You must complete the application, listing all of your eligible dependents for whom you are applying for coverage. Unmarried dependent children are covered through the first of the month following their 26th birthday, or until they are no longer eligible dependents, whichever comes first.
When enrolling only your child, list his or her name as an "applicant." Complete a separate application for each child you want covered. A parent or guardian must sign applications for all children under 18 years of age.
If your application is approved, you will receive an identification card along with your contract packet.
Important: Acceptance to the program is not guaranteed. Do not cancel any health insurance coverage you have now until Blue Cross and Blue Shield of Kansas confirms your enrollment to the Short Term Medical Plan.
Mail your application to:
Blue Cross and Blue Shield of Kansas
Individual Sales Dept.
PO Box 517
Topeka, KS 66601
or you may fax your application to: 785-290-0716
Thank you for your interest in the Short Term Medical Plan. This program is designed to offer you choices and value for your health care dollar. If you have questions regarding the program, e-mail us at IndFamilyRep@bcbsks.com or call 1-800-641-1019, or 291-4306, in Topeka.