LACERS - Out-of-Country Medical Plan

Out-of-Country Health Plans

For Retired Members Living outside the U.S. & its Territories

The Anthem Blue Cross PPO Out-of-Country medical plan is the only LACERS medical plan available to you if you reside permanently outside the U.S.¹

A summary of the Anthem Blue Cross Out-of-Country Plan Benefits:

Key Features	Paid by remibursement only Claim forms are required Claims may take up to 30 days to be processed upon receipt by Anthem
Medical Services	Must meet U.S. standards of care²
Prescription Drugs	$10 copay per 30-day supply (All Anthem Blue Cross approved drugs) Co-payment will not apply towards your calendar year deductible
Hearing Aids	No deductible $2,000 maximum per ear every 3 years
Key Plan Benefits	$500 deductible/person 70% reimbursement of UCR³ charges Up to $10,000 out-of-pocket maximum per calendar year, 100% thereafter Up to $2,000,000 lifetime maximum
Other Benefits May Differ	Request a Certificate of Insurance booklet from LACERS for details

The Vision Service Plan (VSP) and MetLife PPO Dental are also available outside the U.S.
As defined by the American Medical Association
(www.ama-assn.org)
UCR = Usual and Customary Rates as defined by Anthem Blue Cross

Premium and Deduction Amounts

The premium and deduction amounts for the LACERS Anthem Blue Cross PPO Out-of-Country Plan are the same as for the LACERS Anthem Blue Cross PPO non-Medicare premium, regardless of the age of the member residing outside the country.

Note: These premium and deduction amounts are more costly than LACERS corresponding Anthem Blue Cross Medicare Advantage LPPO plan because Medicare does not subsidize the cost of services received outside the U.S.

Will Medicare Cover My Medical Expenses Outside The U.S.?

If you live or travel outside the U.S. , Medicare does not cover you. This is because the program provides protection against the cost of hospital and medical expenses you incur in the U.S.

You do not need to enroll in Medicare Part B if you reside permanently outside the U.S. and its territories. However, if you decide to return and reside in the U.S. at a later date and enroll in a LACERS health plan, Social Security may impose a lifetime penalty for lapsed Medicare coverage.

Contact the Social Security Administration (SSA) regarding Medicare rules, regulations or penalties that may affect your medical plan coverage should you decide to return to the U.S. Continued coverage of Medicare Part B should be discussed with the SSA in advance .

LACERS will not reimburse your Medicare Part B premium while you are enrolled in the Anthem Blue Cross Out-of-Country plan.

However, the Anthem Blue Cross Out-of-Country Prescription Drug coverage provides creditable coverage equivalent to Medicare Part D benefits, so you will not be penalized for not having Medicare Part D while out of the country.