Blue Cross and Blue Shield of Illinois - PPO

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Pre-Existing Condition Exclusion

Pre-existing Conditions are those health conditions which were diagnosed or treated by a provider during the 12 months prior to the coverage effective date, or for which symptoms existed which would cause an ordinarily prudent person to seek diagnosis or treatment.  Any Pre-existing Condition will be subject to a waiting period of 365 days.

Exception for Prior BCBSIL Group Plan

For applicants with continuous prior coverage (no more than a 31 day gap) under a Blue Cross and Blue Shield of Illinois employer-sponsored plan, Blue Cross and Blue Shield of Illinois provides credit against the individual plan pre-existing condition exclusion waiting period.

For example, if you enroll in a Blue Cross and Blue Shield of Illinois "individual" plan after being continuously covered for 10 months under a Blue Cross and Blue Shield of Illinois "group" health plan, you'll be considered to have satisfied 10 months of the 12 month pre-existing condition exclusion waiting period.

Medical Condition-Specific Waivers

If you have a condition, illness, or injury that can be identified as one that does not necessarily affect your overall good health but could affect the risk balance of all insureds, Blue Cross and Blue Shield of Illinois may waive that condition from coverage.  This means that expenses for treatment of that condition or any other condition related to it will not be covered for a specified period of time.