Be sure to check your Insurance documents!

[bwink23]

OK, after much deliberating over the cost of overseas and no coverage, I decided to look at my insurance policy with BCBS....this is what i found:


"When you travel outside of the United States, you still have access to your benefit as long as services are provided by a licensed physician or accredited hospital. " It then goes on to describe the BlueCard PPO program and how to find in-network doctors and hospitals.

Now, i had called the office before and they told me i have emergency coverage overseas, but no coverage for scheduled operations or things of that nature. So i was bummed about that. But, she wasn't completely sure.

Now that i have it in WRITING on my plan....should i just do it, and forego a pre-authorization ?? Has anyone else had this on their BCBS plan and still did not get covered??

I understand there is still the matter of "experimental." Does "experimental" get thrown out the window in an environment not bound by the FDA, so long as it is medically necessary?? Anyway, this is a big step in the right direction towards coverage. All i would have to do is prove that in Europe, it is not experimental(in case i do have to fight), which shouldn't be too difficult considering they've been doing it for 20+ years.

Anyone here have overseas coverage with Blue Cross Blue Shield and still didn't get covered?

[jasonhhh]

Originally Posted by bwink23

OK, after much deliberating over the cost of overseas and no coverage, I decided to look at my insurance policy with BCBS....this is what i found:


"When you travel outside of the United States, you still have access to your benefit as long as services are provided by a licensed physician or accredited hospital. " It then goes on to describe the BlueCard PPO program and how to find in-network doctors and hospitals.

Now, i had called the office before and they told me i have emergency coverage overseas, but no coverage for scheduled operations or things of that nature. So i was bummed about that. But, she wasn't completely sure.

Now that i have it in WRITING on my plan....should i just do it, and forego a pre-authorization ?? Has anyone else had this on their BCBS plan and still did not get covered??

I understand there is still the matter of "experimental." Does "experimental" get thrown out the window in an environment not bound by the FDA, so long as it is medically necessary?? Anyway, this is a big step in the right direction towards coverage. All i would have to do is prove that in Europe, it is not experimental(in case i do have to fight), which shouldn't be too difficult considering they've been doing it for 20+ years.

Anyone here have overseas coverage with Blue Cross Blue Shield and still didn't get covered?

don't get preauthorization that's what kills the chance of getting reimbursed go have the surgery as long as doctors and hospital are in network your good to go this is the standard back surgery operation overseas

[bwink23]

Confused....if they are in-network with BCBS and they recognize it as the standard back surgery outside the U.S, then why would pre-authorization kill the chance for reimbursement?

Anyways, my policy states...

"Most hospitals and doctors in foreign countries will ask you to pay the bill up front. Try to get itemized receipts, preferably written in English."


Most likely i will have to pay the "upfront" bill. So i guess pre-authorization wouldn't really be necessary? If Clavel's office is in-network, why wouldn't they just submit the billing themselves? I don't know, got questions i need answered.