FAQs
General Coverage
What happens to my coverage
if I move out of the area?
What happens to my coverage
if I quit my job or I'm laid off or fired?
What happens to my coverage
when I turn 65?
What happens to my coverage
if I retire?
What if I become disabled?
What if my spouse and I divorce?
Is my child covered while in
college?
Do I have coverage for pre-existing
conditions?
Q: What happens to
my coverage if I move out of the area?
A: Answers vary according to plan. For
more information, please visit the FAQs on your plan's
member page.
Q: What happens to
my coverage if I quit my job or I'm laid off or fired?
A: If your employment ends, you may have
certain options such as continuing health insurance under
this health benefit plan or purchasing a nongroup conversion
policy. Contact your employer or group administrator to
learn about the options available.
Continuation of Coverage Under COBRA
Under a federal law known as COBRA, covered employees
and their dependent(s) of employers with 20 or more employees
can elect to continue coverage for up to 18 months by
paying applicable fees to their employer in the following
circumstances:
Your employment is terminated (unless the termination is
the result of gross misconduct)
Your hours worked are reduced, causing you to be ineligible
for coverage
For more information about your coverage options under COBRA,
contact your group administrator or refer to your Member
Guide.
Continuation of Coverage Under State Law
Under state law, employees and their dependent(s) of any
size group have the option to continue group coverage for
18 months from the date that they cease to be eligible for
coverage under the health benefit plan. Employees are not
eligible for continuation under state law if:
The employee is currently eligible for COBRA coverage
The employee's insurance is terminated because they failed
to pay the appropriate contribution
The employee or their dependent(s) requesting continuation
are eligible for another group health plan
The employee was covered less than three consecutive months
prior to termination.
You must notify the group of your intention to continue
coverage and pay the applicable fees before your period
of eligibility has ended. The state law benefits run concurrently
and not in addition to any applicable federal continuation
rights.
For more information about your coverage options under state
law, contact your group administrator or refer to your Member
Guide.
Purchasing a Non-Group Conversion Policy
If you would like more information about purchasing a non-group
policy, please contact Customer Service at 1-800-914-4220
or visit the Plans for Individuals section of our
site. http://www.bcbsnc.com/plans/individual.cfm
Q: What happens to
my coverage when I turn 65?
A: When you reach age 65, you may be eligible
for Medicare Part A hospital and Medicare Part B medical
benefits. If you become eligible for Medicare and you remain
actively employed with your current employer, your health
plan will coordinate with Medicare and pay either primary
or secondary benefits. Just before either you or your spouse
turns 65, you should contact the nearest Social Security
office and apply for Medicare benefits. They can tell you
what Medicare benefits are available.
Q: What happens to
my coverage if I retire?
A: You may be eligible to continue your
coverage under your group health plan for a certain period
of time after you retire. Your group administrator will
advise you about continuation of coverage under your health
benefit plan.
Q: What if I become
disabled?
A: If you become temporarily disabled,
you would first exhaust short term/long term disability
periods with your company and retain coverage under your
group plan as long as you are employed.
In the event that you become permanently disabled, contact
the nearest Social Security office and apply for Medicare
benefits. They can tell you what Medicare benefits are available.
You should also supply BCBSNC with a copy of your Social
Security card as evidence of your disability and our Group
Membership Services Department will document your status.
If you terminate employment because of your disability,
you may continue coverage under your group plan. Please
refer to the frequently asked question, "What happens
to my coverage if I quit my job or I'm laid off or fired?"
If you become disabled while you are on a continuation plan,
the following principle applies: Employees or their dependent(s)
who are determined to be disabled under the Social Security
Act within the first 60 days of continuation of coverage
are eligible to extend their 18 months of continuation to
29 months. Your group administrator will advise you about
continuation of coverage under your health benefit plan.
Q: What if my spouse
and I divorce?
A: If you divorce or become legally separated,
your spouse's eligibility under your group health benefit
plan will end. (Legal separation requires court documentation
in order to be acknowledged as a qualifying event.) However,
the spouse will be eligible to continue coverage under COBRA
(if eligible) or under state law. See "What happens
to my coverage if I quit my job or I'm laid off or fired?"
Your group administrator will advise you about continuation
of coverage under your health benefit plan.
Q: Is my child covered
while in college?
A: Yes. An unmarried dependent child who
attends a licensed or accredited school as a full-time student
is eligible for coverage. Most groups cover students until
their 26th birthday if a full-time student. Please review
the Member Guide to determine the age limit for students
on your group health plan and contact Customer Service at
1-877-258-3334 to provide proof of student status.
Q: Do I have coverage
for pre-existing conditions?
A: Review your Member Guide. Most employer
groups require a 12-month waiting period for pre-existing
conditions. However, the waiting period for pre-existing
conditions is reduced by the amount of time spent on prior
coverage if your prior coverage was terminated within 63
days of your new enrollment date. If you or your dependent(s)
have such prior insurance, remember to include the effective
termination dates of your previous coverage on your application.
Please refer to your Member Guide for specific information
about your policy. Your group administrator can also advise
you about the length of your waiting period for pre-existing
conditions, if applicable.
