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big RB

Anyone used BLUE CROSS/BLUE SHIELD of California in the Philippines?

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big RB

           As a retirement benny, I get Blue Cross/Blue Shield of California PPO. Which claims to pay any hospital anywhere in an emergency. Anyone used it here with any success ( or failure). They claim all the hospital has to do is call them within 24 hours, and be an accredited hospital. But Silliman in Dumaguete was not able to deal with them a few years ago. So I ask if anyone knows of any in country?

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NOSOCALPINOY
Below are a few comments from the U.S. Blue Cross Blue Shield Health Insurance Coverage from the 

International Assistance Coordinator

AXA Assistance USA, agent for FEP Overseas

 

For anyone here in the Philippines that has US Blue Cross Blue Shield Health Insurance.

It was confirmed that all the major hospitals that used to accept it as primary coverage has dropped it for the time being. This has nothing to due with Blue Cross Blue Shield itself but with the underwriter, a company called AXA International who handles all the international claims for Blue Cross. This company just took over at the beginning of the year and for some reason has not completed the accreditation process with the Philippines. The good news is, the process has started and somewhere in the bureaucratic process between countries. Once the process is complete at least Asian Hospital and St. Lukes will again start accepting it again. Who knows how long the process will take.

A notice from BCBC some time back that AXA was taking over international claims. If you go to the BCBC website and then to MyBlue at the bottom of that page you will find minimal information about AXA being the international partner.

 

AXA reference BCBS; Although it still doesn't answer about St. Lukes or Asian in NCR Luzon it does specifically state they have a recent contract with The Medical City and their clinic. 

 

As a federal employee you do have worldwide Blue Cross Blue Shield coverage through the Federal Employee Program; however, please keep in mind that Blue Cross Blue Shield has a network of “participating providers” that are contracted to accept your insurance card within the U.S. territory. We do not have such a network overseas like we do domestically. It has always been the ultimate decision of the providers overseas either to accept or deny your request to set up direct billing. This is not something we have any control over.

 

We have recently signed a contract with The Medical City network of hospitals in the Philippines; however, some of them have not been willing to accept our Guarantee of Benefits Letters for outpatient visits. Again, this is the decision of the hospitals and we have no control over that. I do recommend you contact the closest location to you and see if they will accept our Guarantee of Benefits (GOB) Letter for outpatient treatment.

Under the FEP program, medical benefits for outpatient services—which is defined as any treatment that does not result in a hospital stay of more than 24 hours—are to be paid upfront by yourself and then you are eligible to file for reimbursement. This is the only service that Blue Cross and Blue Shield guarantees. For inpatient hospitalization—which is defined as treatment that results in a hospital stay for more than 24 hours—we will attempt to set up direct billing and you will only be responsible for your co-pay, deductible and any items that are not covered by your policy. This is not guaranteed, and again is ultimately the decision of the provider.

 

About Medical City in Manila. They do in fact have a contract with AXA who underwrites for Blue Cross Blue Shield overseas, but it is only good at the hospital itself and not the outlying clinics.

 

One of our network of clinics here in Manila. To clarify, we have an existing agreement with AXA USA which started last March 2013. However, the agreement only covers The Medical CIty HOSPITAL which is located in Pasig City. For your convenience, you may directly call or go to International Patient Services (IPS) located at the 2nd flr of our Podium Building for any assistance or queries regarding authorization or coverage.

 

Assistant Manager 

Relationship Management and Business Development

THE MEDICAL CITY


The Medical City is one of the US JCI accredited hospitals in Manila.

 

Not sure what's going with St. Lukes,and Asian Hospital is in a world of their own. Previously BCBS did have a contract with St. Lukes but got dropped for some reason. Just guessing that it was all about BCBS changing their Underwriter to this AXA USA for the overseas claims. It sounds like all the original contracts in the Philippines were voided when this company took over and now this firm has to go back to square one and renegotiate everything. At least for sure now that The Medical City will take care of billing the insurance company directly. Plus, Medical City is JCI accredited which means members should get the same level of care one would expect from a stateside hospital.

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lopburi3

FEP Blue is not the same as poster has.  And that information is old (AXA took over 18 months ago) and currently there are agreements for direct billing for inpatient stay with 4 Cebu hospitals per there directory

 

Believe for any other Blue Cross or normal US insurance payment will be required first and then itemized bills submitted for reimbursement on forms that insurance says to use.  Unless you can get hospital to contact and work with insurance directly and assign payment.  

Edited by lopburi3

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NOSOCALPINOY

FEP Blue is not the same as poster has.  And that information is old (AXA took over 18 months ago) and currently there are agreements for direct billing for inpatient stay with 4 Cebu hospitals per there directory

Believe for any other Blue Cross or normal US insurance payment will be required first and then itemized bills submitted for reimbursement on forms that insurance says to use.  Unless you can get hospital to contact and work with insurance directly and assign payment.  

The OP didn't mention anything about it being FEP Blue or not or just plain Blue Cross! He stated he has BCBS aka Blue Cross Blue Shield of California and also Canada has their own version of the health coverage! I don't know the OP personally, but just trying to help answer his question! He can contact AXA's website and deal with them directly! 

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big RB

My retirement is from California Public Employees Retirement System, CalPERS. But it is a Blue Cross affiliate that changes names ever few years. Anthem Blue for example. M

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big RB

             I had typed 4 paragraphs, but when it would not post I lost it. Weather is bad here now. Anyway, never heard of AXA, need to get in touch with them. I got no password for the link above.

             If anyone can name some of the 4 hospitals in Cebu I will go by and talk to them next month. I been ignoring this since 2010, but I am pissing blood at night so I better get serious.

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big RB

      I would still like to hear from anyone who has actually used American Blue Cross in the Philippines.

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lopburi3

You should not need a password - that directory site is open.

 

FEP Blue is the Federal Employee Plan and is not the same as others which is why I mentioned it - that letter was specific to FEP plan - it fully covers worldwide and is not limited to emergency treatment.  I use it regularly here in Thailand but have always used the pay/submit bill option rather than direct payment (which is only available for inpatient most places). 

 

For Cebu below is current listing of member hospitals:

1CHONG HUA HOSPITAL 0.96 +63 32 255 8000   2CEBU DOCTOR'S UNIVERSITY HOSPITAL 2.53 +63 32 255 5555   3VISAYAS COMMUNITY MEDICAL CENTRE 0.35 +63 32 253 1901   4PERPETUAL SUCCOUR HOSPITAL 1.65 +63 32 233 86 20  
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lopburi3

 

 

but I am pissing blood at night so I better get serious.

I would not wait for insurance as a visit/testing should be within financials and then can make claim with paid bills.  Hopefully nothing serious - it could just be you are passing stones and can solve problem by drinking more water during hot weather so bladder does not get too empty at night (even if you have to get up a time or two extra).

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