Other Coverage Details

Just as each individual is unique, so too are the prices for PersonalBlue plans. Good thing it's easy to get your very own PersonalBlue quote. Here's how:

Completing Health Questions

We want to issue a health insurance policy. But you have to tell us the truth – and disclose your health information – when answering questions on your application. Not doing so can be considered fraud. Your acceptance will be based on the information you provide. You must also meet height and weight guidelines and minimum health requirements before your application can be approved. If approved for coverage, your monthly premium rate will be determined based on the health status of all applicants (if you applied for more than one person). Rest assured, once approved for coverage, your premiums cannot be increased due to changes in your health status or the number of claims you file.

Pre-Existing Conditions

PersonalBlue policies include a 12-month waiting period before any benefits will be paid for pre-existing conditions. A pre-existing condition is any physical or mental condition that was present during the 12-month period before your coverage became effective, for which medical advice, diagnosis, care or treatment was recommended or received, or symptoms existed and a reasonably prudent person would have sought medical advice, diagnosis, care or treatment from a health care provider.

Limits on pre-existing conditions are a standard part of most health plans. They make sure benefits are paid only for conditions that occur after your health coverage becomes effective. Paying only for approved services and conditions helps control health care costs and prevent possible insurance abuse. Please carefully read the information on pre-existing conditions when you receive your policy.

Pre-Existing Condition Waiting Period does not apply to those under age 19. 

Benefit Exclusion Riders

Our underwriting policies may require that we place a "benefit exclusion rider" on your policy for a particular condition you or one of your dependents may have. That means BlueCross won't provide benefits for the condition for the life of your policy. This may include (but is not limited to) benefits for services, supplies, treatment, charges and possibly medications related to the condition. You may ask that we reconsider a benefit exclusion rider by sending a letter and any medical records related to the condition(s).


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