The BlueCard^® Program

Contact Us

• Health Advantage: 800-843-1329
• ASE/PSE members: 800-482-8416

As a Health Advantage health plan member, your healthcare needs will be met when you are traveling or living outside of Arkansas. Your ID card is your link to coverage and network providers throughout the United States and across the world.

Blue Cross Blue Shield Global® Core [pdf] is a national program that allows traditional and PPO members to receive the same healthcare benefits and balance billing protection of their local Blue Plan when traveling or living outside of their Plan's area.

How the BlueCard Program Works

When you are a Health Advantage member, your benefits travel with you wherever you go, both in the United States and around the world. When members travel or live out-of-state, they can take advantage of the Blue Plan provider relationships in other states because they are a Blue Plan member. By using BlueCard participating providers, you will reduce your out-of-pocket expenses and will not receive "balance billing" from participating providers for covered services.

To use the BlueCard program, members should:

• Always carry your most current Health Advantage ID card.
• When you're outside of Arkansas, pull out your ID card and call BlueCard access at 800-810-BLUE (2583) for information on the nearest Blue Cross and Blue Shield doctors and hospitals in the area where you are traveling or living. For other questions, call Health Advantage Customer Service.
• When you arrive at the doctor's office or hospital, present your Health Advantage ID card, and the doctor's office or hospital will verify your membership and coverage.
• After you receive medical attention, your claims will be routed to Health Advantage by the Blue Plan in that area.
• All participating providers are paid directly, relieving you of any hassle or worry for covered benefits claims submission and processing. You usually will need to pay only for out-of-pocket expenses (non-covered services, deductibles, copayments or coinsurance).

Health Advantage will send you a detailed Explanation of Benefits (EOB) report. Your EOB also is available under Blueprint Portal. After a member has received care, in most cases, the member should:

• Not have to file any claim forms.
• Not have to pay upfront for medical services except for the usual out-of-pocket expenses (non-covered services, deductible, copayment and coinsurance).
• Receive an Explanation of Benefits (EOB) from Health Advantage. Your EOB also is available under Blueprint Portal.

The BlueCard program has three components:

1. National Coverage
   Any Blue Plan member can take advantage of the program when traveling or living in another Blue Plan area anywhere in the country. More than 85 percent of all hospitals and physicians throughout the United States contract with Blue Cross and Blue Shield Plans. The BlueCard program links each of these healthcare providers.

2. BlueCard PPO
   Members of Blue Plan-affiliated preferred provider organizations (PPOs), such as True Blue PPO, may take their cost-saving benefits and negotiated healthcare provider discounts with them around the nation. BlueCard PPO links Blue Plan PPO network doctors and hospitals to Blue Plans throughout the United States.

   If you or your family are traveling or living in another Blue Plan's area, you can present your ID card to any BlueCard PPO doctor or hospital. An estimated 95 percent of the U.S. population lives in areas covered by Blue Cross and Blue Shield PPOs.

   BlueCard doctors and hospitals will recognize your BlueCard PPO membership by a special "PPO in a suitcase" symbol on your ID card. You do not need to fill out a claim form for this service.

3. Coverage Abroad
   Blue Cross Blue Shield Global® Core lets you use your ID card to receive covered inpatient care at participating hospitals in many countries around the world. Blue Cross Blue Shield Global® Core participating hospitals are located in major travel destinations and business centers around the world. When you're traveling or temporarily living outside the United States and require inpatient hospital care, show your ID card to any of these participating hospitals, and your claim will be handled just like it is at home.

Finding a Provider

The BlueCard® program makes it easy for you to obtain information about doctors and hospitals participating with a Blue Cross and Blue Shield Plan outside your Blue Plan's area. Simply pull out your ID card and call BlueCard Access® at 800-810-BLUE (2583) for the names and addresses of participating doctors and hospitals in the area where you are traveling or living. If you are traveling abroad, you can use the toll-free number outside the United States by using an AT&T Direct® Access Number.

On the Internet, to find a BlueCard healthcare provider anywhere from coast to coast and to view a map with detailed driving instructions, visit the National Doctor & Hospital Finder.

Information for Members Traveling Outside Arkansas

If you are a member of Health Advantage and are traveling out of state, Health Advantage is considered your "home" Plan. When you are traveling in another state, the Blue Cross Plan in the other state is your "host" Plan. Arkansas, as your home Plan, always will be responsible for the "member relationship." The host Plan manages the "provider relationship." If you are traveling out of state and need medical care, call 800-810-BLUE (2583) to find the name of the nearest participating hospital. If it is an emergency, go directly to the nearest hospital’s emergency room. When you travel out-of-state, you can take advantage of the provider relationships in other states because you are a Blue Plan member. By using BlueCard® participating providers, you will reduce your out-of-pocket expenses and will not be "balance billed" by participating providers for covered services.

Information for Members Living Outside Arkansas

If you are a member of Health Advantage and are living out of state, Health Advantage is considered your "home" Plan. When you are living in another state, the Blue Cross Plan in the other state is your "host" Plan. Arkansas, as your home Plan, always will be responsible for the "member relationship." The host Plan manages the "provider relationship." If you are living out of state and need medical care, call 800-810-BLUE (2583) to find the name of the nearest participating hospital. If it is an emergency, go directly to the nearest hospital’s emergency room. When you live out-of-state, you can take advantage of the provider relationships in that state because you are a Blue Plan member. By using BlueCard® participating providers, you will reduce your out-of-pocket expenses and will not be "balance billed" by participating providers for covered services.

Non-Participating Provider

You have the option of using a non-participating hospital or doctor, but you may have to pay that provider directly and then file a claim with Health Advantage for reimbursement of covered expenses. Also, a non-participating provider may not accept the plan's allowances as payment in full; therefore, you would be responsible for any account balance above these allowances. Coverage may vary, so contact Health Advantage for details.

Emergencies

In case of an emergency, seek immediate care from the nearest provider.

"Medical Emergency" is defined as follows: medical care and treatment provided after the sudden onset of a medical condition that manifests itself by acute symptoms, including severe pain. Symptoms are severe enough that, in the judgment of a reasonable person, the lack of immediate medical attention could reasonably be expected to result in any of the following:

• The patient’s health would be placed in serious jeopardy; or,
• Bodily function would be seriously impaired; or,
• There would be serious dysfunction of a bodily organ or other part of the body.

Frequently Asked Questions (FAQ)

1. Where do I go to receive medical care if I am traveling or living outside of Arkansas (my home Blue Plan service area)?
   If it's an emergency, go directly to the nearest hospital. To find a doctor or hospital in the area where you are traveling or living, call 800-810-BLUE (2583).
2. What do I pay for services?
   The benefits under your Health Advantage home Plan will be applied. For example, if your copayment is $100 in Arkansas, it will be $100 no matter where you are visiting or living.
3. How does the claim get filed?
   The host Blue Plan will file the claim.
4. What telephone number should I call for customer service if I live out of state?
   And, what number do I call for service when I return to Arkansas? Call your home plan number at the top of this page.
5. How can I get a prescription filled when I am traveling or living outside of Arkansas?
   To find a participating pharmacy, call the pharmacy telephone number on the back of your ID card.
6. How long will the entire process take?
   The entire process — from the time the claim is filed until it is finalized and paid — could be from 14 to 24 days. The amount of time also depends on whether there are any issues that need resolution.
7. Can I visit an out-of-network provider when traveling or living in another area?
   You have the option of using a non-participating hospital or doctor, but you may have to pay that provider directly and then file a claim with Health Advantage for reimbursement of covered expenses. Also, a non-participating provider may not accept the plan's allowances as payment in full; therefore, you would be responsible for any amount over these allowances. Coverage may vary, so contact Health Advantage for details.