Frequently Asked Questions (FAQs)
Have questions? We have answers.
General
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How do I apply for insurance?
BCBSF makes it easy to apply for insurance. You can use this website to get an instant quote, choose a plan type, and apply online whenever it’s convenient for you. Please call your agent if you need assistance or call the number in the 'Get Help' menu.
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Will I have to take a medical exam to get insurance?
In most cases, you are required to complete a medical underwriting process that examines your medical history and health conditions before you can be approved for coverage. Sometimes a telephone interview with a medical underwriter is all that’s required to make a decision, however you may have to undergo a paramedical exam for further screening.
After you submit your application, we’ll let you know how to proceed. Whether it’s a telephone interview or an exam, it’s important to respond in a timely manner and make yourself and all applicants over 18 years available to participate. You can expedite the process by jotting down the names and addresses of your physicians and the dates first seen and last seen; dates of medical tests and test results; and the names and dosages of all the medications you take and why you take them. -
What is a paramedical exam?
If a paramedical exam is required, you will make an appointment with one of our contracted vendors to come to your home (or other place) at a time that’s convenient for you. During the exam you’ll answer questions about your health history, height and weight; have your blood pressure and pulse readings taken; and provide a urine sample and blood sample for screening.
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How soon will I know if I qualify for insurance coverage?
If the information we need to make a decision can be collected during a telephone interview with an underwriter, you may know within 48 hours of the interview. If a paramedical exam is required and/or we need to review your medical records, you should be notified within three weeks after we receive the results.
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Can I add dependents to my plan?
Yes you can. If you’re adding a spouse, he or she will first have to complete an application and go through necessary medical underwriting for approval. If you’re adding a child (whether by birth, adoption, or legal guardianship), contact BCBSF as soon as possible because there may be certain requirements and time guidelines to consider depending on your plan.
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What is the age limit to be qualified as a dependent?
Your unmarried children or stepchildren (by birth, legal adoption, or legal guardianship) may be covered until the end of the calendar year that they turn 30.
Your mentally or physically disabled child who depends mainly on you for support may be eligible to continue coverage as a dependent if he or she has a mental or physical handicap that existed before age 19, and this handicap makes it impossible to gain self-sustaining employment. -
If I purchase a plan now – can I switch at any time?
You sure can. Depending on the plan you’re enrolled in, and the one you want to switch to, there may be some restrictions or limitations to consider, but we can help you get the coverage you want when you want it.
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How can I save on my monthly premiums?
Generally, if you want to lower your monthly payments, choose a plan with a higher deductible and a higher coinsurance. The idea is that the more you share the cost of your health care, the less you will pay for the plan. BCBSF offers several plan options to fit your monthly budget.
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If I lose my job, do I lose my group health insurance, too?
If you leave or lose your job and your employer had 20 or more employees in the previous year, you can temporarily continue your existing group coverage, at your expense, through what’s called COBRA.
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What is COBRA?
COBRA, or the Consolidated Omnibus Budget Reconciliation Act, gives workers who lose their jobs the option to continue their family’s health coverage through their employer’s group plan if their employer had at least 20 employees during the previous year. You can generally stay on the plan for up to 36 months, but you must pay the full premium amount, and possibly an administration fee up to 2% of the premium. The cost per month can vary, but it will be clearly listed on the COBRA letter you’ll receive after your last day of employment.
Plans and Benefits
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What is an HSA?
An HSA (Health Savings Account) is a tax-free, interest-bearing savings account you own and control, but it only works if you purchase a BCBSF high-deductible health plan that is HSA compatible. The money you put into an HSA is pre-tax, and can be used tax-free for qualified medical expenses that are defined by the IRS, but can include physician and hospital fees, prescription drugs, over-the-counter medications like aspirin, dental and hearing care expenses, deductibles, coinsurance, and much more. The money you don’t use continues to earn interest.
Like an IRA, the money is yours to save or spend. You can invest your HSA dollars once your account balance reaches a certain dollar amount; withdraw it for any reason (with penalty and taxes); keep it in the account earning interest for future medical expenses; or access it penalty-free when you turn 65. Unlike an IRA, your employer can make contributions to your HSA plan.
For more information, see IRS Publication 502 at www.irs.gov -
What are the advantages of an HSA?
An HSA is yours, which means you take it with you if you change jobs or switch health plans. The money you put into the account is pre-tax, which means you can reduce your taxable income.You can use the money tax-free to pay for qualifying medical expenses.The funds rollover year after year, so money you don’t use continues earning interest.You can use the money to save for retirement or spend it when you need it.Unlike an IRA, your employer can make contributions to your HSA account.It’s easy to open an HSA. When you enroll in an HSA-compatible plan, you’ll have the option to elect a financial institution and it’s automatically set up for you.
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What is a “tiered formulary”?
A formulary is a list of prescription drugs that a plan covers. Drugs on a formulary are categorized into cost tiers: Tier I includes lower-cost generic drugs; Tier II includes more expensive generic drugs and preferred brand name drugs; and Tier III includes more expensive, or non-preferred, brand name drugs. Your copayment depends on which tier your prescription drug is on.
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What are my options if I only need health insurance while I’m between jobs?
If you’re between jobs or waiting for health care insurance to kick in, you can get comprehensive health insurance in 30, 60, and 90-day limited-renewal terms. Called temporary insurance, you can enroll in a plan without providing a medical history or undergoing a medical exam, which means your acceptance is guaranteed for the specific timeframe.
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Do BCBSF plans include prescription drug coverage?
Yes. All of our Under 65 Individual and Family Insurance Plans offer prescription drug coverage or discounts on prescription drugs at participating pharmacies. Our prescription drug options include: BlueScript, Integrated Rx, and BlueRx Discounts. You can find out more about each of these programs in the description of the plans you’re considering.
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Does BCBSF offer dental insurance?
Yes, you can purchase dental insurance in addition to your health plan, or choose an integrated health and dental plan with one premium. Currently BCBSF offers BlueDental Care insurance, a pre-paid dental plan that focuses on preventive care, and BlueDental Choice, a PPO plan that offers basic and major dental coverage as well. All dental plans provide discounts on specialty services and orthodontics.
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Do BCBSF plans include maternity/obstetrical coverage?
Yes, many plans offer the option to add maternity coverage. We call it the Maternity/Obstetrical Benefit Endorsement. You can choose your own doctor and be confident knowing you’re covered for prenatal care through delivery with varying cost sharing options. The endorsement must be in effect 30 days prior to conception.
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What is the difference between BCBSF BlueOptions and BlueSelect plans?
BlueOptions is what we call a group of health plans that offer comprehensive medical coverage for preventive and routine care, prescription drugs, hospitalization, out-patient services, lab and imaging, and more. There are many plan options available in the BlueOptions portfolio:
- Predictable Cost plans with set copayments and coinsurance;
- Lower Premium plans with higher deductibles and out-of-pocket limits;
- Health Savings Account (HSA) Compatible plans; and
- Temporary Insurance plans offering up to six months of coverage.
There are no network restrictions, which means you can visit any provider you want, in-network or out, without referrals, but will save more staying in the large BlueOptions network.
BlueSelect plans feature similar traditional medical coverage, with much lower premiums – up to 20% less in some cases. Plans provide coverage for adult and child preventive care, outpatient provider services and therapies, and prescription drugs, and you get major cost saving opportunities if you use our exclusive, locally-based provider network. You can see providers outside the network, but may pay more for their services. Note that there are some services, like diabetes medical equipment and supplies, mental health, lab, and home health care, which require you to stay within the BlueSelect Exclusive Provider network.
Both BlueOptions and BlueSelect offer plans with maternity benefits for an additional cost. -
What are the differences in BCBSF health care coverage options?
BCBSF has something for everyone with a wide variety of products designed for every budget. Our Predictable Cost and HSA-Compatible plans feature comprehensive benefits with in network plans and plans with no network restrictions. You can choose your benefit levels with low premiums, high deductibles, and predictable copayments – it’s all about the options that work best for you. We also have health and medical discount benefits offered in our Low Cost and Limited Benefit plans. These limited benefit plans feature big savings with discounts on routine and preventive care, and hospital and emergency services, for a low monthly fee. There are no medical questions asked, so your enrollment is guaranteed.
Miami-Dade Blue offers quality, affordable health care and local, network-specific coverage for citizens working and living in Miami-Dade County.
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