC
Answered 10/03/06 01:52:10 by Scott Ashcraft
A: Because of your medical issues, it might be considered risky to stop your medical insurance, even for 60 days. You can go to your former employer, formally request and pay the premium for 60 days coverage. Short term and individual coverage, such as Blue Advantage, are available as alternatives to compare. Your health issues will be the deciding factor, because they will affect the rates Blue Cross Blue Shield will charge for coverage.
1-800NewHealth.com is a Blue Cross Blue Shield of North Carolina (BCBSNC) Agency
Submitted by Anonymous from Virginia
Q: I currently have Health Alliance PPO at my employer and have recently (yesterday) just confirmed with a Dr.'s office that I am pregnant (due in May). I am considering taking a job with Blue Cross Blue Shield of Illinois and am wondering if my new insurance at BCBS will cover my pregnancy or how that will work. Any information would be appreciated! Thank you!
Answered 09/15/06 02:55:32 by Scott Ashcraft
A: With most group plans, including BCBS, maternity is not a pre-existing condition and is covered even if you are currently pregnant. Expect a waiting period of up to 90 days after you become a fulltime employee, before your benefits become effective.
1-800NewHealth.com is a Blue Cross Blue Shield of North Carolina (BCBSNC) Agency
Submitted by hannah from Salisbury, North Carolina
Q: What are some of the memebership requirements to be in the Blue Cross Blue Shield of North Carolina?
Answered 09/14/06 02:14:22 by Scott Ashcraft
A: Eligibility requirements for Blue Advantage include that you are a North Carolina resident, you are under 65 years old, and you do not qualify for Medicare.
1-800NewHealth.com is a Blue Cross Blue Shield of North Carolina (BCBSNC) Agency
Submitted by Angie from Salisbury, NC
Q: We are considering a small group BCBS health plan for our company. How do the rates differ from the individual plans. How do they get the rates for group plans. Also, is this guaranteed issue.
Answered 09/14/06 02:08:30 by Scott Ashcraft
A: The dynamics of choosing a Group Plan over an Individual Plan are complex and different for every case because the factors that insurance carriers look at are different for every person and group.
The most important requirement is to work with an Insurance Broker that you trust.
It is the responsibility of your broker to represent you or your company and shop the market and present final quotes for all competitive carriers and provide service when problems arise.
Group contracts with group insurance carriers are renewed annually and coverage for "small group", groups with 1 to 50 employees, can not be denied and have rate limits.
1-800NewHealth.com is a Blue Cross Blue Shield of North Carolina (BCBSNC) Agency
Submitted by Anonymous from Cape Carteret NC
Q: I have a BCBS Blue Adv. plan. I am hoping to add maternity coverage in Dec. to start in Jan. I have had an emergency c-section in the past (covered by another insurance co.). Will BCBS cover another c-section, as my doctor has already determined that I will need one for subsequent childbirth? I don't want to get the maternity coverage if they will not cover the birth. If they will not, are there other insurance companies that cover maternity in NC? Thanks!
Answered 08/03/06 15:43:25 by Scott Ashcraft
A: Blue Cross Blue Shield will cover the cost of the C-section if your doctor feels this is best for you and/or your baby.
It is important to understand that with the maternity option, you cannot be pregnant when your maternity coverage becomes effective.
BCBSNC participating providers or specialists will coordinate prior approvals or precertification for you. You may want to check with your participating provider to make sure prior approval has been obtained. For services from a nonparticipating provider or out-of-state, you are responsible or having your provider request preauthorization for those services that require prior approval from BCBSNC.
1-800NewHealth.com is a Blue Cross Blue Shield of North Carolina (BCBSNC) Agency
Submitted by Anonymous from charlotte
Q: What services require prior approval or a referral for Blue Advantage coverage with Blue Cross Blue Shield of North Carolina?
Answered 06/06/06 20:42:31 by Scott Ashcraft
A: Most inpatient admissions, skilled nursing facility admissions, and all private duty nursing services require prior approval from BCBSNC. In addition, BCBSNC requires prior approval for certain other outpatient services received on or after July 1, 2005.
For maternity admissions, your doctor is not required to obtain prior approval from BCBSNC for prescribing a length of stay up to 48 hours for a normal vaginal delivery or up to 96 hours for delivery by cesarean section. You or your doctor must request prior approval for coverage for additional days. Although no prior approval is required for emergency situations, please notify BCBSNC of your inpatient admission as soon as reasonably possible.
The list of services that must be approved in advance, may change from time to time. For the current list of services requiring prior approval, please refer to our prior approval list or call the Customer Service number on the back of your BCBSNC ID card.
Additionally, some prescription drugs require prior approval to be covered. Some prescription drugs are also subject to quantity limits based on criteria developed by BCBSNC. For these drugs, prior approval is required before excess quantities will be covered. To get a list of these types of prescription drugs, visit our Prior approval and quantity limitations page or call the Customer Service number on your BCBSNC ID card. Please note that BCBSNC may occasionally change the list of these prescription drugs. Prior approval will be waived for restricted access drugs and devices if the member's provider certifies that a no restricted formulary drug or device has been harmful or ineffective in treating the member's condition.
If your services are out-of-network or you receive services outside of North Carolina, you are responsible for requesting or having your provider request prior approval for those services that require preauthorization from BCBSNC.
Submitted by Anonymous from Concord
Q: How often do premiums change? When will I be notified of the changes for Blue Advantage coverage with Blue Cross Blue Shield of North Carolina?
Answered 06/06/06 20:42:11 by Scott Ashcraft
A: You won't be singled out for a premium change, although your premiums may be adjusted as you age, add or remove eligible dependents, or if you move. You will be notified 31 days in advance of any change. Currently our rates are adjusted on January 1st each year.
1-800NewHealth.com is a Blue Cross Blue Shield of North Carolina (BCBSNC) Agency
Submitted by Anonymous from Rock Hill, S.C.
Q: How do I renew my coverage for Blue Advantage coverage with Blue Cross Blue Shield of North Carolina?
Answered 06/06/06 20:42:01 by Scott Ashcraft
A: Your coverage is automatically renewed when you continue to pay premiums as they are due. BCBSNC must renew your policy unless we discontinue all policies like yours.
1-800NewHealth.com is a Blue Cross Blue Shield of North Carolina (BCBSNC) Agency
Submitted by Big fan from No location specified
Q: When will my Blue Advantage with Blue Cross Blue Shield of North Carolina coverage begin?
Answered 06/06/06 20:41:50 by Scott Ashcraft
A: You can choose for your coverage to begin on either the 1st or 15th day of the month, following approval of your completed application.
1-800NewHealth.com is a Blue Cross Blue Shield of North Carolina (BCBSNC) Agency
Submitted by Anonymous from No location specified
Q: What are benefit period deductibles for Blue Advantage coverage with Blue Cross Blue Shield of North Carolina?
Answered 06/06/06 20:35:19 by Scott Ashcraft
A: This is the amount you pay for some services before Blue Advantage pays its portion. Once three family members meet their individual deductibles, no additional individual deductibles are required for the remainder of the benefit period.
Deductible Options - Choose the deductible that best meets your needs:
Plan A $250 $500 $1000 $2500
Plan B $500 $1000 $2500 $5000
Plan C $1000 $2500 $3500 $5000
1-800NewHealth.com is a Blue Cross Blue Shield of North Carolina (BCBSNC) Agency