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University of California - Davis | 06/18/2017 International Health Insurance for Higher Education GeoBlue ® Student Member Guide

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Page 1: GeoBlue Student Member Guide - Study Abroad · schedule a doctor visit or employ home remedies. Find a doctor or facility Review detailed profiles of contracted doctors to find the

University of California - Davis | 06/18/2017International Health Insurance for Higher Education

GeoBlue® Student Member Guide

Page 2: GeoBlue Student Member Guide - Study Abroad · schedule a doctor visit or employ home remedies. Find a doctor or facility Review detailed profiles of contracted doctors to find the

GeoBlue is the trade name of Worldwide Insurance Services, LLC (Worldwide Services Insurance Agency, LLC in California and New York), an independent licensee of the Blue Cross and Blue Shield Association. GeoBlue is the administrator of coverage provided under insurance policies issued in the District of Columbia by 4 Ever Life International Limited, Bermuda, an independent licensee of the Blue Cross Blue Shield Association. This coverage is offered to the members of the Global Citizens Association, Washington, D.C.

Welcome to GeoBlue, a program designed to keep you safe and healthy throughout your journey. Your GeoBlue® health insurance plan provides you access to global medical expertise with responsive, multi-channel service. Download our app or register online to learn about the extra care you receive when you travel with GeoBlue.

Your Guide to GeoBlue®

Getting Started Important plan information and health tools

Getting Care How to get care when you are abroad

Accessing Self-Service Tools Convenient online and mobile tools

Submitting a Claim File a claim for reimbursement

Reviewing Plan Benefits What is covered by your plan?

Page 3: GeoBlue Student Member Guide - Study Abroad · schedule a doctor visit or employ home remedies. Find a doctor or facility Review detailed profiles of contracted doctors to find the

geobluestudents.com

This pamphlet contains a brief summary of the features and benefits for insured participants covered under your school health insurance. This is not a contract of insurance. Coverage is provided under an insurance policy under which your school is a participating school. Coverage is provided under insurance policies issued by 4 Ever Life International Limited, Bermuda. Complete information on the insurance is contained in the Certificate of Insurance which is on file with the school and is made available to all insured participants. If there is a difference between this program description and the certificate wording, the certificate controls. GeoBlue is the trade name of Worldwide Insurance Services, LLC (Worldwide Services Insurance Agency, LLC in California and New York), an independent licensee of the Blue Cross and Blue Shield Association. GeoBlue is the administrator of coverage provided under insurance policies issued in the District of Columbia by 4 Ever Life International Limited, Bermuda, an independent licensee of the Blue Cross Blue Shield Association. This coverage is offered to the members of the Global Citizens Association, Washington, D.C.

Getting Started Important plan information and health tools

Need help with registration?Contact us for assistance:

Inside the U.S. call 1.844.268.2686 Outside the U.S. call +1.610.263.2847 [email protected]

Get your GeoBlue ID cardIt is important to have your GeoBlue ID card to access healthcare services; you will need to present your ID card whenever you receive medical care. This card can be accessed from multiple sources:

• Your ID card(s) will be mailed to you

• You can show, fax or email your ID card through the app

• Your ID card is available in the Member Hub on www.geobluestudents.com

• Customer Service can provide replacement ID cards

When you receive your ID card, please check the information for accuracy. Call Customer Service if you find an error.

Download the GeoBlue app to registerDownload our app from the Apple, Amazon or Google Play app stores to put your plan in the palm of your hand:

• Display an electronic ID card

• Locate carefully selected, trusted providers and hospitals outside of the U.S.

• Arrange direct payment to your provider

• Access global health and safety tools including translations, drug equivalents, news and safety information

• Submit and track claims

You can also register online at www.geobluestudents.com.

Visit the GeoBlue Member HubVisit the Member Hub on www.geobluestudents.com to view important plan information and to access convenient self-service tools. Login with the username and password you created when you registered through the app. If you have not previously registered through the app, you can register directly online.

Page 4: GeoBlue Student Member Guide - Study Abroad · schedule a doctor visit or employ home remedies. Find a doctor or facility Review detailed profiles of contracted doctors to find the

GeoBlue is the trade name of Worldwide Insurance Services, LLC (Worldwide Services Insurance Agency, LLC in California and New York), an independent licensee of the Blue Cross and Blue Shield Association. GeoBlue is the administrator of coverage provided under insurance policies issued in the District of Columbia by 4 Ever Life International Limited, Bermuda, an independent licensee of the Blue Cross Blue Shield Association. This coverage is offered to the members of the Global Citizens Association, Washington, D.C.

1. Find a providerOutside the U.S. you have access to care through the GeoBlue provider network. To find a contracted doctor or facility, visit the “Provider Finder” section in the Member Hub on www.geobluestudents.com or in the app. For optimal service, request Direct Pay at least 48 hours prior to your appointment to avoid paying out-of-pocket for medical care and submitting claims.*

Outside of the U.S. you are free to see any provider you choose without a reduction of benefits. If you see a non-contracted provider, you may have to pay out of pocket for treatment and submit a claim.

2. Schedule an appointmentTo schedule an appointment, choose a participating provider or hospital through the Member Hub or app. Contact them directly using the information in their profile. After you make your appointment, contact us to provide the doctor’s office with the information required to arrange Direct Pay. For optimal service, request Direct Pay at least 48 hours prior to your appointment. This is necessary when scheduling follow-up appointments as well. In many countries providers require payment at the time of the visit unless Direct Pay has been arranged.

Contact us to arrange for Direct Pay:

• Use www.geobluestudents.com or the GeoBlue app

• Email [email protected]

• Call collect on +1.610.254.8771

• Call toll free inside the U.S. on 1.800.257.4823

3. Request Direct PayTo avoid paying up front for medical care and submitting a claim, arrange for Direct Pay:*

• Use www.geobluestudents.com or the GeoBlue app to find a provider, view a profile and complete a request form

• Email [email protected] the name of your provider, the reason for your appointment and the date and time of your scheduled visit

• Call collect on +1.610.254.8771

For optimal service, request Direct Pay at least 48 hours prior to your appointment.

Getting Care Get care when you are abroad: find providers and schedule appointments

geobluestudents.com

In the event of a medical emergencyYou should go immediately to the nearest physician or hospital and then call the Medical Assistance phone number for 24/7 care located on the back of your ID card. We will then take the appropriate action to assist and monitor your medical care until the situation is resolved.

*Members are required to pay any applicable copayments, coinsurance or deductibles at the time of service.

Page 5: GeoBlue Student Member Guide - Study Abroad · schedule a doctor visit or employ home remedies. Find a doctor or facility Review detailed profiles of contracted doctors to find the

GeoBlue is the trade name of Worldwide Insurance Services, LLC (Worldwide Services Insurance Agency, LLC in California and New York), an independent licensee of the Blue Cross and Blue Shield Association. GeoBlue is the administrator of coverage provided under insurance policies issued in the District of Columbia by 4 Ever Life International Limited, Bermuda, an independent licensee of the Blue Cross Blue Shield Association. This coverage is offered to the members of the Global Citizens Association, Washington, D.C.

geobluestudents.com

*Certain limitations and exclusions apply to your coverage under this plan and may affect your coverage. Your Certificate of Insurance is on file with your school and in the Member Hub on www.geobluestudents.com.

The Political, Military and Natural Disaster Evacuation Services (PEND) are provided through Drum Cussac Group Ltd. (Drum), an independent third party, non-affiliated service provider based in the UK. Drum does not supply Blue Cross or Blue Shield products or other benefits, and is therefore solely responsible for and accepts all liability for PEND and other collateral services it provides. GeoBlue makes no warranty, express or implied, and accepts no responsibility resulting from the provision or use of Drum PEND or other Drum services.

Prescription benefitsYour prescription medications are covered at 100%.* Simply pay out of pocket and submit a claim for reimbursement. Submit claims electronically using the GeoBlue app or the “File an eClaim” link on the Member Hub. If you prefer to submit a paper claim form, click “How to File a Claim” in the Member Hub on www.geobluestudents.com to download the appropriate claim form.

Service requests If you need assistance with any non-urgent medical issue, you can submit a service request directly to our Global Health and Safety team. Common service requests include help managing prescriptions and finding specialists overseas.

To place a service request, visit the “Service Requests” section in the Member Hub on www.geobluestudents.com.

Assistance with appointment schedulingWhile it’s often easier to set up your own appointments, we can help when you are unsure about where to seek care. You may have a new diagnosis, be in a remote area with limited options, in need of translation, or struggling to adapt to your new surroundings.

To request help scheduling a convenient, cashless office visit with one of GeoBlue’s trusted English-speaking doctors. Contact us 24/7: +1.610.254.8771.

Getting Care Get care when you are abroad: prescriptions, assistance and other services

Page 6: GeoBlue Student Member Guide - Study Abroad · schedule a doctor visit or employ home remedies. Find a doctor or facility Review detailed profiles of contracted doctors to find the

GeoBlue is the trade name of Worldwide Insurance Services, LLC (Worldwide Services Insurance Agency, LLC in California and New York), an independent licensee of the Blue Cross and Blue Shield Association. GeoBlue is the administrator of coverage provided under insurance policies issued in the District of Columbia by 4 Ever Life International Limited, Bermuda, an independent licensee of the Blue Cross Blue Shield Association. This coverage is offered to the members of the Global Citizens Association, Washington, D.C.

Visit www.geobluestudents.com or download the GeoBlue app to access self-service tools for navigating risks and finding the

best care options.

geobluestudents.com

Check your symptoms* Translate symptoms into action with this authoritative triage tool. You can decide to seek treatment in an emergency room, schedule a doctor visit or employ home remedies.

Find a doctor or facilityReview detailed profiles of contracted doctors to find the best match and then locate the office.

Translate medications Find country-specific equivalents for prescription and over-the-counter medications.

Translate medical terms and phrases Translate hundreds of key medical phrases and terms into the most widely spoken languages with audio clips and transliterations.

Understand health and security risks Receive daily alerts detailing the latest security and health issues in your destination. View country or city profiles on crime, terrorism or natural disasters.

Accessing Self-Service Tools Convenient online and mobile tools

*Available on www.geobluestudents.com only.

Page 7: GeoBlue Student Member Guide - Study Abroad · schedule a doctor visit or employ home remedies. Find a doctor or facility Review detailed profiles of contracted doctors to find the

GeoBlue is the trade name of Worldwide Insurance Services, LLC (Worldwide Services Insurance Agency, LLC in California and New York), an independent licensee of the Blue Cross and Blue Shield Association. GeoBlue is the administrator of coverage provided under insurance policies issued in the District of Columbia by 4 Ever Life International Limited, Bermuda, an independent licensee of the Blue Cross Blue Shield Association. This coverage is offered to the members of the Global Citizens Association, Washington, D.C.

geobluestudents.com

Submitting a Claim File a claim for reimbursement

eClaimsYou can quickly and conveniently submit claims electronically, through the app or through the Member Hub on www.geobluestudents.com. Scanned paper documents are delivered directly to our Claims Department and your eClaims are saved in the Claims section of the Member Hub.

Choose “Claims” in the GeoBlue app or visit the “File an eClaim” section of the Member Hub on www.geobluestudents.com.

Email and faxIf you prefer to submit a claim via email or fax, a printable claim form and detailed instructions are available in the Member Hub on www.geobluestudents.com.

Visit the “How to File a Claim” section of the Member Hub on www.geobluestudents.com and click “How do you file a claim with GeoBlue?” to download the appropriate claim form.

Email: [email protected]

Fax: +1.610.482.9623

Postal mailIf you prefer to submit a claim via postal mail, a printable claim form and detailed instructions are available in the Member Hub on www.geobluestudents.com.

Visit the “How to File a Claim” section of the Member Hub on www.geobluestudents.com and click “How do you file a claim with GeoBlue?” to download the appropriate claim form.

Claims Incurred Outside the U.S., Puerto Rico and U.S. Virgin Islands:

GeoBlue, Attn: Claims Department, P.O. Box 1748, Southeastern, PA 19399-1748, USA.

Checking the status of your claimTo check your claim status, choose “Claims” in the GeoBlue app or visit the “View My Claims” section of the Member Hub on www.geobluestudents.com.

Page 8: GeoBlue Student Member Guide - Study Abroad · schedule a doctor visit or employ home remedies. Find a doctor or facility Review detailed profiles of contracted doctors to find the

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100 Matsonford Road, One Radnor Corporate Center, Suite 100, Radnor PA 19087

1.855.682.7965 | 1.610.254.5300 | fax 1.610.482.9953

GeoBlue is the trade name of Worldwide Insurance Services, LLC (Worldwide Services Insurance Agency, LLC in California and New York), an independent licensee of the Blue Cross and Blue Shield

Association. GeoBlue is the administrator of coverage provided under insurance policies issued in the District of Columbia by 4 Ever Life International Limited, Bermuda, an independent licensee of the

Blue Cross Blue Shield Association. This coverage is offered to the members of the Global Citizens Association, Washington, D.C.

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Page 9: GeoBlue Student Member Guide - Study Abroad · schedule a doctor visit or employ home remedies. Find a doctor or facility Review detailed profiles of contracted doctors to find the

100 Matsonford Road, One Radnor Corporate Center, Suite 100, Radnor PA 19087

1.855.682.7965 | 1.610.254.5300 | fax 1.610.482.9953

GeoBlue is the trade name of Worldwide Insurance Services, LLC (Worldwide Services Insurance Agency, LLC in California and New York), an independent licensee of the Blue Cross and Blue Shield

Association. GeoBlue is the administrator of coverage provided under insurance policies issued in the District of Columbia by 4 Ever Life International Limited, Bermuda, an independent licensee of the

Blue Cross Blue Shield Association. This coverage is offered to the members of the Global Citizens Association, Washington, D.C.

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Page 10: GeoBlue Student Member Guide - Study Abroad · schedule a doctor visit or employ home remedies. Find a doctor or facility Review detailed profiles of contracted doctors to find the

100 Matsonford Road, One Radnor Corporate Center, Suite 100, Radnor PA 19087

1.855.682.7965 | 1.610.254.5300 | fax 1.610.482.9953

This is not meant to be a complete list of exclusions and exclusions can vary by policy.

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Page 11: GeoBlue Student Member Guide - Study Abroad · schedule a doctor visit or employ home remedies. Find a doctor or facility Review detailed profiles of contracted doctors to find the

100 Matsonford Road, One Radnor Corporate Center, Suite 100, Radnor PA 19087

1.855.682.7965 | 1.610.254.5300 | fax 1.610.482.9953

This is not meant to be a complete list of exclusions and exclusions can vary by policy.

! " # $ % & ' ( ) * + $ ( , - $ . , / $ . $ 0 & , 1 2 + 3 4 & 1 & 3 . 0 3 + ) 3 1 1 % 5 $ , 3 3 + ( + & 1 & . 6 0 + 3 - ( - 3 , 3 + 4 $ 7 & ' ) $ ' ' & % $ . , & 0 , 7 $ 8 3 4 $ + $ % 9 $ + 1 3 .3 2 $ + ( , $ % , 7 $ 4 $ 7 & ' ) $ : & , 7 3 5 , ( 2 + 3 2 $ + ) & ' $ . 1 $ & . , 7 $ ; 5 + & 1 % & ' , & 3 . : 7 $ + $ , 7 $ ' ' & % $ . , 3 ' ' 5 + + $ % "< = " ! . % $ + , 7 $ ' ' & % $ . , ( ) " $ ( , 7 ( . % " & 1 - $ - > $ + - $ . , 2 + 3 4 & 1 & 3 . ? 0 3 + ) 3 1 1 3 0 ) & 0 $ 3 + % & 1 - $ - > $ + - $ . , 0 3 + 3 + ( + & 1 & . 6 0 + 3 - ( . ' ' & % $ . , & . , 7 $ 8 3 4 $ + $ % 9 $ + 1 3 . @ 1 A 3 - $ 8 3 5 . , + B "< C " D . 2 ( , & $ . , + 3 3 - ( . % > 3 ( + % ' 7 ( + 6 $ 1 & . ' 3 . . $ ' , & 3 . : & , 7 ( A 3 1 2 & , ( ) 1 , ( B 2 + & - ( + & ) B 0 3 + % & ( 6 . 3 1 , & ' , $ 1 , 1 : 7 & ' 7 ' 3 5 ) % 7 ( 4 $> $ $ . 2 $ + 0 3 + - $ % 1 ( 0 $ ) B 3 . ( . 3 5 , 2 ( , & $ . , > ( 1 & 1 "< " * $ ) $ 2 7 3 . $ ? $ E - ( & ) ? ( . % D . , $ + . $ , ' 3 . 1 5 ) , ( , & 3 . 1 5 . ) $ 1 1 1 2 $ ' & 0 & ' ( ) ) B ( 2 2 + 3 4 $ % > B , 7 $ % - & . & 1 , + ( , 3 + % 5 $ , 3 ) & - & , $ %+ $ 1 3 5 + ' $ 1 : 7 & ) $ ) 3 ' ( , $ % & . ( ' 3 5 . , + B 3 5 , 1 & % $ 3 0 , 7 $ ! . & , $ % F , ( , $ 1 "< < " G + , 7 3 2 $ % & ' 1 7 3 $ 1 # $ H ' $ 2 , : 7 $ . ; 3 & . $ % , 3 > + ( ' $ 1 $ 3 + 1 7 3 $ & . 1 $ + , 1 ? & . ' ) 5 % & . 6 3 + , 7 3 , & ' 1 "< I " * 3 , 7 $ $ H , $ . , , 7 ( , 1 5 ' 7 2 ( B - $ . , 1 : 3 5 ) % > $ 2 + 3 7 & > & , $ % > B ) ( : "

Page 12: GeoBlue Student Member Guide - Study Abroad · schedule a doctor visit or employ home remedies. Find a doctor or facility Review detailed profiles of contracted doctors to find the

GeoBlue is the trade name of Worldwide Insurance Services, LLC (Worldwide Services Insurance Agency, LLC in California and New York), an independent licensee of the Blue Cross and Blue Shield Association. GeoBlue is the administrator of coverage provided under insurance policies issued in the District of Columbia by 4 Ever Life International Limited, Bermuda, an independent licensee of the Blue Cross Blue Shield Association. This coverage is offered to the members of the Global Citizens Association, Washington, D.C.

100 Matsonford Road, One Radnor Corporate Center, Suite 100, Radnor, PA 19087

©2016 GeoBlue

For questions about your medical plan:

Outside the U.S. call +1.610.263.2847 Toll free within the U.S. call 1.844.268.2686

[email protected]

For medical assistance,(including Direct Pay outside the U.S.):

Collect calls accepted on +1.610.254.8771 Toll free within the U.S. call 1.800.257.4823

[email protected]