Making a Health Insurance Claim is Easier Than You Think

 

No matter how much you plan for a vacation, unforeseen illnesses and injuries can sneak up on you. Maybe it’s a broken arm while you’re skiing or strep throat during a beach vacation. In those situations, when you need medical care while away from home, you may end up seeing an out-of-network doctor or going to a non-participating pharmacy to get a prescription filled.

Because you visited a non-participating doctor or pharmacy, you may have to pay for your services yourself out of your own pocket. This depends on what type of plan you have—a PPO, HMO or EPO network plan. Once you return home, submit a claim to Blue Cross Blue Shield of Michigan for review. If it’s determined that the service was covered, Blue Cross will reimburse you for any part of the cost included in your plan, such as for medical, hearing, and vision services. Keep in mind that emergency services are covered if you’re visiting an out-of-network hospital or doctor.

Making a claim is simple and is done in three steps:

  1. Fill out a claim form (if you were in a different country, fill out an international claims form). You will need to have your insurance card handy. If more than one person in your family is submitting a claim, a separate form will be needed for each person.
  2. Attach original copies of your receipts to the claims form. The receipt should be an itemized list of services that were provided. (Make a copy of the claims form and the receipts for your own files.)
  3. Mail the claim to the address on top of the form.

As a Blue Cross member, you’re part of our overall mission and voice to keep Michigan healthy, happy and covered. Being a member has benefits that go beyond receiving first-class medical coverage. And one of the most important benefits: That blue-and-white card in your wallet gives you the confidence and peace of mind to know that you’ve made the right choice in selecting a health care plan.

To sign up for health coverage or reenroll for 2016, call a health plan advisor at 888-899-4931 or visit the Blue Cross Blue Shield of Michigan open enrollment website, bcbsm.com/myblue, for more information.

To learn more about health plan options from Blue Cross, these blogs may help:

 

Photo credit: Alexis O’Toole

 

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