Benefits While You Travel
UT System provides health insurance benefits and travel assistance to eligible plan participants and their dependents while traveling or working in a foreign country.
Domestic Travel
UT SELECT through Blue Cross and Blue Shield of Texas provide you with access to one of the largest networks of contracting doctors and hospitals in Texas. There are more than 45,000 contracting physicians and specialists and over 400 contracting hospitals in Texas alone. If you are traveling outside of Texas, there are even more Blue Cross and Blue Shield Network providers from which to choose. In fact, more than 85 percent of all doctors and hospitals throughout the United States contract with Blue Cross and Blue Shield. If you use a network physician or hospital throughout the United States, your benefits will be the same robust benefits you enjoy in Texas or if you reside outside of Texas, the benefits you enjoy as an out-of-area participant.
To find a network physician or specialist near you, search online at www.bcbstx.com/ut or contact UT SELECT Customer Service toll free at 1-866-882-2034.
To assist you in summarizing your network, out-of-network and out-of-area benefits, you may review the Benefits Summary Chart.
International Travel
When you travel abroad, always carry your UT SELECT Identification Card which has the telephone number to the BlueCard Worldwide® program and contains important information about your plan. With BlueCard Worldwide®, you have access to a large number of hospitals on almost every continent and to a broad range of medical assistance services.
BlueCard Worldwide® provides the following services to UT SELECT Participants:
- Provider location
- Referral information
- Medical monitoring
- Wire transfers/overseas mailing
- Translation
- Coverage confirmation
- Currency conversion
Call BlueCard® Access toll free at 1-800-810-BLUE (2583) or call collect at (804) 673-1177, 24 hours a day, seven days a week to locate a participating physician or hospital. In some instances participating physicians or hospitals will submit your claim on your behalf. You may also contact your Institution Benefits Office or download and print the Benefits Summary Chartfor benefit details.
International SOS
As an international traveler, additional services are available through the UT System-wide International SOS program. International SOS is a comprehensive, 24-hour medical and emergency response organization that works on your behalf to coordinate with your insurance provider in the United States and providers abroad to ensure that you receive the assistance you need.
Membership benefits through International SOS are available at no cost when traveling abroad on University business and are available at a discount for traveling companions and employees traveling abroad for leisure.
For additional information regarding the International SOS program, contact your Institution Travel Office.
Information and a quick reference to the International SOS program and the UT SELECT plan can be found on the Foreign Coverage Quick Reference Sheet.
Prescription Drug Coverage
Foreign drug claims are submitted and processed in the same manner as domestic claims received from a non-network pharmacy. After you purchase your prescription while traveling internationally, you should submit a claim form and receipt. Be sure to include all the member and patient information, including your Benefits Identification Number, along with the drug information, currency used and country of purchase. Once the claim is received by Medco, the claim will be entered into the system and subject to eligibility and edits, including drug coverage and plan design. The National Drug Code used by Medco is specific to foreign claims, and prices at 100% of the amount submitted (converted to United States dollars). Medco will then apply a reduction in the reimbursement by the appropriate copayment. To calculate the converted value, Medco uses the services of a financial web site which provides the exchange rate in effect when the prescription was filled.
Due to FDA regulations, Medco Home Delivery is unable to ship prescription medication internationally. Be sure you have an adequate supply of medication to take with you. You may also call Medco Customer Service at 1-800-818-0155 to request a Vacation Override and receive an extended supply of medication prior to departure.
UT SELECT Prescription Plan – Medco Health Solutions
| Coverage |
Generic |
Preferred |
Non-Preferred |
Retail Prescription
(up to a 30 day supply) |
$10 |
$30 |
$45 |
Home Delivery Prescription
(up to 90 day supply) |
Due to FDA regulations, Medco is unable to ship Home Delivery prescriptions internationally. |
| Reimbursement Level: |
Claims will be subject to plan maximums and will be reimbursed based on 100% of cost submitted, less copayment. |
| Customer Service and Vacation Override Requests: |
Call 1-800-818-0155 to request an extended supply of medication to take with you while you travel internationally. |
| Claim Form Mailing Address: |
Medco Health Solutions
P.O. Box 14711
Lexington, KY 40512 |
Your UT Dental Benefits
Delta Dental provides the same level of dental benefits while traveling in the United States or Internationally. Members may be required to pay out-of-pocket for services and submit a copy of the receipt to Delta Dental to receive a refund. For questions, please call Delta Dental Customer Service at 800-893-3582.
The ASSURANT Heritage Plus Plan is limited to emergencies outside of Texas and the United States unless you are seeking routine care from your Primary Care Dentist within Texas. For assistance, please call 800-443-2995.
Dental Benefits for International Travel
| Dental Service |
UT DENTAL SELECT |
ASSURANT Heritage Plus Plan |
| International |
Delta Dental provides the same level of dental benefits while traveling in the United States or Internationally. Members may be required to pay out of pocket for services and submit a copy of receipt to Delta Dental to receive a refund. |
The Heritage Plus Plan is limited to emergencies outside of the United States or when care is received from a provider that is not your Primary Care Dentist. |
| Service Area |
Available Nationwide and Puerto Rico, non-network providers are available internationally |
| Maximum Annual Benefit |
$1,250 |
| Annual Deductible |
$25 per Person2 |
| Oral Exam, X-rays, Cleaning |
$0 |
| Fluoride Treatment |
$0, up to age 19 |
| Sealants |
$0, up to age 14 |
| Space Maintainers |
$0, up to age 14 |
| Fillings |
add 20% up to maximum allowed by plan |
| Extractions |
add 20% up to maximum allowed by plan |
| Root Canals> |
add 20% up to maximum allowed by plan |
| Periodontics3 |
add 20% up to maximum allowed by plan |
| Crowns, Jackets and Cast Restorations |
add 50% up to maximum allowed by plan |
| Bridges and Dentures |
add 50% up to maximum allowed by plan |
| Orthodontics |
50%, $1,250 Lifetime benefit per person> |
| Out-of-Network Benefits |
Yes |
| Claim Form Mailing Address |
Delta Dental Insurance Company
P.O. Box 1809
Alpharetta, GA 30023-1809 |
Assurant Employee Benefits
P.O. Box 830949
Birmingham, Alabama 35283 |
Vision
Superior Vision will provide coverage for eligible out-of-country services and products on an “out-of-network” basis only. In case you have a need to replace glasses, lenses or contacts while you travel, we recommend you have your vision prescription with you when traveling. You pay the provider in full at the time of service and submit to Superior Vision an itemized invoice or receipt. Reimbursement is based on the foreign currency exchange rate at the time of service. Reimbursement is in equivalent United States dollars only. Reimbursement is mailed to the address listed on the claim form by the member. For assistance, please call Superior Vision Customer Service at 800-507-3800.
Superior Vision
| Covered Services |
Out-of-Network Benefits |
| International |
Superior Vision will provide coverage for eligible out-of-country services and product on an “out-of-network” basis only. As a footnote, we recommend to have your vision prescription when traveling. Pay the provider in full and submit Superior Vision an itemized invoice or receipt. Reimbursement is based on the foreign currency exchange rate at the time of service. Reimbursement is in equivalent United States dollars only. Reimbursement is mailed to the address requested by the member. |
| Comprehensive eye exam by an ophthalmologist or optometrist |
Up to $42 (ophthalmologist)
Up to $37 (optometrist)
|
| Standard lenses (per pair) - plastic (CR39), clear, uncoated |
Up to $32 (Single vision)
Up to $46 (Bifocal)
Up to $61 (Trifocal)
Up to $84 (Lenticular)
|
| Frames |
Up to $53 |
| Contact lenses |
Up to $210 (Non-elective)
Up to $100 (Elective) |
| Receipt or Invoice Mailing Address: |
Superior Vision Plan
P.O. Box 967 Rancho Cordova, CA 95741 |
Hartford’s Long Term Disability Travel Assistance Program
The Hartford’s Travel Assistance program provides three kinds of services for UT employees enrolled in the Long Term Disability (LTD) plan for business or vacation travel- pre-trip information, emergency medical assistance and emergency personal services. Additionally, the program offers funds up to $150,000 to cover services provided when Worldwide Assistance Services is contacted prior to travel. For more information about the Travel Assistance Program and a convenient wallet size reference card, view the Hartford brochure.
It is important for employees and their family members to contact Worldwide Assistance in advance of any travel or medical care. Worldwide Assistance relies on the attending physician who determines the medical necessity and the best service based on each individual emergency. Therefore, employees and family members should keep their Travel Assist identification card with them at all times to ensure timely service and access to helpful resources. The Travel Assist Identification Card is located on the Travel Assistance Brochure.
Fort Dearborn Life Insurance and Accidental Death and Dismemberment
While on business or leisure travel, your group term life and accidental death and dismemberment benefits will continue to provide you the same robust coverage as when you are home. There is no reduction in benefits if death or dismemberment occurs while traveling internationally.
INSTITUTION TRAVEL OFFICES
