Healthcare coverage when you are traveling or living abroad

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1 Healthcare coverage when you are traveling or living abroad As a Blue Cross and Blue Shield member, you take your healthcare benefits with you when you are abroad. Through the Blue Cross Blue Shield Global Core program, you have access to doctors and hospitals around the world. To take advantage of the program: Always carry your current member ID card. Before you travel, contact your Blue Cross and Blue Shield (BCBS) company for coverage details. Coverage outside the United States may be different. If you need to locate a doctor or hospital, call the Service Center for Blue Cross Blue Shield Global Core (see number below). An assistance coordinator, in conjunction with a medical professional, will arrange a physician appointment or hospitalization if necessary. If you need inpatient care, call the Service Center (see number below) to arrange direct billing. In most cases, you should not need to pay upfront for inpatient care except for the out-of-pocket expenses (noncovered services, deductible, copayment and coinsurance) you normally pay. The hospital should submit the claim on your behalf. In addition to contacting the Service Center, call your BCBS company for precertification or preauthorization. Refer to the phone number on the back of your member ID card. Note: This number is different from the phone number listed below. For outpatient and doctor care or inpatient care not arranged through the Service Center, you may need to pay upfront. Complete a Blue Cross Blue Shield Global Core International claim form and send it with the bill(s) to the Service Center (the address is on the form). You can also submit your claim online or through the Blue Cross Blue Shield Global Core mobile app. The claim form is available from your BCBS company or online at In an emergency, go directly to the nearest hospital. To learn more about Blue Cross Blue Shield Global Core: Visit Use the Blue Cross Blue Shield Global Core app for Android*, iphone, and ipod touch.** (Rates from your wireless provider may apply). Call your BCBS company. Call the Service Center at or collect at , 24 hours a day, seven days a week. The Blue Cross Blue Shield Global Core program was formerly known as BlueCard Worldwide. Blue Cross, Blue Shield, the Blue Cross and Blue Shield symbols, BlueCard, BlueCard Worldwide, and Blue Cross Blue Shield Global are trademarks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. *Android is a trademark of Google Inc. **Apple, the Apple logo, ipod touch, and itunes are trademarks of Apple Inc., registered in the U.S. and other countries. iphone is a trademark of Apple Inc. App Store is a service mark of Apple Inc N35

2 Notice of Nondiscrimination and Availability of Language Assistance Services CareFirst BlueCross BlueShield, CareFirst BlueChoice, Inc. and all of their corporate affiliates (CareFirst) comply with applicable federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability or sex. CareFirst does not exclude people or treat them differently because of race, color, national origin, age, disability or sex. CareFirst: Provides free aid and services to people with disabilities to communicate effectively with us, such as: Qualified sign language interpreters Written information in other formats (large print, audio, accessible electronic formats, other formats) Provides free language services to people whose primary language is not English, such as: Qualified interpreters Information written in other languages If you need these services, please call If you believe CareFirst has failed to provide these services, or discriminated in another way, on the basis of race, color, national origin, age, disability or sex, you can file a grievance with our CareFirst Civil Rights Coordinator by mail, fax or . If you need help filing a grievance, our CareFirst Civil Rights Coordinator is available to help you. To file a grievance regarding a violation of federal civil rights, please contact the Civil Rights Coordinator as indicated below. Please do not send payments, claims issues, or other documentation to this office. Civil Rights Coordinator, Corporate Office of Civil Rights Mailing Address P.O. Box 8894 Baltimore, Maryland Address civilrightscoordinator@carefirst.com Telephone Number Fax Number You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint portal, available at or by mail or phone at: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C , (TDD) Complaint forms are available at CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., CareFirst BlueChoice, Inc., First Care, Inc. and The Dental Network are independent licensees of the Blue Cross and Blue Shield Association. Registered trademark of the Blue Cross and Blue Shield Association. Registered trademark of CareFirst of Maryland, Inc. SUM3735-1P (5/17)

3 Notice of Nondiscrimination and Availability of Language Assistance Services Foreign Language Assistance

4 Notice of Nondiscrimination and Availability of Language Assistance Services

5 Notice of Nondiscrimination and Availability of Language Assistance Services

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