SPECIAL ENROLLMENT PERIOD

A new Special Enrollment Period (SEP) will be available through August 15, 2021 due to the COVID-19 pandemic.

This means you can still apply for a 2021 Blue Cross and Blue Shield of Texas (BCBSTX) Individual health plan for yourself and family during this time.

IMPORTANT INFORMATION ABOUT THIS NEW SEP

Here are some important things to know before buying your 2021 BCBSTX Individual health plan in this new SEP.

Health Plan Effective Dates

Your BCBSTX plan’s effective date will automatically be the first of the month following the month you select your plan:

• Example 1: If you buy your health plan between May 15 - May 31, 2021 your effective date will be June 1, 2021.
• Example 2: If you buy your health plan between June 1 - June 30, 2021, your effective date will be July 1, 2021.
• Example 3: If you buy your health plan between July 1 – July 31, 2021, your effective date will be August 1, 2021.

Out-of-Pocket Costs

If you have a 2021 BCBSTX health plan, you may have begun paying out-of-pocket costs. If you buy a new BCBSTX health plan, this amount you've paid may count toward your new plan's deductible.

To qualify, your health plan must have started within 30 days of when your current coverage ends.

If you have questions, please call the number on the back of your member ID card. You can also ask your independent licensed agent for more information

Note: If you already have a BCBSTX health plan and have a qualifying life event, such as birth of a child, you can still make changes to your current plan. You’ll need to apply and provide proof of the qualified life event’s date. A birth certificate is a good example. View a full list of required documents .

YOU MAY QUALIFY FOR A SUBSIDY

Good news! Health care coverage may now be more affordable than you think.

You can check to see if you qualify for a subsidy, also known as a premium tax credit, while applying during SEP. This credit may help you lower the amount you’ll pay for your monthly premium bill.

SEP QUALIFYING LIFE EVENTS

If you’re buying a BCBSTX health plan during the new SEP offered February 15 – August 15, 2021, you will not have to provide proof of a qualifying event. Your health care coverage will begin on the first of the month after you apply.

However, as a reminder, if you currently have a BCBSTX health plan, there are many kinds of life events that may qualify you to change your health plan’s effective date.

Major life changes:

• You have or adopt a child or gain a dependent through a court-order
• The policy holder passed away
• You move to a new area that provides you different plans or isn't covered by your HMO network
• You get married
• You are no longer covered on a family member's policy because you turned 26
• You have legally separated from or divorced your spouse

Employment or Financial changes:

• You lose other health coverage due to job loss, a decrease in work hours, end of COBRA coverage or other reasons¹
• Your income or household status changes
• Your employer offered to help with the cost of coverage (through an ICHRA or QSEHRA)

Other Qualifying events:

• Your current health care coverage is ending on a date other than December 31st of the current plan year
• You become a U.S. citizen²
• You can prove that your health insurance company violated its contract with you
• You become a member of an American Indian and Alaska Native tribe²
• You experience an error or other issue when trying to enroll

View a full list of qualifying events .

Not All Life Events Qualify

Remember, if you’re buying a health plan during the new SEP being offered February 15 – August 15, 2021, you will not have to provide proof of a qualifying event.

However, as a reminder, not all major life events will qualify you for an SEP outside of this new Special Enrollment Period.

Non-qualifying events may be:

You can always call us at 1-888-697-0683 or use the contact form if you have questions or need help.

APPLYING DURING SEP

You have three ways to buy your plan during this new SEP

• Online - You can buy your health plan on our website
• Phone - Call 1-888-731-0406 to speak with a BCBSTX licensed sales representative
• Agent – Work with an independent, authorized agent to sign you up

While your application is being reviewed, we’ll send you a letter if more documentation is needed. You’ll have 30 days from this letter’s date to reply.

OTHER HEALTH CARE COVERAGE OPTIONS

You may also qualify for Medicaid, Children’s Health Insurance Program (CHIP) or other assistance based on your income. These health care coverage options are provided by the government. There’s no SEP, so you can apply at any time. You may also qualify for financial help.

Note: Members of American Indian and Alaska Native tribes can apply for health care coverage any month of the year.

¹Please note that the following are not considered loss of coverage: voluntarily canceling your health insurance plan, having your plan canceled because you did not pay your premiums or because your plan did not meet the requirements set by the Affordable Care Act for Minimum Essential Coverage.

²Only for health plans bought on the Marketplace.

³BCBSTX does not offer temporary or short-term plans. These plans may not provide the full benefits of a BCBSTX health plan, including essential health benefits.