Travel reimbursement program

Blue Shield of California is committed to serving our members and putting them first. As such, we have a new travel reimbursement program that will provide up to $2,000 to support our members who need to travel for pregnancy termination services due to those services being banned or restricted in the member’s state of residence.

Effective June 24, 2022 Blue Shield of California group plan members living in states with restricted access to pregnancy termination services will be eligible for travel reimbursement for the purpose of obtaining these services in states where they remain legally available. 

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 a pregnancy termination service (or services) or submit documentation that covered pregnancy termination services were 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 terminating a pregnancy is banned or restricted. As of July 14, 2023, this includes: Alabama, Arkansas, Arizona, Florida, Georgia, Idaho, Iowa, Indiana, Kentucky, Louisiana, Mississippi, Missouri, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wisconsin.
  
• Members must be enrolled in a Blue Shield of California fully insured commercial group plan with eligible pregnancy termination coverage services (see “Pregnancy Termination Coverage” below).
• Covered services must be provided from a licensed practitioner, in a state other than the members’ state of residence where the services can be lawfully provided, through the member’s BlueCard benefit, or an out-of-network provider if the member’s plan covers out-of-network benefits.
• Travel reimbursement is provided for both surgical and medical (medication) pregnancy termination services.
• Travel Reimbursement Program applies to pre- and post-care for surgical and medical pregnancy termination services.
• 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 covered pregnancy termination services, or documentation showing proof that services were rendered, are required to process a Travel Reimbursement Program claim.
• Prior authorization is not required.
• Reimbursement is only available where permitted under applicable law.
• Travel reimbursement is limited to pregnancy termination services and does not extend to travel to obtain fertility and/or other reproductive-type services. Please refer to your Evidence of Coverage for pregnancy termination covered benefits. 
• Blue Shield of California will provide reimbursement for sales taxes assessed on eligible expenses but will not be responsible for any taxes that may be imposed as a result of a member’s receipt of reimbursements through this program.
• 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) may 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. 
• Travel reimbursement cannot exceed $2,000 per pregnancy termination event; costs accrued by the member above the $2,000 threshold are the member’s responsibility.
• Expenses must be reasonable and necessary. Reimbursable expenses 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 pregnancy termination 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, when: 
    • You need a companion to be present to receive pregnancy termination services (including for physical and/or emotional support), or; 
    • The companion is a dependent child (example: member needs to travel with their child because they have no childcare; the child does not need to be enrolled in the member’s plan).
  • Exclusions
    • Tobacco, alcohol, phone charges, personal expenses and other items excluded under existing travel benefits
    • Premium economy, business, or first-class airfare
    • Limousine and car services
    • Reimbursements is not available if the reimbursements themselves or the underlying pregnancy termination services would be unlawful under applicable law.