Beginning next year, the BlueCard Worldwide plan will include physicians in its overseas network, which has contracts with 106 hospitals in 37 countries.
The move will mean that any of the 500,000 people enrolled overseas in the Blues international program, called BlueCard Worldwide, can get physician care nearly anywhere in the world.
"We hope to cover virtually every country where there is an appropriate physician," says Barry Weinrebe, director of BlueCard Worldwide. "If we don't have an appropriate physician, we will do our best to get (an enrollee) to the closest physician."
The Blues began the BlueCard Worldwide program in 1997. The Blues had hoped to expand the hospital network to 45 countries by year-end but won't meet that goal until the first quarter of 1999, says Pat Hays, president of the Blue Cross and Blue Shield Association, Chicago.
The hospital locations were chosen to cover heavily traveled tourist destinations and areas with a significant concentration of U.S. government workers, Hays says. Foreign countries with the most hospital contracts are, in descending order, Germany, the United Kingdom, France, Japan and Italy.
All hospitals in the Blues' international network must meet certain criteria: Their blood supplies must comply with World Health Organization blood standards; and they must have English-speaking personnel on staff, 24-hour emergency services and an intensive-care unit. The hospitals charge the enrollee for copayments and deductibles but bill the Blues directly for the service.
Physicians also must meet certain licensing criteria and must speak English, Weinrebe says.
The national Blues association will not contract with the physicians the way it does with the hospitals, because of the difficulty in executing hundreds of physician contracts. Instead, it will function more as a "referral service," Hays says.
The Blues began the overseas network for several reasons, Hays says. One is "brand protection."
"There is an element of `use it or lose it' in international law," Hays says. "You either use (the brand), or you can lose it."
The overseas network also gives Blues plans a competitive advantage, especially with large employers that have a significant foreign presence-for example United Airlines and the federal government, which is the largest overseas employer.
