Understanding Your Blue Cross Member ID Card
You present your insurance card when you go to the doctor's office or visit a pharmacy. You know it's important and you need to have it, but why?
As part of the federal Consolidated Appropriations Act of 2021 (also known as the No Surprises Act), updates have been made to your member ID to help you better understand your plan’s deductibles and out-of-pocket maximums.
All members will receive a new member ID card in 2022. Please dispose of your old card properly to protect your member information and keep your new card in a safe and secure place.
How to Read Your Member ID Card
Note: This is a sample ID card. Cards may vary from member to member.
1. Your Member ID Number
Your Blue Cross ID card has your identification number (also known as your member ID number in some applications) and group number. You’ll need this information when receiving medical services at the doctor or pharmacy, or when calling customer service for assistance.
Your member ID number is also important to have so that you can register for the Member Resource Center and access various member benefits including discounts and health and wellness services. When referencing your member ID number, you often times need the last 13 digits of your ID (exclude the first three letters) and the 2-digit number on the Member line (typically above your name on the card).
2. Your Plan Type
If you aren’t sure what type of health insurance plan you have, you can find out on the upper right corner of your ID card. The type of plan you have can affect what providers are in-network.
- Four products will show the PPO suitcase icon in the lower right corner: Open Access Plan, Exclusive Provider Organization (PCP), Exclusive Provider Organization, Vermont Freedom Plan (PPO). All other products will have an empty suitcase icon.
3. Your Costs
Your co-pays are printed on the front right side of your card so that you know what to expect upon your next visit. Your ID card may also include your deductible and out-of-pocket maximum.
- A co-pay is a fixed amount you pay for a covered health care service.
- A deductible is the amount you pay for covered health care services before your insurance plan starts to pay.
- Coinsurance is the percentage of costs you pay after you’ve paid your deductible.
- The out-of-pocket maximum is the upper limit on the amount of money you will pay for healthcare services in a plan year.
4. Pharmacy Coverage
If you have pharmacy benefits through Blue Cross, the back of your ID card will have VERMONT BLUE Rx printed on the bottom.
- Your RX Group is used by your pharmacy to process your prescription benefit
- Your BIN or bank identification number tells your pharmacy that you are covered by Blue Cross and Blue Shield of Vermont.
- Your PCN or processor control number is used by your pharmacy to locate your pharmacy member profile.
- The Formulary code represents a list of prescription drugs covered by us.
5. Contact Information
The back of your ID card provides important contact information for customer and provider service.
FAQ’s About Your member ID Card
Q: I just signed up for a plan, when will I receive my member ID Card?
A: You can expect your Member ID card to arrive within 7-10 business days from the date that you enrolled.
Q: How often do I get a new member ID Card?
A: Members will receive a new ID card when a change is made that impacts the information on the ID card, or if one is requested.
Q: What do I do if I lose my member ID Card?
A: You can request a new ID card by using our secure Member Resource Center, emailing firstname.lastname@example.org, or calling Customer Service at (800) 247-2583 Monday-Friday from 7:00 a.m. to 6:00 p.m.
Q: I have an appointment, but I don’t have my member ID Card, what do I do?
A: You can request a new card or confirm your ID information before your appointment by using our secure Member Resource Center, emailing email@example.com, or calling Customer Service at (800) 247-2583 Monday-Friday from 7:00 a.m. to 6:00 p.m.
- Through the Member Resource Center, you can also access a proof of coverage letter to keep with you until your new card arrives.
- To find the letter, click the benefits/coverage details button in the Member Resource Center, then click continue to be redirected to your benefit summary. On the right, you will see a link that says, “Hover here for a link to view your Outline of Coverage.” Click the link to download a PDF of the letter.
Q: How much does a new ID card cost?
A: New ID cards are always free to members.
Q: I have two ID cards; how do I know which is the right version?
A: You can check for the most recent effective date listed on the lower left side of your card.
Q: My doctor’s office requested I pay the co-pay on my current card, but my 2022 plan has a different co-pay. Will I be reimbursed?
A: If you are seeing an in-network provider, they are responsible for the difference.
Q: Can I get my prescription filled without my card?
A: Yes. If you have prescription coverage, when contacting the pharmacy to fill your prescription, please let them know that you are a member with Blue Cross and Blue Shield of Vermont. If you don’t have your member ID number, they may ask you for your date of birth and address to confirm your eligibility and coverage.