Services received outside the United States ALERT! The plan does not cover prescription drugs ordered through mail-order pharmacies located outside the U.S. See “Prescription drugs purchased outside the U.S.” on page 96 to learn more. Blue Cross Blue Shield Global® Core ALERT! Claims for services received outside the U.S. may take longer to process. UMP Customer Service is available to assist members with the Global® Core claim process. If you are outside the U.S., you may be able to take advantage of Blue Cross Blue Shield Global® Core when accessing covered health services. Blue Cross Blue Shield Global® Core is unlike the BlueCard® Program available in the U.S. in certain ways. For instance, although the Blue Cross Blue Shield Global® Core assists you with accessing a network of inpatient, outpatient, and professional providers, the network is not served by a Host Blue. As such, when you receive care from providers outside the U.S., you will typically have to pay the providers and submit the claims yourself to obtain reimbursement for these services. If you need medical services (including locating a doctor or hospital) outside the U.S., you should call the service center at 1-800-810-BLUE (2583) or call collect at 1-804-673-1177, 24 hours a day, 7 days a week. An assistance coordinator, working with a medical professional, will arrange a physician appointment or hospitalization, if necessary. Inpatient services In most cases, if you contact the service center for assistance, hospitals will not require you to pay upfront for covered inpatient services, except for your medical deductible, coinsurance, and copays. In such cases, the hospital will submit your claims to the service center to begin claims processing. However, if you paid in full at the time of services, you must submit a claim to receive reimbursement for covered health care services. Outpatient services Physicians, urgent care centers, and other outpatient providers located outside the U.S. will typically require you to pay in full at the time of services. You must submit a claim to obtain reimbursement for covered health care services. Submitting a Blue Cross Blue Shield Global® Core claim When you pay for covered health care services outside the BlueCard® service area, you must submit a claim to obtain reimbursement. For institutional and professional claims, complete a Blue Cross Blue Shield Global® Core claim form and send the claim form with the provider's itemized bill(s) to the service center (the address is on the form) to initiate claims processing. Following the instructions on the claim form will help ensure timely processing of your claim. The claim form is available from the claims administrator, the service center, or online at the Blue Cross Blue Shield Global Core® website at bcbsglobalcore.com. If you need assistance with your claim submission, you should call the service center at 1-800-810-BLUE (2583) or call collect at 1-804-673-1177, 24 hours a day, 7 days a week. 2024 UMP Plus–UW Medicine ACN (PEBB) Certificate of Coverage 27