Are You Going on a Trip?
As you know there are many things to prepare for above and beyond where you’re going, what you will pack and how you will get there. If you have expected Medical or Prescription Drug (Rx) needs or if you simply want to prepare for the unexpected, having a plan of action in place, and knowledge and access to applicable resources is vital to your health, bank account, and peace of mind while away from home.
For our faculty and staff who are enrolled on a Medica health plan through Augsburg, we want to share with you some information that may be helpful as you are planning or taking a vacation or traveling on business.
Tips to Remember When Planning Your Travel:
Search for In-Network Providers at Your Destination
- Search the Find a Physician or Facility tool on Medica’s website which can easily be accessed through the Welcome to Medica site at welcometomedica.com/AugsburgUniversity or by logging into your Medica account at medica.com/SignIn.
- If you are on the Passport network:
- Click Medica Choice Passport with UnitedHealthcare Choice Plus Network, select “See your 2023 Choices” under Providers and Facilities, update your location (city and/or zip code in the upper right corner), and enter a facility or physician name or type.
- If you are on the VantagePlus or Park Nicollet and HealthPartners First networks:
- Click the below link, update your location (city and/or zip code in the upper right corner), and enter a facility or physician name or type.
- You can also access the Travel Program provider search tool by clicking the link corresponding with the network name, select “See your 2023 Choices” under Providers and Facilities, then click “Find a Travel Program Provider” under the Explore and Learn More
- If you are on the Passport network:
Can’t Find an In-Network Provider?
- You can still receive care at an out-of-network provider while traveling; however, please know that you may need to pay for the claim at point-of-service and submit the claim directly to Medica upon your return home. If approved, your claim will be processed according to out-of-network coverage levels. Claim submission instructions are as follows:
- Claim forms are provided in the Document Center at Medica.com/SignIn. You may also request claim forms by calling Member Services at 800.952.3455 or by calling the number on the back of your ID card.
- You should retain copies of all claim forms and correspondence for your records.
- You must submit the claim in English along with a Medica claim form to Medica no later than 365 days after receiving benefits. Your Medica member number must be on the claim.
- Mail to the address identified on the back of your identification card.
- Upon receipt of your claim for benefits from non-network providers, Medica will generally pay to you directly the non-network provider reimbursement amount. Medica will only pay the provider of services if:
- The non-network provider is one that Medica has determined can be paid directly; and
- The non-network provider notifies Medica of your signature on file authorizing that payment is made directly to the provider.
- Medica will notify you of authorization or denial of the claim within 30 days of receipt of the claim. If your claim does not contain all the information Medica needs to make a determination, Medica may request additional information. Medica will notify you of its decision within 15 days of receiving the additional information. If you do not respond to Medica’s request within 45 days, your claim may be denied.
Determine if You Have Enough Medication for Your Trip
- If you are traveling for a longer duration than your current Rx prescription accounts for, you may qualify for a “Vacation Override”
- A vacation override will allow a member to pick up more than their normal amount of prescriptions for a short period of time.
- Medica allows two (2) vacation overrides per year, and it can contain multiple medications.
- The overrides cannot be longer than six (6) months.
- Medica needs the following information prior to setting up a vacation override:
- Medication name and dosage
- Number of months requested
- Proof of travel- this can include copies of plane tickets, travel itineraries, or a screenshot of hotel/lodging confirmation
- Depending on the medication, there may be additional requirements needed in order to qualify for a vacation override.
- Examples of medications requiring further attention include: specialty Rx and controlled substances.
- It is strongly encouraged that you reach out to Medica directly at 800-952-3455 as their representatives can assist with setting up the vacation override, provide specific details and requirements, and help complete the process so you can fill your prescription accordingly.
- Discussing your vacation plans with your physician and pharmacy ahead of time is also highly recommended.
Traveling Out of the Country?
- Services received out of the country are considered out-of-network unless they are emergency related which means they are required in order to:
- Preserve life.
- Prevent serious impairment to bodily functions, organs, or parts.
- Prevent placing physical or mental health in jeopardy.
- Scheduled visits and follow-up visits are NOT considered emergency care.
- Medica plan members are required to pay the cost of their services (emergency and non-emergency) up-front at point of service and submit a claim upon their return home.
- Members can request reimbursement from Medica by submitting a claim along with other documentation including:
- Medica Foreign Claim Questionnaire
- A copy of the itemized bill
- Proof of payment for the services
- Related medical records
- A copy of the entire passport
- A copy of the airline ticket/boarding pass
- Medica recommends that anyone submitting out-of-country claim information to make copies of everything they submit for their personal records.
- Claims must be submitted within 365 days from the date of service.
- Please refer to additional claim submission instructions above under the “Can’t Find an In-Network Provider” section.
The medical benefits offered to Augsburg faculty and staff are meant to be meaningful and affordable. We hope this additional information is helpful as you navigate these specific components of your medical plan.