Filing a Claim for Services Received Outside the U.S.

This page includes instructions on how to file a claim for medical, prescription, dental and vision services received outside the United States.

NOTE: Your itemized bills DO NOT have to be translated into English or dollars. The dollars will be converted based on the exchange rates in effect as of the date of service.

For instructions on how to file your claim, click your claim type from the list below:

Submitting a medical claim

Submitting a Medical Claim

To submit a medical claim for services received outside the U.S., follow the three steps below.

Step 1: Download the Claim Form – Medical – Services Received Outside the U.S.

This is the Blue Cross Blue Shield Global Core International Claim Form. You should submit the completed form along with any itemized bill you might have.

Step 2: Be sure your completed claim (which includes a completed Blue Cross Blue Shield Global Core International Claim Form with or without an itemized bill) includes all the information below. If you do not provide all of the required information, your claim could be delayed.

Health Plan Participant’s information
- Name
- Health Plan ID Number (as it appears on your Health Plan ID Card)
- Health Plan Group Number
Patient’s information
- Name
- Date of Birth
Provider’s Information
- Name
- Address
- Federal Tax ID Number
Service Information
- A Description of Services and Diagnosis (provided by the doctor).
- Amount Paid (if any)

Step 3: Submit your claim to Blue Cross Blue Shield Global Core using the information below.

It is recommended that you submit your claim by email, mobile app or online in order to have proof of your claim submission.

Email: claims@bcbsglobalcore.com

Mobile Phone: Download the Blue Cross Blue Shield Global Core mobile app: Android or iOS

Online: www.bcbsglobalcore.com

Mail:

DO NOT submit claims to the Health Plan Office.

Mail your claim directly to Blue Cross at the address below:

Service Center
P.O. Box 2048
Southeastern, PA 19399

If you have any questions regarding your medical claim, you can reach Blue Cross Blue Shield Global Core at (800) 810-BLUE (2583) or collect at (804) 673-1177.

Submitting a medical claim when you have both Medicare and DGA Health Plan coverage ONLY

This information applies only to those covered by both Medicare and the DGA Health Plan ONLY. If you have additional coverage, please contact Participant Services at (877) 866-2200, Ext. 401 to discuss how best to file your international medical claims.

If you have coverage with both Medicare and the DGA Health Plan only and need to file a claim for services received outside the U.S., the DGA Health Plan should pay your non-U.S. claims as your primary insurer.

Medicare does not cover services received outside the U.S. except in very limited circumstances. Generally, claims incurred outside the U.S. will be processed as if the Health Plan is your primary insurer. Follow the instructions below to file your international claim with the DGA Health Plan.

To submit a medical claim for services received outside the U.S., follow the three steps below.

Step 1: Download the Claim Form – Medical – Services Received Outside the U.S.

This is the Blue Cross Blue Shield Global Core International Claim Form. You should submit the completed form along with any itemized bill you might have.

Health Plan Participant’s information
- Name
- Health Plan ID Number (as it appears on your Health Plan ID Card)
- Health Plan Group Number
Patient’s information
- Name
- Date of Birth
Provider’s Information
- Name
- Address
- Federal Tax ID Number
Service Information
- A Description of Services and Diagnosis (provided by the doctor).
- Amount Paid (if any)

Step 3: Submit your claim to Blue Cross Blue Shield Global Core using the information below.

It is recommended that you submit your claim by email, mobile app or online in order to have proof of your claim submission.