How To Use Your Health Plan When You Travel
June 8, 2023
Vacations should be restful and fun. The last thing you want to do when you are traveling is worry about your health insurance.
BlueCross BlueShield of South Carolina can help.
Coverage when you travel depends on where you are going and what kind of insurance you have. Are you traveling within South Carolina, nationally or internationally? Do you have group insurance through your employer, or did you buy insurance through the Marketplace as an individual?
Our experts share how BlueCross can help when you travel, no matter the type of insurance you have.
Before you go
Make sure you have created a My Health Toolkit® account and downloaded the app on your phone before you leave home. My Health Toolkit can do a lot for you. It can help you find a doctor, check your claims and understand your benefits.
But for traveling, the important thing it can do is store digital ID cards so you always have your health plan information with you. The app will also help if you need to reach someone at BlueCross while you are traveling. You can find important numbers there to call or send a message.
“One of my biggest recommendations is to call us if you have questions before you go,” says Heather Strickland, director of Major Group customer service.
My Health Toolkit gives members access to customer service even after hours.
Jennifer Millard, director of member services, says to keep that digital card handy so you can access service without delay.
It may be best to refill prescriptions before you travel. If a medication has a limit on refills, BlueCross can work with you to make sure you have the medicine you need before you travel.
Certain classes of drugs are more closely monitored and cannot be refilled. Be sure to plan ahead so you have the medication you need while you’re away.
If you forget or lose your medication, BlueCross can help you get a vacation override for an early refill. Many pharmacies can transfer prescriptions within the United States. Your normal pharmacy benefits and copay will apply.
Call the number on the back of your member ID card if you have any issues with your medications while traveling.
“We do the legwork behind the scenes and call the member to tell him or her where to pick up the medication and what it will cost,” Millard says.
If you need to fill your prescription overseas, you will pay the full price for the medication and file a claim with your plan when you return. You can visit our website or contact customer service for assistance filing your claim.
Remember to transfer the prescription back to your home pharmacy when you return from your trip.
Traveling in the state
If you are staying in South Carolina, you can use My Health Toolkit to find local doctors or other providers. You can also search the website here to find care.
Some health plans only offer local networks. This means in-network care is only available with certain doctors. This is where understanding your health plan can be key. Logging in to My Health Toolkit will allow you to search for in-network providers for your specific plan.
Traveling in the U.S.
Most BlueCross members with an employer-sponsored plan have coverage for care in all 50 states. There are a few exceptions.
BlueCross members traveling outside of the state can find a doctor through the Blue Cross Blue Shield Association website or through My Health Toolkit. They shouldn’t notice a difference in how those claims are handled, Strickland says.
If you have an individual plan through the Marketplace, coverage for care is limited outside of South Carolina unless it’s an emergency.
“To have coverage outside of South Carolina, it would have to be urgent or emergent,” Millard says. “That would be covered as in-network care. I always tell people not to worry about the network and just get to the closest urgent care facility.”
If you do seek care outside of the state, call the customer service team for help.
“Depending on the circumstances, we will see if we have any available recourses,” Millard says.
Most BlueCross employer-sponsored plans use Blue Cross Blue Shield Global® Core for international coverage. Members can get proof of coverage for countries that require it before travel.
Nonemergency care likely will be an out-of-pocket expense when you’re traveling. Members can file a claim when they get home through the Blue Cross Blue Shield Global Core website. You will need to fill out the paperwork for any care or prescriptions you got overseas once you return. Strickland says BlueCross will apply benefits as usual.
Individual members with a Marketplace plan also have coverage outside the country for emergency care through GeoBlue®. You will likely have to pay for this care up front. The BlueCross customer service team will work with you to file the claims when you return.
Members can also call the international care number on the ID card. If you have trouble, you can call the customer service number on the back of the card. The dedicated team for your plan will help you find what you need.
Everyone has emergency benefits. There is a higher level of benefits for true emergency room care. Recent laws ensure members do not get surprise medical bills for getting emergency care from a provider that is not in the network.
“Emergency care is always covered out of network and out of state,” Strickland says.
The law that protects members from surprise bills for emergency care includes air ambulance service. It does not include ground ambulance service.
Care in an emergency room for something that isn’t an emergency most likely will not be covered.
"Nine times out of 10, if it's a really bad cold and you go to the emergency room, the claim will probably be denied,” Millard says.
Virtual care can be a better option than waiting in an emergency room.
Virtual doctor visits are an important option to keep in mind when you travel. Through services like Blue CareOnDemandSM, members can see a doctor anywhere.
“It offers peace of mind to know that, if you are in an area that may not have a lot of in-network options, there is an option for help,” Strickland says.
In addition to routine care, Blue CareOnDemand offers behavioral health visits and lactation consultations. Doctors on these chats can call in prescriptions if you need one.
Some plans have different telehealth or virtual care options. You can check your benefits through My Health Toolkit. You can also check Blue CareOnDemand to see if you have access to the service.
“Nobody wants to go and find a location they aren’t familiar with if they aren’t feeling well. We want to make sure our members know about the virtual health option,” Millard says. “Enjoy your summer, and have peace of mind knowing that, if something happens, we are here to help and advocate in any way that we can.”
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