HMSA members, except those covered by the HMSA Children’s plan, have benefits for medical services delivered outside the U.S. through the BlueCard Worldwide network.
Note: The HMSA Children’s Plan covers emergency services, but urgent care isn’t a benefit.
PPO plan benefits
HMSA’s PPO plans cover medical services delivered outside the U.S. by both participating BlueCard Worldwide providers and nonparticipating providers. To get the best benefit, visit a BlueCard Worldwide provider. You’ll pay more of the total costs if you see a nonparticipating provider.
Note: Participating BlueCard Worldwide providers may be available in some areas for inpatient services. However, all outpatient services outside the U.S. are delivered by nonparticipating providers.
HMO plan benefits
HMSA’s HMO plans cover limited services outside the U.S. Emergency services are a benefit. Urgent care is also a benefit when services are received from a BlueCard Worldwide provider. All other medical services must have a referral from your primary care provider and approval from HMSA before services are rendered or you’ll bear the entire cost of services, which can be significant.
Please refer to your Guide to Benefit or call HMSA Customer Relations for information about your specific plan benefits.
Payment for services outside the U.S.
You may be responsible for the total charge in full at the time of service for outpatient services. You may also be responsible for the total charge in full at the time of service for inpatient services received from a nonparticipating provider. HMSA will reimburse you for part of the costs, based on your plan benefits, when your claim is processed.
HMSA pays benefits based on the foreign currency conversion rate in effect at the time services were rendered. Reimbursement for medical services rendered in foreign countries are based on the actual charge you paid or the eligible charge for equivalent services in Hawaii, whichever is lower.
When services are delivered by nonparticipating providers, your share of the cost may include any copayment or coinsurance amounts, deductible amounts, and the difference between the total charge and the eligible charge for each service.
For more information about filing your claim to HMSA for services received outside the U.S., please read Filing Medical Claims for Services from Nonparticipating Providers. If you want to be reimbursed in the foreign currency of the country you’re visiting, you may file your claim with BlueCard Worldwide instead of HMSA. BlueCard Worldwide claim filing information can be found on the BlueCard Worldwide - When Traveling Outside the U.S. webpage.
For additional important information, we encourage you to read:
- Accessing Care Outside the U.S.
- Find a Participating Blue Cross Blue Shield Global® Core Provider
- Emergency Services and Urgent Care Outside the U.S.