Your questions answered
Who is Blue Cross Blue Shield Global?
Who is Blue Cross Blue Shield Global?
Blue Cross Blue Shield Global is a brand owned by the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield Association is an association of independent, community-based and locally operated Blue Cross and Blue Shield companies that, collectively, provide healthcare coverage for one in three Americans. It delivers health insurance coverage for over 116 million members across all 50 U.S. states, the District of Columbia and Puerto Rico. Trusted for over 90 years, it is the oldest and largest family of health benefits companies in the U.S.
For more information on Blue Cross Blue Shield, refer to your customer documentation or visit the BCBS website.
Who is Bupa Global?
Who is Bupa Global?
Bupa Global is the worldwide Bupa business offering health plans to support employees, individuals and families. We provide our customers with premium international coverage that gives them direct access to world-leading specialists and medical providers at home or abroad. Bupa Global is part of Bupa, an international private health insurance company dedicated to helping people live longer, healthier, happier lives and making a better world.
For more information on Bupa Global, refer to your customer documentation or visit the Bupa Global homepage.
How do I find out more about the partnership between Blue Cross Blue Shield Global and Bupa Global?
How do I find out more about the partnership between Blue Cross Blue Shield Global and Bupa Global?
You can find out more about our partnership on the About our partnership webpage.
Which hospitals and doctors in the U.S. are covered by the network?
Which hospitals and doctors in the U.S. are covered by the network?
Please use the U.S. National Doctor and Hospital Finder to find a full database of treatment providers. If you have a product that requires pre-authorisation, please call the number on the back of your card. Access to this network is subject to the terms and conditions of your existing policy.
What is the Blue High Performance Network® (BlueHPN®)?
What is the Blue High Performance Network® (BlueHPN®)?
BlueHPN® is a national network in the U.S. consisting of carefully selected doctors, hospitals, and specialists. Providers are chosen based on recognised quality standards and their commitment to improving health outcomes.
Where is it available?
BlueHPN® is available in more than 68 major metropolitan areas across the U.S., including 20 of the largest cities. This network ensures comprehensive access to high-quality care in most major markets, providing you with peace of mind about your healthcare options.
What makes it different?
BlueHPN® emphasises quality in its design. The providers in this network are not just dedicated to delivering safe and effective care, but also to making you, the patient, the centre of their focus. Their strong performance in preventive care and chronic condition management, as well as their efforts to reduce avoidable hospital visits, all reflect this commitment to you.
Can I see a provider outside the network?
BlueHPN® is an Exclusive Provider Organization (EPO), which means your coverage only applies to providers within the network, except in emergencies.
How do I know if my plan includes BlueHPN®?
Check for the 'BlueHPN' indicator on your Blue Cross Blue Shield Global member ID card to confirm your access to the network.
What are Blue Distinction® Centers?
What are Blue Distinction® Centers?
Blue Distinction® Centers are medical facilities in the U.S. known for their expertise and consistent delivery of high-quality speciality care. Each center adheres to strict evaluation criteria developed with input from national medical experts and leading professional organisations.
Why choose a Blue Distinction® Center?
When you select a Blue Distinction® Center, you can be confident that:
- The facility you choose has undergone a thorough evaluation against stringent national quality standards, giving you the confidence that you're in good hands.
- Specialists are highly experienced and recognised for their expertise in their fields.
- Patient safety is our top priority, ensuring that your care is effective and well-coordinated, giving you peace of mind.
What types of care are included?
Blue Distinction® Centers focus on complex and high-impact medical specialities, including:
- Bariatric surgery
- Cardiac care
- Cellular immunotherapy
- Fertility and reproductive care
- Gene therapy
- Knee and hip replacement
- Maternity care
- Spine surgery
- Substance use treatment and recovery
- Transplants
What is the difference between Blue Distinction® Centers and Blue Distinction® Centers+?
Blue Distinction® Centers (BDC) are recognised for delivering high-quality speciality care. Blue Distinction® Centers+ (BDC+) meet the same standards and are also acknowledged for demonstrating strong performance in additional clinical measures.
Note: Designation as a Blue Distinction® Center means these facilities' overall experience and aggregate data met objective criteria established in collaboration with expert clinicians and leading professional organisations' recommendations. Individual outcomes may vary.
Do I need a physical I.D. card to access the provider network?
Do I need a physical I.D. card to access the provider network?
You don’t need a physical I.D. card. You can access U.S. network using digital Blue Cross Blue Shield Global or Blue Shield Global cards. Bupa Global customers can also obtain their I.D. cards via our MembersWorld portal, and Bupa Latin America and Bupa Mexico customers can visit My Bupa Latin America.
I’m being asked to fill out a subrogation claims form. What does that mean?
I’m being asked to fill out a subrogation claims form. What does that mean?
Subrogation is when we seek to recover medical costs from another party who may be responsible for your injury. This may happen if your medical expenses were due to incidents like car accidents or negligence, where another party is liable.
You may be contacted by Bupa Global to provide details about an incident related to a paid medical claim. Providing this information helps us manage healthcare costs by recovering expenses from the responsible party.
How do I find out further information?
How do I find out further information?
Please feel free to call us any time using the number on the back of your membership card.
Pharmacy information
How do I access my prescriptions?
How do I access my prescriptions?
You can access prescriptions through our U.S Out-Patient Pharmacy Savings or Funded Programs. With your Blue Cross Blue Shield Global card, you can purchase prescription medication at discounted prices at participating pharmacies.
Who is your pharmacy partner?
Who is your pharmacy partner?
Our U.S. prescriptions partner is Universal Rx, a leading provider of prescription services. They were founded in 1995 and provide services to expatriate populations through a national network of pharmacies.
Over the years, Universal Rx has broadened its experience and management skills and developed a proven formula for delivering cost-effective, high-quality benefit programs to diverse population of clients.
U.S. Prescriptions Savings Program
U.S. Prescriptions Savings Program
You qualify for this program if your Rx Group Number on your Blue Cross Blue Shield Global card starts with BTN or MIA.
This will give you an average of 25-30% discounts on medications, including those not covered by your plan, at over 55,000 pharmacies across the U.S. Present your Blue Cross Blue Shield Global card at a participating pharmacy to benefit from these savings. However, this is not a direct settlement program; you are still responsible for paying in full for your medications, after any applicable discounts, at the time of purchase.
To find a participating pharmacy, please use our pharmacy locator tool.
For reimbursement, please submit your claim to Bupa Global through the usual channels.
Contact us
For additional information, please call the Pharmacy Help Desk on +1 855-767-1864.
The Pharmacy Help Desk hours are: Monday-Friday, 8:30am - 10:00pm and Saturday, 9:00am - 5:00pm (EST)
U.S. Prescriptions Funded Program
U.S. Prescriptions Funded Program
You qualify for this program if your Rx Group Number on your Blue Cross Blue Shield Global card starts with 9999.
The U.S. Prescriptions Funded Program is designed to support you when purchasing prescription medications in the U.S. If your plan includes a co-payment, you will only need to pay that specific amount at the time of purchase, provided you are using a participating pharmacy from a network of over 65,000 pharmacies across the U.S.
We will settle the remaining cost directly, meaning there is no need to collect receipts or claim reimbursement. This makes accessing and paying for prescription medications simpler and more convenient.
You may be eligible to purchase discounted prescription medications that are not covered under your plan or when the annual limit has been reached. These medications would not be covered by Bupa Global.
Prior Authorisation Process
Specialty Prescribed Drug Products are drugs/pharmaceuticals or category of drugs/pharmaceuticals, that will require your physician to contact the pharmacy in advance to provide additional information for coverage approval purposes. These medications generally meet most of the following criteria:
- are produced through biotechnology or recombinant DNA technology mechanisms;
- are high cost (typically over USD 250 per dose or USD 1000 per month of therapy);
- are generally, but not always, administered by injection;
- require specialised patient monitoring, special handling, or unique education prior to use;
- have restricted distribution procedures.
Examples of drugs that qualify as Specialty Prescribed Drug Products include, but are not limited to, drugs/pharmaceuticals that are used to treat Crohn’s disease, haemophilia, growth hormone deficiency, RSV, cystic fibrosis, multiple sclerosis, hepatitis C, rheumatoid arthritis, and Gaucher’s disease.
Download the Prior Authorisation Form (PDF, 4,122KB)
To find a participating pharmacy, please use our pharmacy locator tool.
Contact us
For additional information, please call the Pharmacy Help Desk on +1 855-767-1864.
The Pharmacy Help Desk hours are: Monday-Friday, 8:30am - 10:00pm and Saturday, 9:00am - 5:00pm (EST)
What is the Formulary Drug list?
What is the Formulary Drug list?
The Universal Rx Formulary Drug list defines the co-payment tier status of the medicines most commonly prescribed.
The 2 tier “formulary list” provides a partial listing of the most commonly used medications and what co-payment tier the medications fall under. If your U.S. pharmacy plan has a 2-tier co-payment structure, Tier 1 is for Generic medications and Tier 2 is for Brand medications. If a medication is not on the list, you may contact the Pharmacy Help Desk at 1-855-767-1864 to determine which tier your medication falls under.
Formularies help keep drugs affordable by providing medications that are equally effective in treating an illness when compared to other medications available, but are generally the more cost-effective choices. Please consult with your physician to discuss which drugs are most appropriate for you.
Should I ask my doctor to approve a generic substitution whenever possible?
Yes, a generic drug is a copy of the brand name medication and typically offers a substantial savings over the brand name drug. The generic drug is preferred if your physician has confirmed it is acceptable for you to take it. By using the generic drug, it saves both you and your employer money.
My doctor prescribed a brand medication. Why did I receive a generic?
This means the box marked “may substitute” was checked on the prescription. If this box is checked, it means your physician has allowed the pharmacy to substitute the generic drug when there is one available.
Download the Universal Rx Formulary Drug list (PDF, 1,323KB)