The Blue Cross and Blue Shield Association, of which we are a member/Independent Licensee, administers a program called the Blue Card Program, in which we participate, which allows our Members to have the reciprocal use of Participating Providers that contract with other Blue Cross and/or Blue Shield Plans. Providers available to you through the Blue Card Program have not entered into contracts with Anthem Blue Cross. If you have any questions or complaints about the Blue Card Program, please call us at 1-800-333-0912.

If you are traveling outside of California and require medical care or treatment, you may use a local Blue Cross and/or Blue Shield Participating Provider. If you use one of these providers, your out-of-pocket expenses may be lower than those incurred when using a provider that does not participate with a local Blue Cross and/or Blue Shield Plan.

In order for you to receive access to whatever reductions in out-of-pocket expenses may be available, we must abide by the rules Blue Card Program rules, as set by the Blue Cross and/or Blue Shield Association.

When you obtain health care services through the Blue Card Program outside of California, the amount you pay for Covered Services is calculated on the lower of:

The billed charges for your Covered Services, or

The Negotiated Price that the on-site Blue Cross and/or Blue Shield (“Host Blue”) passes on to us.

Often, this “Negotiated Price” will consist of a simple discount which reflects the actual price paid by the Host Blue. But sometimes it is an estimated price that factors into the actual price expected settlements, withholds, any other contingent payment arrangements and non-claims transactions with your health care provider or with a specified group of providers. The Negotiated Price may also be billed charges reduced to reflect an average expected savings with your health care provider or with a specified group of providers. The price that reflects average savings may result in greater variation (more or less) from the actual price paid than will the estimated price. The Negotiated Price will also be adjusted in the future to correct for over-or underestimation of past prices. However, the amount you pay is considered a final price.

Statutes in a small number of states may require the Host Blue to use a basis for calculating Subscriber liability for Covered Services that does not reflect the entire savings realized or expected to be realized on a particular claim or to add a surcharge. Should any state mandate Subscriber liability calculation methods that differ from the usual Blue Card method noted above in the preceding paragraph four of this item or require a surcharge, we would then calculate your liability for any covered health care services in accordance with the applicable state statute in effect at the time you received your care.

These are primarily Hospitals and Physicians who participate in a Blue Card PPO network and have agreed to provide PPO Members with health care services at a discounted rate that is generally lower than the rate charged by Traditional Providers.

These are providers who might not participate in a Blue Card PPO network, but have agreed to provide PPO Members with health care services at a discounted rate.

These are providers that do not have a contract with their local Blue Cross and/or Blue Shield plan and have not accepted the Blue Card PPO or Traditional Provider negotiated rates.

For an individual that is currently insurable but plans to travel and relocate not only in the USA but also out of the country extensively, I would recommend an individual Global Citizen Policy that will be good in  the USA and anywhere in the world and is subject to evident initially and then renews every 12 months at the market rates.

I still believe the Global one is the better one since he indicated that he is planning to be out of the country for extensive period and Nationwide would not do the trick; unless you want to buy Nationwide for him AND buy Travel Insurance to supplement the Nationwide

Nationwide is one of our individual carriers and if he buys this plans right now it will be based on his present residence. Whenever he relocated to another State he would let Nationwide know right away but it won't effect his rates or benefits which only change on anniversary. His Policy will always be rated with the originating residential zip code and there is no new underwriting and as long as he pays his premium he will have coverage doesn't matter where he moves to in the USA, however, there is no out of the country coverage except emergency hospitalization and then only if you are not out of the country in excess of 6 months.

Call or email us for a Nationwide Quote

When the Member Becomes Ineligible