[Rag Bagger]

If you have BCBS major medical insurance in another state is the Florida BCBS requiered to write a new policy for Florida?

[skip0358]

I had BC/BS in New York when I moved down here I had to get new cards with a different classification, my wife had the same issue on her policy.

[mfp509]

I've been here for 6 yrs and have Connecticut BCBS. I don't understand the process but I think the Dr's bill through Florida BCBS. Florida then puts the claim in to CT. I had a mix up a couple of times and it was because FL didn't submit the claim to CT. It all works out though. I might have been issued new cards also.

[iaudit]

Six years ago when I was auditing medical claims, the doctor or facility that provided the service would submit a claim to the local Blue Cross/Blue Shield plan. They would electronically submit the claim information to the plan (Host Plan) that wrote the policy through what they call the "Blue Card" system. If the claim is a covered service under the policy they electronically notify the local plan to pay the provider at the local negotiated rate. The local plan then bills the host plan for reimbursement. This only pertains to Blue Cross/Blue Shield Major Medical policies.

The PPO's and HMO's are a whole other ballgame and sometimes out of system providers are not covered or are only covered at the local plan rates. The difference can then be billed to the patient, sometimes at the fully charged rate. You also get into precertification and other limitations except in cases of emergency.

[Rag Bagger]

With some of the comments you still seem to have a policy that is in a different state than Florida. In order to do that do you have to maintain a resident in that state? Do you still pay your premieums in the old hame state?

[Rag Bagger]

The real question is, if you have a BCBS in a different state than Florida is it required by law that Florida BCBS accept you even with pre-existing conditions?

Normally an insurance co. cannot cancel you so long as you make the premiums regardless of your health. But it seems if you change states they may be able to do just that. We are not on medicare so we have to buy our own major medical and have been for 40 years.

Do you know of an agent who can clarify this point?