Frequently Asked Questions
Premiums help pay policyholders' claims, and other expenses, such as producers' commissions, premium taxes, and administrative expenses.
- Medical care costs
- Age of policyholder when policy is issued
- Current age
- Habits (such as smoking)
- Geographic area
Yes, as long as the treating physician is licensed and the hospital is accredited. You will probably be required to pay when services are rendered. It is important to keep your receipts and send them to BCBSM along with a Subscriber Application for Payment form. BCBSM will reimburse you at the rate of exchange on the day services were performed.
No. You must notify the MOA Insurance Administrator in writing within 30 days of the birth of your child. You can do so by completing a Subscriber Enrollment/Change of Status form.
Yes, MOA offers Surviving Spouse coverage. Your spouse can continue to be insured as long as he or she doesn’t remarry or move out of the State of Michigan.
An individual policy covers you and your family. We have several plans available, including BCBSM Traditional and Community Blue. Some plans offer prescription drug and vision coverage. If you are looking for coverage for you and your office staff, we also offer group coverage. To see if you qualify for group benefits, please contact Julie Watson at 248-359-6489 ext 167.
I have an individual policy and I may be moving to another area in the state. Will my BCBSM rate change?
It may, because your premium is based on the area in which you live as well as your age. Your premium may stay the same, decrease or possibly increase. It is important to let us know in writing within 30 days of a change of address. You can do so by completing a Subscriber Enrollment/Change of Status form. We will notify you if there is any change in premium.
What is an Exchange?
An Exchange should be an efficient method of comparing and purchasing health insurance designed to provide individuals and small businesses access to health coverage.
The Patient Protection and Affordable Care Act (PPACA) has mandated that states create, establish, and administer Exchanges by January 1st, 2014 or a Federal Exchange will be implemented for the residents of that state. States can operate Exchanges in partnership with other states. The federal government will provide funding until 2015 to allow for flexibility.
What do Exchanges offer?
Exchanges will offer health insurance plans based on different “metal tiers” of benefit levels based upon their actuarial value; the average amount the insurer pays of covered benefits. A 90% actuarial value means that, on average, the insurer will pay 90% of the cost of benefits Member will pay the remaining 10% through deductibles, copays, or coinsurance.
Rating factors on the exchanges are limited to age, tobacco use, geography, and family status. Insurers cannot increase premiums based on pre-existing conditions or health issues.