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Guidelines for Highmark Blue Cross Blue Shield West Virginia Individual Policies

Rates are based on five year age bands, demographics, and gender. When an individual moves from one age band to another, the new age band rates will apply in the beginning of the month in which the birthday occurs.

The dependent age limit is 26 (even if a full-time student). Coverage on a dependent reaching age 26 will terminate on the last day of the month in which the birthday occurs.

All medical questions must be answered YES or NO on the individual application.

All applications will be effective the first of the month. Mid-month effective dates are not available. Any application received after the first of the month will be effective the first of the following month.

The maternity rider can only be added at initial enrollment or at renewal. The election can only be changed once in the life of the contract. There is an additional cost for the maternity rider.

Any individual moving from one rating area to another area will be billed the appropriate rating area the first of the month following the move.

Coverage is only offered to West Virginia residents.

Individuals over age 65 are not eligible for Individual Coverage.

Medical History Questionnaires are considered invalid if they are more than 120 days old.

To protect confidentiality and limit any liability, Highmark West Virginia never releases the individual medical data compiled on the individual and/or their dependents.

Freestanding drug and vision riders are not available in this market segment. However, there is a vision discount program and free annual eye exam with Participating Vendors.