The Blue Card program and California health insurance plans

What is the Blue Card program and how does it help California health insurance members?

First, what is the Blue Card program?

The Blue Card program is offered by the nationwide Association of Blue Cross Blue Shield. It does not apply to HMO networks or plans. The Blue Card program essentially extends a members network to Blue Cross Blue Shield providers in other States for PPO plans. This is a huge benefit to going with Anthem Blue Cross or Blue Shield of California in our State. Other carriers may have a network (either shared or their own) in other States but the other carriers generally do not have the breadth to compete with the Blue Card network. This option is important if you travel to other States (for vacation or work) or if your company offers California group health benefits and you have employees outside the State. There are some States such as Hawaii who do not participate so it's important to verify at www.bluecard.com to make sure a given State participates in the network.

How does the claims side work with the Blue Card Network?

When a claim is filed in another State to a Blue Cross Blue Shield provider. the claim goes through the state in which the services occurs. That BCBS then forwards the claim through the Blue Card system and network to the home BCBS (two separate companies in California: Anthem Blue Cross or Blue Shield of California). The home BCBS then processes the claims as usual. The system is pretty seamless to a member here in California. As usual, you need your ID card and/or number. There is a three letter prefix which tells the Blue Card network which State to bill ultimately. We have had groups with employees in multiple States with no issues relating to the processing of the claims through this Blue Card system.

International coverage for PPO members as part of Blue Card

BlueCard Worldwide� provides Blue Cross and Blue Shield members with access to a network of traditional inpatient, outpatient and professional healthcare providers around the world. The program includes a range of medical assistance and claim support services for members traveling or living in countries outside their Home Plan service area.

Find a Doctor or Hospital Worldwide

BlueCard Doctor and Hospital Finder (you will be sent to the BlueCard Worldwide website)
BlueCard Worldwide Service Center Inside the U.S.: 1.800.810.BLUE (2583)
BlueCard Worldwide Service Center Outside the U.S. (call collect): 1.804.673.1177

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When You Need Healthcare Outside The U.S.

Always carry your Blue Cross and Blue Shield identification card.
Check with your Blue Cross and Blue Shield company before leaving the U.S. because your health care benefits may be different outside the U.S.
If you need emergency medical care, go to the nearest hospital. Call the BlueCard Worldwide Service Center at 1.800.810.BLUE (2583) or call collect at 1.804.673.1177 if you're admitted.
If you need non-emergency inpatient medical care, you must call the BlueCard Worldwide Service Center. The Service Center will facilitate hospitalization at a BlueCard Worldwide hospital or make an appointment with a doctor. It is important that you call the BlueCard Worldwide Service Center in order to obtain cash-less access for inpatient care except for your usual out-of-pocket expenses (e.g., deductible, coinsurance). The Service Center is staffed with multilingual representatives and is available 24 hours a day, seven days a week.
Call your local BCBS company for pre-certification or prior authorization, if necessary. Refer to the phone number on the back of your card.

Claims Filing and Payment Information

For inpatient care at a BlueCard Worldwide� hospital that was arranged through the BlueCard Worldwide Service Center, 1.800.810.BLUE (2583), you only pay the provider the usual out-of-pocket expenses (non-covered services, deductible, co-payment and co-insurance). The provider files the claim for you.
For all outpatient and professional medical care, you pay the provider and submit a claim. You may also have to pay the hospital (and submit a claim) for inpatient care obtained from a non-BlueCard Worldwide� hospital or when inpatient care was not arranged through the BlueCard Worldwide Service Center.
To submit a claim, you complete an International Claim Form and send it to the BlueCard Worldwide Service Center. The claim form must be completed fully otherwise it will be returned to you and payment will be delayed. Please click here for an example of a completed form.

Download an International Claim Form

You will need Adobe Acrobat Reader to open the International Claim Form. You can get the Acrobat Reader at www.adobe.com.

Neither the Blue Cross and Blue Shield Association nor any of its independent Licensees shall be liable for any losses, damages, or uncovered charges as a result of using the BlueCard Worldwide Service Center or receiving care from any provider listed on this site.