Overseas FAQs
- Am I covered overseas?
- Do I have benefits for evacuation?
- Does Caremark send medication overseas?
- What do I do if I need to find a provider?
- How do I file a claim?
- How do I fax overseas claims to a toll free number?
- What is an itemized bill?
- How do I get paid?
- What if my claims are in a different language and currency?
- What if I have Medicare or supplemental travel insurance?
- What types of providers are in your international provider network?
- What happens if a member needs inpatient care?
- Is pre-certification required when a member is hospitalized?
Yes, your Service Benefit Plan coverage protects you around the world. Benefits for covered services under both Standard and Basic Option are paid at the Preferred level. Professional care is paid at the Preferred benefit level based on the overseas fee schedule. You may be responsible for differences between our payment and the provider charge since overseas providers do not agree to accept our payment as payment in full in all cases. See Section 5(i) in the Service Benefit Plan brochure for more information about how benefits are paid for care performed overseas.
Do I have benefits for evacuation?
Our Overseas Assistance Center offers emergency evacuation services to the nearest facility to adequately treat your condition only. We do not consider benefits to transport you to the United States unless that is the closest facility that can provide adequate treatment. We do not consider benefits for evacuation in the event of a natural disaster.
Does Caremark send medication overseas?
If you have Standard Option, your coverage includes our Mail Service Pharmacy benefit. You can order prescription drugs through the Mail Service Pharmacy if your address has a US zip code, and the prescribing physician is licensed in the US. We suggest you contact Caremark directly to ensure your specific medication can be mailed overseas. You may contact them by calling 1-800-262-7890 or by writing to them at Caremark, P.O. Box 52080, Phoenix, AZ 85072-2080. You may be eligible for an extended filling of the prescription from Caremark while overseas or before going overseas, so you may also want to discuss this with Caremark. Please note this will require a prescription from your doctor for 12 months and is not applicable for controlled substances.
What do I do if I need to find a provider?
You can access a listing of overseas providers on our overseas assistance web site in the Provider Directory. You can also call our Overseas Assistance Center collect at 1-804-673-1678 or email the Center at FEPOverseas@mondialusa.com.
We do have a network of participating hospitals overseas. Although we do not have a network of physicians and other health care professionals, the Center can also help you locate a physician.
You do not have to use the providers in our network overseas.
You can find our Overseas Medical Claim Form and the Retail Prescription Drug Overseas Claim Form in the forms library , or you can request that we send you some claim forms.
If you access a claim form on our web site, you can enter the information directly on the claim form; print a copy to send to us.
In most situations, you will need to pay the provider up front and submit the medical charge(s) to us at Mail Room Administrator, FEP Overseas Claims, P.O. Box 14113, Lexington, KY 40512-4113. Effective 01/01/10, you may also fax your overseas claims to 1-888-650-6525 or 1-410-781-7637 (See below for instructions on how to fax claims). Payment for covered services will be sent to you. If the provider does not require payment at the time the care is performed, you may request we pay the provider directly by filling out 6B of the claim form and leaving 6 and 6A blank. Send the claim form along with the itemized bills from the provider to the address or fax number listed above and on the back of the form. Box 4 must include the diagnosis or reason for the services in order to process your claim.
To file a claim for covered drugs and supplies you purchase from pharmacies outside of the United States and Puerto Rico, send a completed Retail Prescription Drug Overseas Claim Form, along with itemized pharmacy receipts or bills to Blue Cross and Blue Shield Service Benefit Plan Retail Pharmacy Program P.O. Box 52057, Phoenix, AZ 85072-2057.
How do I fax overseas claims to a toll free number?
There is a two step process for faxing claims to our toll free number in the United States from most overseas locations.
- The international caller first dials the AT&T Direct Access Code for the country from which they are faxing.
- The caller will hear a recording asking them to enter the U.S. toll free number they want to fax. A "1" is not required before the toll free number.
AT&T has a dialing guide and a list of access codes available at
http://www.business.att.com/bt/dial_guide.jsp
An itemized bill must include:
- Name of the patient;
- Name and address of person or firm providing the service or supply;
- Date for each service or supply;
- Type or description for each service or supply;
- The diagnosis for each service or supply.
If you would like a wire transfer or payment in a foreign currency for your medical claims, be sure to follow the directions, and fill out boxes 6 and 6A on the Overseas Medical Claim Form. Please note the wire transfer or a check in the local currency may take longer than a paper check in US dollars. If you do not request these options payment will be made by check in US dollars.
Payments for covered drugs and supplies you purchase from pharmacies outside of the United States and Puerto Rico will only be made by check in US dollars.
What if my claims are in a different language and currency?
That is not a problem. When your claim is received, we will do the translation and currency conversion. The currency conversion is based on the date of service or the date you paid the bill, if you provide that information. For the most accurate currency conversion, please provide us a receipt with the date the bill was paid, the amount you paid and the exchange rate used if available.
What if I have Medicare or supplemental travel insurance?
Medicare does not provide benefits for care performed outside the US. Therefore, if you have Medicare as your primary insurer and services were rendered outside the United States and US Territories, there is no need to send your claim first to Medicare. Please send the completed claim form and itemized bills to us. We will consider benefits at 100% of our plan allowance.
If you choose a supplemental insurance plan to cover you while overseas, we will remain the primary insurance. This means that you will submit any claims for medical care to us first.
What types of providers are in your international provider network?
The provider network consists mainly of hospitals. Information regarding providers is available by contacting our Overseas Assistance Center directly at 1-800-699-4337 if you are in the US, collect at 1-804-673-1678, or via email at FEPOverseas@mondialusa.com.
What happens if a member needs inpatient care?
If the member is hospitalized at a participating provider, our Overseas Assistance Center will arrange for cashless access. This means you will not have to pay upon admission to the hospital. At the time discharge, you need only pay the out-of-pocket expenses, such as deductible, coinsurance and copayment amounts. If you are hospitalized at a non-participating hospital, our Overseas Assistance Center will try to negotiate this same cashless access but may not get the hospital to agree. In this case, you may be required to pay a deposit at the time of admission and all charges upon discharge. To request help with this type of care, contact our Overseas Assistance Center directly at 1-800-699-4337 if you are in the US or collect at
1-804-673-1678, if you are calling from outside the US.
Is pre-certification required when a member is hospitalized?
No, precertification is not required for inpatient services provided outside the US.
Page last updated: January 03, 2012