Arkansas Blue Cross and Blue Shield

My Application Short-term Blue

Apply Online

Apply Now



Thank you for applying for health insurance with Arkansas Blue Cross and Blue Shield. We know you have other choices, and we are grateful you chose us! We know your time is valuable, so we appreciate that you are taking the time to complete an online application for our Short-Term Blue plan.

PLEASE BE CERTAIN YOU ARE ELIGIBLE TO APPLY

We are sorry, but there are certain circumstances which will make you ineligible to apply for this short-term health insurance plan. Please read through the list below to make certain none of these apply to you before completing the application:

  • You are pregnant.
  • You have received consultation or treatment for the following: liver disorders; kidney disorders; chronic obstructive pulmonary disease (COPD); emphysema; diabetes, cancer (other than skin cancer); heart or circulatory system disorders; alcohol or drug abuse; immune system disorders (including HIV infection) or you have tested positive for HIV infection.
  • You are covered by Medicare or other insurance. (Short-Term Blue does not coordinate benefits with other health insurance, including other Arkansas Blue Cross policies.)
  • You are not an Arkansas resident.
  • The applicant is under six months of age or age 65 or older.

Additionally, you are ineligible to apply for this plan online if you:

  • Are not a U.S. citizen.
  • Are a non-custodial parent or guardian: If any dependent to be listed on this application does not reside with the proposed insured, an application including this dependent cannot be submitted online because the custodial parent also must sign the application. A guardian applying for coverage for a dependent child must submit court documentation with the application.

Special Note: So sorry … but if there is no activity after 20 minutes, your session will time out and the information you have entered will be lost.

AGAIN, THANK YOU FOR CHOOSING ARKANSAS BLUE CROSS!

Apply Now
 
Cancel
Cancel