Application for waiver of the pre-existing condition waiting period
Who is this for?
If you are have an individual health insurance policy, use this form to apply for a waiver of the pre-existing condition waiting period.
You can use this form if you have an individual health insurance policy and qualify for a waiver of the 180-day waiting period during which pre-existing conditions aren’t covered by your health insurance policy.
What you’ll need:
- Your enrollee ID card
- A Certificate of Creditable Coverage from your previous insurance company to show proof of 18 months of continuous health care coverage
- If applicable, a letter from your employer or COBRA administrator explaining why you weren’t eligible for COBRA coverage
- If applicable, a letter from your employer-sponsored health plan or COBRA administrator explaining that you’ve exhausted your COBRA coverage
- A printer to print the form
- An envelope and postage to mail the form, or a fax machine. Each form includes instructions on where to send it.
How to apply:
- Print the Application for Waiver of Pre-Existing Waiting Period (PDF).
- Fill out and sign the Application for Waiver of Pre-Existing Waiting Period.
- Send us the application and any additional documentation by mail or fax.
|Blue Cross Blue Shield of Michigan
600 E. Lafayette Blvd.
Detroit, MI 48226
Mail Code X513
For more information, please contact us.