A. The HMO and PPO plans cover emergencies and urgent care when you are out of the service areas. Worldwide emergency coverage is available through the BlueCard program when HMO services are received outside of the HMO network, and when PPO services are received by providers not in the PPO network. These participating health care providers can be accessed at www.bcbstx.com or by calling (800) 810-2583 or calling collect (804) 673-1177.

See the chart below for applicable emergency HMO copayments and PPO coinsurance amounts. Whether you are covered under the HMO or the PPO, the provider may require you to pay more than your plan copayment or coinsurance. If this happens, seek reimbursement from BlueCross BlueShield of Texas for your out-of-pocket emergency medical expenses. Submit a completed claim form with original itemized receipts to BCBSTX, and BCBSTX will send your reimbursement, less your plan copayment or coinsurance for the emergency care you received. HMO members should contact their primary care physician within 48 hours after receiving emergency care.

You can get prescriptions at your plan’s copayment by using network pharmacies such as Walgreen’s, Sam’s Club, Wal-Mart, CVS or Target. If you use a non-network pharmacy in an emergency, you will pay full price. You can be reimbursed for this expense, less your plan copayment, by submitting a claim form to BCBSTX with original itemized receipts.

Q: Can I get reimbursed from my Healthcare Flexible Spending Account with foreign medical receipts?

A: You can get reimbursed for eligible out-of-pocket medical expenses if your receipt meets all requirements; the cost is shown in U.S. dollars; and if the prescribed drugs are FDA approved. Submit a completed claim form and an itemized statement of services to FLEXONE within 90 days of the plan’s year-end or within 90 days after you leave the city, whichever is soonest. The statement should include the patient’s name, provider’s name and address, date(s) of service, description of services, cost, and proof of your payment.

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