FAQs

Frequently asked questions about overseas coverage.

Overseas

Overseas Coverage

Am I covered overseas?

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. Physician care performed outside the U.S. is paid at the Preferred level using an Overseas Fee Schedule or a provider-negotiated amount. 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 Worldwide Assistance Center offers emergency evacuation services only to the nearest facility that is adequately equipped to treat your condition. Benefits are not available to transport you to a facility in the United States unless it is the closest facility that can provide adequate treatment. Benefits are not available for evacuation in the event of a natural disaster.

What is a direct billing or guarantee of benefits arrangement?

A direct billing or guarantee of benefits arrangement is an agreement between AXA Assistance, our overseas vendor, and our overseas providers. When a provider agrees to a direct billing arrangement they will bill AXA directly so there’s no need for you to file a claim. These providers also agree to accept our allowance as payment in full for their services.

How do I arrange a direct billing or guarantee of benefits arrangement?

You can ask AXA Assistance to work with your provider to arrange a direct billing or guarantee of benefits arrangement by contacting our Worldwide Assistance Center. If you’re in the U.S., Puerto Rico or the U.S. Virgin Islands, call 1-800-699-4337. If you’re overseas, call 001-804-673-1678.

I received inpatient care earlier this year and my claim was processed, but the provider didn’t have a direct billing or guarantee of benefits arrangement at the time of processing. Can I request a direct billing or guarantee of benefits arrangement now?

Please contact our Worldwide Assistance Center. If you’re in the U.S., Puerto Rico or the U.S. Virgin Islands, call 1-800-699-4337. If you’re overseas, call 001-804-673-1678.

Filing a Claim

How do I file a claim?

You can file your overseas claims by completing your claim form online by logging into your MyBlue account or by mailing or faxing your claim.

How do I file a claim online?

Filing your overseas medical and pharmacy claims online is easy and provides faster processing and claims payment. You can do so by logging on to our secure member website, MyBlue®.

  • Use your username and password to sign in at www.fepblue.org/myblue. If you are new to MyBlue, go to www.fepblue.org/signup to set up an account. Please note that you will need a PIN to complete registration, which you can get by calling the customer service number on the back of your member ID card during regular business hours. If you are overseas, please call customer service at 1-888-999-9862 from 3:00 a.m. – 6:00 p.m. Eastern time, Monday through Friday.
  • Once you have signed in, click on “Health Tools” on the top tool bar, then under “Get Care” select the option “Submit Overseas Claim.”
  • In order to submit claims electronically, you will need:

    • Your policy information.
    • Claim(s) information.
    • Relevant receipts or bills.
    • Adobe® Reader software.

    How do I file a claim by mail or fax?

    You can find our Overseas Medical Claim Form and the Retail Prescription Drug Overseas Claim Form in the forms library, or you can call 1-888-999-9862 to request that we send you the claim forms.

    If you access a claim form on our website, you can enter the information directly on the form; print a copy to send to us and save a copy for your records.

    In most situations, you will need to pay the provider up front and submit a completed Overseas Medical Claim Form and your itemized bills to us at:

    Federal Employee Program
    Overseas Claims
    P.O. Box 261570
    Miami, FL 33126

    You may also fax your claims to us at 001-410-781-7637 (or 1-888-650-6525 toll-free).

    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 section B (Authorization for the Assignment of Benefits) of the charges and payment information on the claim form, and leaving the Member Payment Information and section A (Bank Wire Information) 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 claim 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, Puerto Rico, and the U.S. Virgin Islands, 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

    You can also fax your claim to us at 001-480-614-7674.

    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.

    1. First, dial the AT&T Direct Access Code for the country from which you are faxing the claim.
    2. You will hear a recording asking you to enter the U.S. toll-free number you 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.

    What is an itemized bill?

    An itemized bill must be on the provider’s letterhead or the equivalent and must include:

    1. Name of the patient.
    2. Name and address of the person or firm providing the service or supply.
    3. Date for each service or supply. If your claim contains a range of dates, we must have the exact date, service rendered, and charge for each specified date within the range.
    4. Type or description for each service or supply.
    5. The diagnosis for each service or supply.
    6. The charge for each service or supply.

    Claims from a military facility must be made payable to the provider unless the claim contains proof that the member has already paid the provider. The itemized bill or receipt from the provider must clearly state the claim was paid up front.

    Please note, we cannot accept a statement of account or a payment reminder as an itemized bill. To be considered valid and itemized, the bill must include the information listed above.

    Why was my claim returned to me?

    We need certain information in order to determine benefits and therefore, properly process your claim under the Service Benefit Plan. When we do not have the necessary information, it will delay the processing of your claim while we try to obtain it from you. Listed below are some commonly omitted items that cause claim delays. We hope that providing this information to you will enable us to serve you better by reducing delays.

    Commonly MISSING items on the Overseas Medical Claim Form and/or the provider’s bill include:

    1. Diagnosis or reason for treatment.
    2. Accident date or date of onset of injury.
    3. Patient’s complete name on both the bill and the claim form.
    4. U.S. brand name (or generic equivalent) for drugs purchased - if you do not have this information, please provide the insert that comes with the drug (usually a white sheet of paper that describes the drug).
    5. Description of medical or dental services performed.
    6. Description of surgical procedure performed.
    7. Length of time patient was anesthetized.
    8. Signature of the member.
    9. Dates of service - a range of dates, such as indicating “10 visits between January and March,” is not sufficient. We must have each individual date that medical service was provided. We also need to have inpatient dates of service when you are hospitalized.
    10. If available, please submit any supporting medical records, such as medical orders and notes with the claim to prevent unnecessary claim delays.

    How do I receive reimbursement?

    If you would like a wire transfer or payment in a foreign currency for your medical claims, fill out the bank wire information in the charges and payments section of the Overseas Medical Claim Form. Payments to members via wire transfer can only be made to the contract holder’s account.

    Please note a wire transfer or a check in the local currency may take longer to process than a paper check in U.S. dollars. If you do not request these options, payment will be made by check in U.S. 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 U.S. dollars.

    Note concerning the Authorization For Assignment of Benefits section on the claim form - Please remember that if you would like to have our payment assigned (made payable to the provider of service), the Authorization for Assignment of Benefits section on the Overseas Medical Claim Form must be completed in its entirety.

    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. 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 U.S. Therefore, if you have Medicare as your primary insurer and you receive services outside the United States and U.S. Territories, there is no need to send your claim 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 your primary insurance. This means that you will submit any claims for medical care to us first.

    Overseas Providers

    How do I find an overseas provider?

    We have a network of professional providers who have agreed to accept a negotiated amount as payment in full for their services. The Worldwide Assistance Center can help you locate a hospital or physician in our network closest to your area. You may also view a list of our network providers on our website. 

    If you are overseas and need assistance locating providers (whether in or out of network), contact the Worldwide Assistance Center.

    Overseas: 001-804-673-1678
    U.S., Puerto Rico, or the U.S. Virgin Islands: 1-800-699-4337 (toll-free)
    Email: fepoverseas@axa-assistance.us

    For your convenience, you can contact one of the multilingual operators at the Worldwide Assistance Center 24 hours a day, 365 days a year.

    Can I get a printed copy of the overseas provider directory?

    We are continuing our efforts to "go green" with your help; therefore, we no longer produce printed overseas provider directories. The online provider directory is your best source for provider information. It’s updated frequently and offers detailed, fully searchable information about our overseas network. You can also call the Worldwide Assistance Center and request a printed list of hospitals and providers in your area. If you are overseas, please call 1-804-673-1678. Members in the United States, Puerto Rico, or the U.S. Virgin Islands should call 1-800-699-4337.

    How can I get a directory if I don't have a computer?

    If you don’t have internet access, please contact the Worldwide Assistance Center to locate a hospital or physician in your area. If you are overseas, please call the center at 1-804-673-1678. Members in the United States, Puerto Rico, or the U.S. Virgin Islands should call 1-800-699-4337 or email the Worldwide Assistance Center at fepoverseas@axa-assistance.us.

    My provider is not listed in the directory. Do I need to change providers?

    You can maintain your existing provider relationship. You can confirm your out-of-pocket costs by calling the Worldwide Assistance Center. If you are overseas, please call the center at 1-804-673-1678. Members in the United States, Puerto Rico, or the U.S. Virgin Islands should call 1-800-699-4337.

    Can my provider join your overseas network?

    We are committed to expanding our overseas provider network. If you would like to nominate your provider, please complete a Provider Nomination Form and email your form to medical.network@axa-assistance.us, or fax it to 1-305-893-5055, Attn. International Medical Network. Click the link to download and save the form to your computer.

    Is there a way for me to know which providers already have a direct billing or guarantee of benefits in place?

    You can call our Worldwide Assistance Center. If you’re in the U.S., Puerto Rico or the U.S. Virgin Islands, call 1-800-699-4337. If you’re overseas, call 001-804-673-1678.

    If I don’t receive a direct billing or guarantee of benefits from the provider, what will be my cost share for inpatient services?

    Pharmacy

    Can I use my Mail Service Prescription Drug Program benefit overseas?

    If you have Standard Option or Basic Option with Medicare Part B primary, your coverage includes our Mail Service Pharmacy benefit. You can order prescription drugs through the Mail Service Pharmacy if your address has a U.S. ZIP code and the prescribing physician is licensed in the U.S. We suggest you contact Caremark directly to ensure your specific drug can be mailed overseas. You may contact them by calling 1-800-262-7890 or by writing to them at:

    Blue Cross and Blue Shield Service Benefit Plan
    Retail Pharmacy Program
    P.O. Box 52057
    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.

    I live in Germany, so how does that affect delivery of my drugs through the mail?

    CVS/caremark cannot accept orders through their mail order or specialty pharmacy for members with APO and FPO shipping addresses in Germany, due to current German law. Members must obtain their prescriptions at a local German pharmacy and submit the claim for reimbursement. Basic Option members must have Medicare Part B primary to be reimbursed for drugs ordered through the mail service, otherwise, they should use a retail pharmacy to receive benefits. Members will be charged the lesser of their mail order or retail cost share when submitting paper claims for covered drugs obtained at a local retail pharmacy in Germany on or after December 4, 2012. Claims should be submitted by fax to 001-480-614-7674 or online for reimbursement. Members residing in Germany with DPO military addresses may continue to receive non-cold pack medications delivery of mail order and specialty medications through CVS/caremark.