Member Identification Card Quick Reference Guide

Member Identification Card Quick Reference Guide Member Identification cards contain important membership and coverage information that help you correctly route your claims. Be sure to verify eligibility using carefirst Direct or carefirst on Call prior to rendering care. The front of the Member ID card contains [Network information about the Member , the primary care 1 Logo] 4. provider (PCP), copayments/coinsurance and Member Name [Product Name]. some Member benefits FIRST NAME LAST NAME. Member ID 5 [GROUP NAME]. PCP Name ### ###### [LAST NAME, FIRST NAME]. 2 Group #### Coverage IND. 1 carefirst logo 6 P$0 S$30 CC$0 UC$50 ER30%. RX PD PV. 2 M. ember ID and Group number Medical In-Network Out-of-Network 3 R. x deductible and out-of-pocket max Eff Date 01/01/2021. BC/BS Plan 190/960. 7 IND Deductible IND Out-of-Pocket $1000. $5000. $4000. $8000. Rx Deductible IND $100. 3 Rx Out-of-Pocket IND $500 8. 4 Plan network 5 Plan name, PCP name (if applicable) For eligibility or benefits: 410-872-9500.

BLUE SHIELD ® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. SUM MAXXXX-1N (X/20) CareFirst Administrators is the business name of CFA, LLC, an independent licensee of the Blue Cross and Blue Shield Association.

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