Many U.s. Blue Cross Policies Cover "urgent Care" Worldwide. Anybody Filed A Claim?

[Lopburi99]

I have a Medicare Advantage Health Plan with Blue Care Network, a Blue Cross/Blue Shield health insurance company in the U.S. I knew I had coverage here (worldwide) for emergency room treatment but in reviewing my policy I now notice "Urgent Care" also is covered (with a small copay). "Urgently Needed Care is a non-emergency, unforeseen medical illness, injury or condition, that requires immediate medical care. The unforeseen condition could be, for instance, an unforeseen flare-up of a known condition you have."

My goodness this is significant! To some extent it means I DO, in fact, have health coverage here for all sorts of important medical care! It is the emergency or "Urgently needed" care which I mostly am concerned about being able to cover financially. I never even considered something like a sprained ankle, for example, would be covered since it isn't a life threatening emergency. If I read the policy correctly, since it was unforeseen, and arguably needed immediate care - it appears to be.

Recently I filed a claim for emergency room treatment I received at Bangkok Hospital in Chanthaburi and am awaiting an outcome.

Has anybody filed either an emergency or urgent care claim with a BCBS company?

Edited February 17, 2013 by Lopburi99

[chris1dna]

I sure hope you follow up with the outcome. I am very interested in this also. When I retire, one of the co provided med plans is the blue cross one u describe. I will be provided free upon my retirement. Would be nice to know it actually covers and delivers when needed.

Sent from my iPhone using ThaiVisa app

[lopburi3]

I file routinely for treatment with FEP Blue Cross but my plan is specific for Government Service so full coverage anywhere. Have found them very good and payment normally made within a 3-6 week window of filing (by online fax). Some Thai hospitals will accept for direct in-patient payment. Expect may take longer by local systems where translations/exchange rates must be figured out. I expect with the low costs here for most treatments your plan will consider claims in a positive light.

[Lopburi99]

"The unforeseen condition could be, for instance, an unforeseen flare-up of a known condition you have."

In other words, pre-existing conditions are covered. Jeez, such medical coverage is probably not even available (or affordable) in Thailand! Especially for a 66 y/o health problematic expat like me.

This really is good news because I never thought hospital treatment say for instance [another] kidney stone attack would possibly be covered here but it clearly is. I would pay only a small copay.

Live and learn. Given this information I may not have booked a flight to the U.S. next month for a variety of treatment/tests/etc. It will certainly be a determining factor when I return again.

(Note: I do not know for sure if worldwide coverage is included in all BCBS policies, probably not. Be sure to confirm before counting on it).

Edited February 18, 2013 by Lopburi99

[Lopburi99]

Received my claim check from BCBS some time ago, yes the claim was accepted. BUT, was considered an "out-of-network" doctor so they only paid 50%.

Ok, next time I'll look for an in-network doctor here.

But better than not being covered at all, as for most other U.S. insurance companies.

Edited August 29, 2013 by Lopburi99

[Mike45]

I've read that many Advantage plans will cover urgent care but for a limited number of months outside the USA.

[NancyL]

When used to travel back-and-forth between Thailand and the U.S., we checked out that our BCBS plan would cover urgent care. They listed accepted hospitals on their website -- there were many in Thailand. But, there was a limit to how long you could be out of the U.S. and claim coverage. Now that we're here full-time, we've dropped the BCBS and acquired other global health insurance. (Actually, it's not really global -- we're covered anywhere in the world EXCEPT the U.S.. Says something about the cost of U.S. medical care doesn't it?)