Important tips for receiving care outside the U.S. • Always carry your UMP member ID card. • If you need emergency medical care, go to the nearest hospital. • If you need urgent medical care, contact the Blue Cross Blue Shield Global® Core Service Center for help finding a network provider. • If you are admitted to the hospital, call the Blue Cross Blue Shield Global® Core Service Center to notify the plan of your admission. Blue Cross Blue Shield Global® Core contact and online information Contact Blue Cross Blue Shield Global® Core to learn about services received outside the U.S., find a provider outside the U.S., or submit a claim for medical care provided outside the U.S. • Call the Blue Cross Blue Shield Global® Core Service Center at 1-800-810-BLUE (2583), or call collect 1-804-673-1177 (available 24 hours a day, 7 days a week). • To use the online provider search tool, register and sign in on the Blue Cross Blue Shield Global® Core website at bcbsglobalcore.com. • Visit the Blue Cross Blue Shield Global® Core website on the Blue Cross Blue Shield Global® Core website at bcbsglobalcore.com. After you create an account, you may find Blue Cross Blue Shield Global® Core information, get an international claim form, and submit claims electronically. Finding a preferred provider outside the U.S. Under Blue Cross Blue Shield Global® Core, you have access to network providers outside the U.S., including hospital care (inpatient and outpatient) and professional provider services at network rates. To find a contracted provider outside the U.S., register and sign in on the Blue Cross Blue Shield Global® Core website at bcbsglobalcore.com or call the Blue Cross Blue Shield Global® Core Service Center: 1-800-810-BLUE (2583) or collect at 1-804-673-1177. What you pay for medical services Deductibles A deductible is a fixed dollar amount you pay each calendar year before the plan begins paying for covered services. Your medical deductible amount is $750 per member, with a maximum of $2,250 per family. When you first get services, you pay the first $750 in charges. After you pay that first $750, the plan begins to pay for covered services. This applies to each covered member, up to the $2,250 maximum. Your medical deductible applies to all services unless otherwise stated in this COC. See below for services that are not subject to your medical deductible. Services apply to your UMP medical deductible in the order claims are received, not necessarily in the order the member receives the services. Note: You also pay a separate deductible for prescription drugs. See the “What you pay for prescription drugs” section for more information. 2024 UMP Select (PEBB) Certificate of Coverage 23