Your UGA health coverage while traveling

(Before you travel, contact Employee Benefits (706-542-2222) to see if details have changed.)

Indemnity | PPO | HMO Summary chart

Indemnity plan:

Under the Indemnity plan, you may go to any doctor or hospital of your choice. However, to avoid balance billing* from providers who are not Blue Cross Blue Shield (BCBS) providers, contact BCBS customer service to find a BCBS provider in the area.

Indemnity within Georgia
For BCBS providers in Georgia, contact BCBS of Georgia (BCBSGA) customer service at 1-800-424-8950. This telephone number is listed on your indemnity plan identification card.

Indemnity outside Georgia
For providers in the BCBS National Provider Network (outside the state of Georgia), contact BCBS Association Customer Service at 1-800-810-BLUE. This telephone number is listed on your indemnity plan identification card.

Indemnity precertification situations
For services requiring precertification by UNICARE, regardless of whether you use a BCBS National Participating Provider or a non-participating physician, it is your responsibility to obtain the necessary precertification from UNICARE for the hospital confinement or for a prescribed outpatient procedure/diagnostic test. You should contact UNICARE at least 48 hours prior to the scheduled procedure or confinement, unless it is an emergency.

Indemnity international care
If you receive medical care while traveling outside the United States, you must pay the provider at the time medical services are rendered. You will have one year from the date of service to file a paper claim and receive reimbursement from BCBSGA. International care will result in a balance billing* situation.

Indemnity emergency care
If you get an emergency room referral from MedCall, you'll receive a higher level of benefit coverage. Contact MedCall at 1-800-785-0006.
See chart below.

PPO plan:

PPO within Georgia
If you need medical care within the state of Georgia (and in selected areas of the border states surrounding Georgia), in order to get the highest level of benefit coverage, you should visit a 1st Medical Network Provider. For information on network providers within the state of Georgia, call 1st Medical Network at 1-800-675-6492. If you choose to use an out-of-network provider, you still have some benefit coverage, but at a lower percentage. Be aware: Out-of-network services are subject to the “National In-Network/Out-of Network” deductible and balance billing* issues.

PPO outside Georgia
Outside Georgia, in order to receive the highest level of benefit coverage, you should see a provider in the Beech Street Network. For information regarding the National PPO Network (Beech Street), call Blue Cross Blue Shield of Georgia Customer Service at 1-800-424-8950. If you choose to use a national (Beech Street) in-network provider, most eligible services will be covered at 80%. Be aware: Even if you use a national in-network (Beech Street) provider, these services are subject to the “National In-Network/Out-of Network” deductible.

PPO out-of-network services
If you choose to use an out-of-network provider, you will have some benefit coverage, but at a lower percentage (most eligible services will be covered at 60%). Be aware: Out-of-network services are subject to balance billing* and to the “National In-Network/Out-of-Network” deductible.

PPO international care
If you receive medical care while traveling outside the United States, you must pay the provider at the time medical services are rendered. You will have one year from the date of service to file a paper claim and receive reimbursement form BCBSGA. International care will result in a balance billing* situation.

PPO precertification situations
For services requiring precertification, if you receive medical care from a national network (Beech Street) provider, or from an out-of-network provider, it is your responsibility to contact UNICARE at 1-800-233-5765 for pre-certification. You should contact UNICARE at least 48 hours prior to the scheduled procedure or confinement, unless it is an emergency.

PPO emergency care
If you get an emergency room referral from MedCall, you'll receive a reduction in your emergency room co-payment. Contact MedCall at 1-800-785-0006. Important note: If you are admitted to a national network (Beech Street) hospital or to an out-of-network hospital, it is your responsibility to contact UNICARE (1-800-233-5765) within 48 hours after the admission.
See chart below.

HMO plan:

HMO within Georgia
In network services are those services either provided or coordinated by your Primary Care Physician (PCP). In order to receive care from a specialist, you must have a referral from your PCP. You still must select a specialist provider from the network. If your PCP does not coordinate the services or you receive medical services from a provider out-of-network, these services are not covered.

HMO outside Georgia
The HMO network includes providers in the state of Georgia. There is no coverage for services provided out-of-network, except in cases of life-threatening medical emergencies.

HMO international care
There is no coverage for services provided out-of-network, except in cases of life-threatening medical emergencies.

HMO pre-authorization
For services requiring pre-authorization, your PCP or the specialist to whom you were referred by your PCP will be responsible for obtaining the necessary prior authorization for surgical procedures or inpatient admissions.

HMO emergency care
Life threatening emergency care or treatment for a medical emergency is covered at any hospital emergency room. Use of an emergency room for conditions that are not medical emergencies is not covered. See chart below.

* Balance billing is the difference between the amount a physician charges and the Usual, Customary and Reasonable (UCR) or network rate the insurance company has established as the reimbursement rate. If you are subject to balance billing, you will be responsible for paying the difference to the provider.

If you are traveling outside the United States, you may wish to purchase travel insurance. View the UGA Office of International Education travel abroad page.

In summary:

	In Georgia	In another state	Outside the United States	Emergency care
Indemnity	Contact BCBSGA Customer Service at 1-800-424-8950 to find a provider.	Contact BCBS Association Customer Service at 1-800-810-BLUE for a BCBS National Participating Provider.	Pay the provider at the time services are rendered. File a claim within one year from the date of service to receive reimbursement. International travel will result in balance billing* issues.	Emergency room referrals by MedCall will result in a higher level of benefit coverage. Contact MedCall at 1-800-785-0006.
PPO	Contact 1st Medical Network at 1-800-675-6492 to find a provider.	Contact BCBSGA Customer Service at 1-800-424-8950 to find a Beech Street Provider.	Benefit coverage will be paid at the out-of-network rates. Pay the provider at the time services are rendered. File a claim within one year from the date of service to receive reimbursement. International travel will result in balance billing* issues.	Emergency room referrals by MedCall will result in a reduction in your emergency room co-pay. Contact MedCall at 1-800-785-0006.
HMO	In-network care must be received from or coordinated by your primary care physician (PCP). Must have a referral from PCP to see a specialist.	No coverage except in cases of life-threatening emergency.	No coverage except in cases of life-threatening emergency.	For emergency room referrals, contact Blue-Choice on Call at 1-888-724-2583. Must have referral from primary care physician or Blue Choice on Call.