A member ID card is the key to receiving services covered under your health plan. Your employees should carry their member ID cards at all times and present them to health care professionals whenever they are seeking treatment or service. For your convenience, your employees will have a single member ID card that represents their entire health care benefits plan, including medical, pharmacy, dental, vision, behavior health, as applicable to your group’s specific plan. Also, each covered family member will have his/her own member ID card.
Member ID cards are to be used only by members of health care plans offered or administered by BCBSGa/BCBSHP. Use of a BCBSGa/BCBSHP member ID card by anyone other than the member named on the card for the purpose of receiving services constitutes fraud. Penalties for fraud include immediate termination of coverage and criminal prosecution.
A Single Member ID Card
A Blue member ID card contains information that is valuable both to your employees and doctors, like the member’s ID number, group number, benefit information and important phone numbers. It also displays your coverage information, like copays, deductibles, and coinsurance amounts for all benefits of your group’s plan.
Typically, your employees can present their member ID card indicating prescription drug coverage at a network pharmacy, pay any applicable copay/deductible and do not need to file a claim. However, if the ID card is not presented or the prescription is filled at an out-of-network pharmacy, the member or covered family member will have to pay for the prescription out-of-pocket, and complete a prescription drug reimbursement form
for reimbursement consideration.
Using ID Cards Outside of Georgia
When your employee is a BCBSHP (HMO, POS or Open Access) member:
BCBSHP provides coverage for care received when your employee or a covered family member is away for an extended period of time, whether it's due to out-of-town business, semesters at school or families living apart. BCBSHP members away from home for 90 to 180 days can request a Guest Membership at an affiliated Blue Cross and Blue Shield HMO in their new county/state.
If a member needs to determine his/her eligibility for a Guest Membership, contact customer care. An associate will forward an application to complete. When the application is approved, the member will receive a special member ID card from the affiliated HMO coordinating care. The member will have to pay any applicable copays when visiting the affiliated Blue Cross and Blue Shield Network HMO(s) in that area.
When your employee is a BCBSGa (PPO, HDHP or Traditional/Indemnity) member:
Your group’s BCBSGa members have access to the BlueCard® network, which expands the in-network doctors, hospitals and other health care professionals from your local area to across the country - even around the world. Over 85% of all doctors and hospitals currently participate in the BlueCard® network. To receive medical care from a health care professional in this expanded network, members simply show their ID card.