Complete List Of Qualifying Life Events
Birth
This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not New Jerseys Health Insurance Marketplace. This website does not display all Qualified Health Plans available through Get Covered NJ. To see all available Qualified Health Plan options, go to the New Jersey Health Insurance Marketplace at Get Covered NJ.
Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Healthcare Dental, Inc., each an independent licensee of the Blue Cross Blue Shield Association. Communications may be issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. The Blue Cross® and Blue Shield® name and symbols are registered marks of the Blue Cross Blue Shield Association. The Horizon® name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey. The Braven Health name and symbols are service marks of Braven Health.
Tied in 2021. For J.D. Power 2021 award information, visit jdpower.com/awards.
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How Do I Change My Information And Coverage
Who is this for?
Blue Cross Blue shield of Michigan and Blue Care Network members under age 65.
Maybe you want to let us know you changed your name.
Maybe you got married, moved, and want to add your spouse to your health insurance.
When, how and where you can make changes depends on:
- If you get your insurance through an employer or group, or buy it yourself
- What it is youre changing
First we’ll explain when you can make changes, then we’ll tell you how to let us know.
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To Assist You In Providing The Verification Documentation
To assist you in providing the verification documentation, our Dependent Verification Services team will send you a letter with a unique bar code from SHBP within 1 to 2 business days via email if you have an email address on file and if no email address is on file, the letter will be mailed to you within 2 to 4 business days if you have an address on file. This process is referred to as your DVS Audit and you and/or your dependent as applicable, will not be enrolled in SHBP coverage until you provide the necessary verification documentation proving eligibility for coverage and the DVS team approves your Audit.
Please do not submit verification documentation until you receive your letter from DVS. Providing documentation to anyone, including your employer or other entity not appointed by SHBP for this purpose, or via any other means not provided for in this letter will result in you failing the DVS Audit. If you fail the DVS Audit, you must wait until the next Open Enrollment period, unless you experience another Qualifying Event or Special Enrollment Event to make a change to your coverage.
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Special Enrollment Having A Baby Or Adopting A Child
Congratulations! Welcoming a new child into your home is an exciting time with many things to consider. We’re glad you’re thinking about your child’s health insurance. Adding to your family size is a qualifying event. This means you can enroll in or change your health insurance coverage during a special enrollment period.
Additionally, if you were ordered by a court to provide health care coverage for a dependent, you may also qualify for a special enrollment period.
Keep in mind you only have 60 days to enroll in health insurance after your baby is born or adopted or you gain a dependent through a court order. After that, you’ll have to wait until open enrollment.
Wedding Bells Diapers And Qualifying Life Events
The summer season is upon us, and to many people that brings one thing: wedding season. The summer season is replete with flowers, veils, cake and potentially, a new Blue Cross Blue Shield health insurance plan for the happy couple.
Between that new cutting board and a check from Great Aunt Sally, couples who get married before the next open enrollment period in November may qualify to purchase health insurance coverage and receive financial assistance – through the Healthcare Marketplace.
Though open enrollment will not begin again until November, getting married is considered a qualifying life event. For those without insurance coverage through an employer, that means you are allotted a 60-day special enrollment period to add your spouse to an existing plan or shop for new coverage.
Dont let your window of opportunity slide while youre on your honeymoon or gazing at wedding photos – once your 60-day special enrollment period ends, youll have to wait until November to sign up for or change your coverage.
Another common qualifying life event is the birth, or adoption, of a child. In that case, the special enrollment period allows you to add the child as a dependent on your plan within 60 days of his or her birth or adoption date.
The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies.
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Get Your Bcbsil Health Plan
Take a look at the health care plans in your area.
1The following are not considered loss of coverage: voluntarily canceling your health insurance plan, having your plan canceled because you did not pay your premiums or because your plan did not meet the requirements set by the Affordable Care Act for Minimum Essential Coverage.
2Only for health plans bought on the Marketplace.
3BCBSIL does not offer temporary or short-term plans. These plans may not provide the full benefits of a BCBSIL health plan, including essential health benefits.
Changes That Have A Deadline
Sometimes you need to add someone to your plan, or you cant keep your current plan. For example, you may need to:
- Add a baby or spouse to your plan
- Get a new plan because you moved out of the area your current plan covers
- Buy your own plan because you lost insurance you had through an employer
In these cases, you have a limited amount of time to act. Members who:
- Get insurance through an employer or group usually have 30 days after the event to make changes
- Buy their own insurance can make changes 60 days before and after qualifying life events
Its important to be aware of these deadlines. If you miss them, you may have to wait until the next open enrollment period.
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Events Most Likely To Result In Addition Of Dependent
If any of these events listed below occur, you may request coverage for an eligible dependent.
| Event | ||
|---|---|---|
| No later than 60 days from date of eligibility | Group determines but not to exceed 90 days from date of hire. | |
| Within 31 days following marriage/civil union. | First of the month following marriage/civil union. | |
| 32 to 60 days following marriage/civil union. | First of the month following receipt. | |
|
Birth |
Within 60 days following birth. | Date of birth for child and 61st day after the birth for the membership type change. |
| 61 to 90 days following birth. | First of the month following receipt. | |
|
Adoption |
Within 60 days following adoption . | Date of adoption . |
| 61 to 90 days following adoption . | First of the month after we receive the request. | |
|
Qualifying Loss of Coverage |
Within 31 days after loss of coverage. |
How And Where To Make Changes
To change your email address:
- Log in to your member account. If using our website, go to Account Settings if using the Blue Cross mobile app, go to My Account
- Or, call the number on the back of your Blue Cross ID card
If you bought your plan on the Marketplace, and want to update your email there too, youll have to log in to your healthcare.gov account.
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Are Breast Pumps Covered By Blue Cross Blue Shield
As breast pumps are categorized as durable medical equipment by most insurance providers, and breast milk is recognized for its potential health benefits, most insurance plans are required to cover the cost of a breast pump under the Affordable Care Act. Although specific coverage is different for each insurance plan, most Blue Cross Blue Shield plans cover the cost of a double electric breast pump for new moms to use while breastfeeding. To see which breast pumps are covered by your insurance, verify your member benefits with Blue Cross Blue Shield and complete Pumps for Moms simple qualification form to immediately see which breast pumps you qualify for.
Welcome To Blue Cross Canada
For more than 70 years the Blue Cross® name in Canada has stood for affordable, quality supplementary individual health and travel insurance coverage, as well as group benefits and group life insurance, delivered with trustworthy and personalized service.
The Canadian Association of Blue Cross Plans represents the independent Blue Cross member plans operating in regions across the country. For more information about the plans and services available in your area, select your province above.
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What If I Dont Qualify For Special Enrollment
Depending on your income, you may qualify for Medicaid or CHIP. There is no special enrollment period for those government offered coverage options you can apply at any time.
Members of American Indian and Alaska Native tribes can enroll any month, not just during open enrollment. You can even apply for cost assistance.
Are You Sure You Want To Leave This Website
You are leaving the Horizon Blue Cross Blue Shield of New Jersey website. Please click Continue to leave this website. Or, if you would like to remain in the current site, click Cancel.
This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not New Jerseys Health Insurance Marketplace. This website does not display all Qualified Health Plans available through Get Covered NJ. To see all available Qualified Health Plan options, go to the New Jersey Health Insurance Marketplace at Get Covered NJ.
Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Healthcare Dental, Inc., each an independent licensee of the Blue Cross Blue Shield Association. Communications may be issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. The Blue Cross® and Blue Shield® name and symbols are registered marks of the Blue Cross Blue Shield Association. The Horizon® name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey. The Braven Health name and symbols are service marks of Braven Health.
Tied in 2021. For J.D. Power 2021 award information, visit jdpower.com/awards.
Information in Other Languages
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For Personal Health Plan Members
If you would like to remove a dependent, contact us directly so we can help you through the process.
To add a dependent, complete the paper version of the Personal Health Plan Application and submit it to us.
If you’re adding a new baby, please call us or notify us in writing within 30 days of the birth.
Adding A New Baby To Your Insurance Plan
Congratulations! There is nothing sweeter than welcoming a new baby into your home. You probably already had a checklist of everything you needed to do pack the hospital bag, install the car seat, and of course, dont forget about adding your newest bundle of joy to your health insurance plan.
The process of adding a new baby to your insurance plan is different based on what kind of insurance plan you have. Group members are enrolled in a group plan, usually offered by an employer. Direct enrolled members purchased their health insurance off marketplace.gov or directly through our website.
Group members:
If you currently have a policy that covers child, the newborns coverage is effective on the birth date. However, a phone call or a change form will still need to be submitted to add the child within 60 days of the date of birth.
If your current policy does not cover children, you may either call our office at 1-800-432-3990 or send in a change form within 60 days of the babys birth in order to change your policy to one that does cover children. If a call is placed to add the child, follow up with your group and send in a change form signed by you and your group leader.
To obtain a copy of the change form please contact your group administrator or contact us.
Direct enrolled members:
If you currently have a policy that covers child, the newborns coverage is effective on the birth date. However, a change form or a phone call will still need to be made to cover the child.
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How Does Insurance Work When Having A Baby
Coverage continues through pregnancy, labor, delivery, and the first 60 days after birth. Some states may cover your maternity care under the Childrens Health Insurance Program. After your Medicaid pregnancy coverage ends, you may still have other insurance options through your state or a private company.
When Can I Enroll During A Special Enrollment Period
A Special Enrollment period occurs if you have a qualifying life event. In most cases, you will have 60 days after the qualifying life event to enroll in or make changes to a health plan.
Certain life events, like moving into the Independence Blue Cross coverage area, allow you to apply for a health plan up to 60 days before a qualifying life event. If you are losing health care coverage provided by an employer, you will have up to 60 days before and after this qualifying life event to enroll in a health plan.
When you apply for a Special Enrollment period for the following qualifying life events, you will be sent an Eligibility Notice for Coverage.
This notice will include a list of acceptable documents you may provide to prove your eligibility for the Special Enrollment period. Please provide these documents by the deadline listed in the notice to avoid disruptions to your health care coverage. You must send the documents before you can start using your health care coverage.
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