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What You Need to Know about Member Identification Cards

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What You Need

to Know about

Member

Identification

Cards

(2)

This guide will give you an overview of the various BlueCross BlueShield of South

Carolina and BlueChoice HealthPlan member identification (ID) cards, the symbols

on these cards and how to use the information on the ID cards.

When members arrive at your office or facility, remember to ask to see their

current member identification cards at each visit. This will help you to identify the

product the member has and get health plan contact information. It will also help

you with claims processing.

Remember, ID cards are for identification purposes only. They do not guarantee

eligibility or payment of your claim. You should always verify patient eligibility by

using My Insurance Manager

SM

on our websites, www.SouthCarolinaBlues.com or

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State Health Plan

State Health Plan (SHP) Network

• Group product lines access the broad commercial BlueCross State Health Plan Network. • The MUSC Health Plan alpha prefix is ZCK.

• The State Health Plan and State Savings Plan alpha prefix is ZCS. • New cards reflect the Public Employee Benefit Authority (PEBA) logo.

• The suitcase on the front of the card, lower right, indicates the network members access when out of state.

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BlueCross BlueShield of South Carolina

Preferred Blue® Network

Federal Employee Program (FEP)

• Group product lines access the broad commercial BlueCross Network (Preferred Blue®). • Cards reflect the Federal Employee Program product name.

• ID numbers begin with the letter “R.” • There are two plans, Basic and Standard.

• The plan name on the front of the card, upper right corner, distinguishes the Basic plan. • Basic plan members do not have out-of-network benefits.

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BlueCross BlueShield of South Carolina

Preferred Blue® Network

BlueCross BlueShield Large Group PPO

• Group product lines access the broad commercial BlueCross Network (Preferred Blue®). • There are multiple alpha prefixes for these plans.

• The suitcase on the front of the card, lower right, indicates the network members access when out of state.

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BlueCross BlueShield of South Carolina

Preferred Blue® Network

BlueCross BlueShield Small Group PPO

• Group product lines access the broad commercial BlueCross Network (Preferred Blue®). • The alpha prefix is ZCY.

• Note: ZCY prefix may also represent an individual PPO policy. • Plan benefits vary.

• The suitcase on the front of the card, lower right, indicates the network members access when out of state.

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Medicare Advantage Plans

Medicare Advantage Networks

• Individual product lines access various Medicare Advantage networks: o Health maintenance organization (HMO)

o Medical savings account (MSA) o Private fee-for-service (PFFS) o Point of service (POS)

o Medicare Advantage preferred provider organization (MA PPO) • The alpha prefix is ZCT.

• Product names are Medicare BlueSM and Medicare BlueSM Saver.

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BlueChoice HealthPlan Medicaid

BlueChoice HealthPlan Medicaid Network

• Individual product lines access the broad BlueChoice HealthPlan Medicaid Network. • Members are required to also carry their State-issued Healthy Connections ID cards (also

pictured here).

• The alpha prefix is ZCD.

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BlueChoice HealthPlan

BlueChoice® Network

Commercial Network Open Access (PPO)

• Group product lines access the broad commercial BlueChoice Network. • Referrals are not required for members to see specialists within the network. • The alpha prefix is ZCL.

• These ID cards also distinguish the plans by having the Carolina Advantage and Advantage Plus logos.

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BlueChoice HealthPlan

BlueChoice Network

Commercial Network High Deductible Open Access (PPO)

• Group product lines access the broad commercial BlueChoice Network. • Referrals are not required for members to see specialists within the network. • The alpha prefix is ZCL.

• These ID cards also distinguish the plans by having the Carolina Advantage High Deductible Health Plan (HDHP), Advantage Plus HDHP, and Consumer-Driven Health Plan logos. • Members have a cost sharing account to help in meeting deductibles and other approved

health care expenses:

o Health savings account (HSA)

o Health reimbursement account (HRA)

BlueCross BlueShield of South Carolina employees only

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BlueChoice HealthPlan

BlueChoice Network

Commercial MyChoice Individual (PPO)

• Individual product lines access the broad commercial BlueChoice Network. • Referrals are not required for members to see specialists within the network. • The alpha prefix is ZCL.

• These ID cards also distinguish the plans by having the MyChoice Individual Coverage, MyChoice Individual Coverage HDHP or MyChoice Open Access logos.

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BlueChoice HealthPlan

BlueChoice Network

Commercial MyChoice Individual (PPO)

• Individual product lines access the broad commercial BlueChoice Network. • Referrals are not required for members to see specialists within the network. • The alpha prefix is ZCL.

• These ID cards also distinguish the plans by having the MyChoice Individual Coverage, MyChoice Open Access HDHP or MyChoice Open Access Value Plan logos.

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BlueChoice HealthPlan

BlueChoice Network

MyChoice (Primary Choice Plans – HMO)

• Individual product lines access the broad commercial BlueChoice Network. • Referrals are not required for members to see specialists within the network. • The alpha prefix is ZCC.

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NEW Individual Product Exchange Network ID

Cards

Only new individual product lines access the new Blue

Essentials

SM

network (BlueCross) and the new MyChoice

Advantage network (BlueChoice).

Alpha prefixes are: BlueCross (ZCU, ZCF, ZCQ) and BlueChoice

(ZCX, ZCJ).

These ID cards also distinguish the new networks by having

“Blue Essentials Network” and “Exclusive Provider

Organization” on the cards for BlueCross and the “My Choice

Advantage” logo and “Exclusive Provider Organization (EPO)

on the cards for BlueChoice.

Benefits are only available in network! See the back of the ID

card.

The suitcase on the front of the card, lower right, indicates

the network that members access when out of state.

Note: all group products continue to access the broad

commercial networks. This includes those purchased through

the federal or private exchange.

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BlueCross BlueShield of South Carolina

Blue Essentials Network

Blue Essentials Individual (EPO) ID Cards

• Only NEW individual product lines access the new Blue Essentials network. • Alpha prefixes are ZCU, ZCF and ZCQ.

• These ID cards also distinguish the new networks by having “Blue Essentials Network” and “Exclusive Provider Organization” on the cards.

• Benefits are only available in network! See the back of the ID card.

• The suitcase on the front of the card, lower right, indicates the network members access when out of state.

• Note: all group products continue to access the broad commercial networks. This includes those purchased through the federal or private exchange.

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BlueCross BlueShield of South Carolina New Product ID

Cards

BlueCross PPO Network

Small Group PPO

• Group product lines access the broad commercial BlueCross Network (Preferred Blue®). • New alpha prefixes are ZCV and ZCR.

• These ID cards also distinguish the network by having “Preferred Blue Network” on the cards.

• The suitcase on the front of the card, lower right, indicates the network members access when out of state.

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BlueChoice HealthPlan New Group Product ID Cards

MyChoice Advantage Network

MyChoice Advantage Individual (EPO)

• Only NEW individual product lines access the new MyChoice Advantage network. • Alpha prefixes are ZCX and ZCJ.

• These ID cards also distinguish the new networks by having the “My Choice Advantage” logo along with “Exclusive Provider Organization (EPO)” on the cards.

• Benefits are only available in network! See the back of the ID card.

• The suitcase on the front of the card, lower right, indicates the network members access when out of state.

• Note: all group products continue to access the broad commercial networks. This includes those purchased through the federal or private exchange.

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BlueChoice HealthPlan New Group Product ID Cards

BlueChoice Network

Business Advantage (Small Group PPO)

• Group product lines access the broad commercial BlueChoice Network. • New alpha prefixes are ZCL and ZCG.

• These ID cards also distinguish the network by having the “Business Advantage” logo on the cards.

• The suitcase on the front of the card, lower right, indicates the network members access when out of state.

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