Blue Shield of California is committed to serving our members and putting them first. As such, we provide travel reimbursement of up to $3,000 to support our members who need to travel for eligible covered services due to those services being banned or restricted in the member’s state of residence.
Effective January 1, 2025, Blue Shield of California will also be expanding the program to include new services.
Program details are set forth below, including eligibility criteria, information on reimbursable expenses and restrictions, and requirements for claims submission. The link below may be used to download the claim form to be completed and submitted via mail with receipts, and other required documentation to obtain reimbursement through this program.
In addition to appropriate documentation for your expenses, to receive reimbursement through this program, you must also have a claim on file with Blue Shield of California for an eligible covered service (or services) or submit documentation that an eligible covered service (or services) was provided by a licensed practitioner. Contact Customer Care to confirm if a claim has been received from your provider. Documentation of services provided, if required, should be submitted along with your claim form and receipts.
Program Rules / Eligibility
- Members must reside in a state where an eligible covered service is banned or restricted.
- As of January 1, 2025, for members seeking reimbursement for travel related to covered services provided for terminating a pregnancy, this includes: Alabama, Arkansas, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Mississippi, Missouri, Nebraska, North Carolina, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wisconsin, and Wyoming.
- As of January 1, 2025, for members seeking reimbursement for travel related to covered services provided for gender affirming care, this includes: Alabama, Arizona, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Mississippi, Missouri, Nebraska, North Carolina, North Dakota, New Hampshire, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, and Wyoming.
- Members must be enrolled in a Blue Shield of California plan that provides coverage for eligible covered services outside of California. Plans that limit coverage outside of California to urgent/emergent services are not included in the program.
- Members should refer to their Evidence of Coverage plan document for benefit coverage. Travel expenses for services at a professional facility and pharmacy related services may be reimbursable if they are covered under the plan’s standard medical or pharmacy benefits.
- Eligible covered services must be provided by a licensed practitioner, in a state other than the members' state of residence where the services can be lawfully provided. Services may be provided by a participating provider under the member’s BlueCard benefit, or an out-of-network provider if the member's plan covers out-of-network benefits.
- Members must fill out the Travel Reimbursement Program claims form, including attestation, in addition to submitting receipts and supporting documentation of expenses.
- A claim on file for eligible covered services, or documentation showing proof that services were rendered, is required to process a travel reimbursement claim.
- Prior authorization is not required for travel reimbursement. However, in some instances, a prior authorization may be required to obtain eligible covered services. Members should refer to their Evidence of Coverage plan document for benefit coverage and prior authorization requirements.
- Reimbursement is only available where permitted under applicable law.
- When required, Blue Shield of California will issue a form 1099-MISC to you, reporting travel expense reimbursements. Blue Shield of California does not provide tax advice. If you have tax questions about travel expense reimbursements, you should consult with your tax advisor.
- Travel reimbursement must be for costs incurred and paid by the member and not also reimbursed or paid by another party (e.g., employer, non-profits, etc.). Amounts reimbursed by another source must be refunded to Blue Shield.
- Members enrolled in Health Savings Account (HSA) eligible High Deductible Health Plans (HDHPs) need to satisfy deductible requirements before receiving reimbursements through this program if they wish to maintain their eligibility for HSA contributions.
Reimbursable Expenses
There are no member cost shares associated with this program, nor do members need to satisfy their deductibles. (Except for HSA eligibility: see above.)
- Travel reimbursement cannot exceed $3,000 annually; costs accrued by the member above the $3,000 threshold are the member’s responsibility.
- Expenses must be reasonable and necessary. Reimbursable expenses may include:
- Transportation to and from the facility or location of services, including airfare, mileage, taxis (including Uber, Lyft, etc.) and shuttles.
- Hotel accommodations if an overnight stay is required to obtain eligible covered services.
- Not to exceed $250 per day. Limited to one double-occupancy room. All other hotel expenses are excluded.
- Meals
- Not to exceed $100 per day.
- Companion expenses for reimbursable expenses as listed above.
Exclusions
- Tobacco, alcohol, drugs, phone charges, television, recreation, and personal expenses.
- Premium economy, business, or first-class airfare.
- Limousine and car services.
- Expenses reimbursed by another source (e.g., employer or non-profit).
- Reimbursement is not available if the reimbursements themselves or the underlying eligible covered service(s) would be unlawful under applicable law.
