Obamacare News Blog

BCBSGA Finally Offers Child-Only Health Coverage in 2013

Blue Cross and Blue Shield of Georgia is offering Child-Only health coverage in 2013. The company has created a new plan with the catchy title of “Georgia Child-Only Health Insurance PPO Assignment Plan” for individuals under 19 years of age.  The good news is that if you’re under 19 and you qualify, you will be accepted regardless of your health history.

How could someone under 19 not qualify for this plan?
A carrier can deny you coverage in a Child-Only plan if you can get creditable coverage somewhere else. This includes enrollment in a high-risk pool plan.  You must apply during an open enrollment period or, if you have a qualifying event, you can apply during a special enrollment period.

When is Open Enrollment?
The Open Enrollment period is January 1-31, 2013 and, if approved, the policy will take effect on March 1, 2013. If you unable to apply during open enrollment you could apply during special enrollment.

What is Special Enrollment?
Two things have to happen to be eligible for Child-Only plans (for children under age 19) during a special enrollment period. First, Blue Cross and Blue Shield of Georgia must receive notice of the qualifying event within 60 days of it happening. Second, you are required to apply within 30 days of sending the notice.

These are examples of qualifying events:

  • Loss of employer-sponsored health insurance coverage
  • Involuntary loss of other existing coverage for any reason other than fraud, misrepresentation or failure to pay premium
  • Loss of health insurance coverage due to a dissolution of marriage.
  • Marriage
  • Entry of a valid court or administrative order that requires that the applicant be covered under a health insurance policy
  • Adoption
  • Birth

The special enrollment period will be open to the applicant for 30 days from the date Blue Cross and Blue Shield of Georgia receives the notice of the qualifying event. 

What is Covered under the Child-Only Plan?
The new plan has a $2500 deductible, 30% coinsurance and an out-of-pocket maximum of $5500.  This plan does not charge for preventive visits and has no lifetime maximum payout. Contact us to access a summary of benefits and to discuss how the plan works.

How much does the New BCBSGA Child-Only plan cost?
The price for the under 19 plan is not available using our online quoting tool and requires a special application. Call us at 800-930-7956 to get a quote and access the application.  Child-Only applicants who do not have creditable coverage within the 63 days preceding the application date will be assessed a surcharge of 50%, billed as a part of the monthly premium. Because of the impact to your rate, it is important to provide prior coverage information on your application if you had prior coverage.

How do I Apply for this plan?
Contact our office to get the new child-only application: 800-930-7956











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