Regence member cards are a snapshot of our member’s basic coverage information. Our member cards may differ, depending on whether they are for group, individual or Medicare members. Member cards will help you determine:

• A member’s benefit coverage plan
• The provider network members should use
• Who to contact for customer service inquiries
• Where to send claims
• Limited benefit information, e.g., copayment, coinsurance or deductible amounts
• Member’s primary care provider (PCP) if applicable

Although member cards determine if your patient has coverage, limits to the coverage may not be listed, such as:

• Annual deductibles (which must be met before payment for covered services begins)
• Limitation periods (generally six to twelve months from the date of enrollment)
• Any services excluded by your patient's benefit contract.

Customer Service specialists or Regence Online Services can verify your patient's benefits, eligibility and coverage limitations.

Section 1 displays the blank 'Suitcase' or 'PPO in a Suitcase' logo if the member is eligible for the BlueCard^® Program.

Section 2 gives the group name, which can be either the employer's name for group coverage, or the product name if individual coverage.

Section 3 gives the member's identification number, which is necessary for claims submission and customer service inquiries. Always include the three-digit alpha prefix.

Section 4 identifies the member's group number.

Section 5 lists each member covered under the policy by suffix number and name (last name, first name, middle initial). The subscriber is listed first, followed by dependents.

Section 6 is comprised of ‘coverage indicator’columns that tell you at a glance the member has medical (M), dental (D), vision (V) and/or prescription (RX) coverage. These fields will show 'Y' (yes) if there is coverage or 'N' (no) if there is no coverage.

Section 7 shows the date the card was issued (this is not the coverage effective date).

Section 8 lists claims submission instructions and Customer Service phone numbers.

Section 9 is crucial for identifying the provider network used by the member's Medical, Dental, Vision and Prescription Drug benefits as well as applicable coinsurance (shows member responsibility portion) for in and out-of-network providers. The following guide helps identify the available provider networks for these members:

Members have lower out-of-pocket costs when they receive services from in-network
providers. If you’re not on the network listed on the member’s card, please let the
member know. Customer Service can help the member find a network provider.

Section 10 displays icons indicating various coverage and corresponding copayments:

	Medical benefit (sample lists $20 office visit [OV] copay for personal physicans, $40 office visit copay for specialists)
	Emergency room benefit (sample lists $100 emergency room copay)
	Hospital benefit
	Vision benefit (sample lists $20 office visit copay)
	Dental benefit
	Prescription benefit (sample lists generic, formulary and non-formulary copays)

Medicare Networks
Regence currently has three Medicare networks:

• First Choice Sixty-Five
• Preferred Choice Sixty-Five
• MedAdvantage

Section 1 displays the name of the medical plan.

Section 2 gives the member’s identification number, name and medical (M) and vision (V), prescription (Rx) coverage which is necessary for claims submission and Customer Service inquiries.

Section 3 identifies the member's group number.

Section 4 identifies the primary care provider, applies only to First Choice Sixty-Five and Preferred Choice Sixty-Five medical plans.

Section 5 displays pharmacy discount information, if applicable.

Section 6 displays the office visit copayment.

Section 7 lists claims submission instructions.

Section 8 lists Customer Service and Pre-authorization telephone numbers.

Section 9 displays claims submission instructions for pharmacy claims.

Section 10 lists Pharmacy Pre-authorization telephone numbers.