MEDICAL field

This field lists the provider network the member must use to receive the greatest benefit. For BlueChoices members, the following networks may be displayed:

• PAR Network
• PPP Network
• Access Network

DENTAL field

This field lists the dental network the member must use to receive the greatest benefit. It will only be populated if the group has chosen a dental benefit rider. For BlueChoices members, the following networks may be displayed:

• PAR Dental Network
• Dental FFS (Fee-for-service)
• Dentacare

VISION field

This field lists the vision network the member must use to receive the greatest benefit. It will only be populated if the group has chosen a vision benefit rider. For BlueChoices members, the only network available is:

• PAR Network

RX field

This field lists prescription medication benefit information for pharmacy use. It will only be populated if the group has chosen a prescription benefit rider. For BlueChoices members, the following type of information will be displayed:

• ARGUS BIN XXXXX

COMMENT lines give detailed benefit information

The comment section was designed to give the maximum amount of benefit information in a standard format. There are four possible lines of information. These lines are formatted as follows:

First Line - Product Information

This line displays the member's product, which will be one of the following:

• BlueEssentials
• BluePreferred
• BlueClassic

This product name can be compared to the BlueChoices Benefit Summary to obtain basic benefit information.

Reminder: BluePreferred is the name of a product. It does not necessarily mean that the member must use a preferred provider. The BluePreferred product is offered with each of the four BlueChoices networks: PAR, PPP and Access. Please remember to review the ID card's Medical field to determine which network the member needs to use to receive the best benefit.

Second Line - Copayments

This line displays any fixed dollar copayment amounts for medical services. For example, if the second line displays: OV COPAY: PERS$20/SPEC$40/ER$100

• The office visit copay for a Personal Physician is $20
• The office visit copay for a Specialist is $40
• The emergency room copay is $100

Third Line - Deductible and coinsurance

This line displays the deductible and copayment amounts due for medical services. For example, if the third line displays: $500DED/80%IN-NTWK/60%OUT-NTWK

• The deductible amount is $500
• In-network services are paid at 80% after the $500 deductible is met
• Out-of-network services are paid at 60% after the $500 deductible is met

Fourth Line - Rider copayments, if applicable

This line displays the fixed dollar copayment amounts for any vision and/or alternative care riders in effect. These riders displayed may include the following:

• VISION
• COMP CARE (complementary care includes services by any licensed chiropractor, naturopath or acupuncturist)
• MANAGED CHIRO (includes services received from a ChiroNet provider only)

  For example, if the fourth line displays: VISION/COMP CARE $20

  • The office visit copay for routine vision is $20
  • The office visit copay for complementary care providers is $20

Back of card

• Claims submission addresses
• Web site address
• Single toll-free phone number for all members

Examples of member's identification cards occur on pages 12 through 18. To view these cards you must have Macromedia Flash Player installed. If you do not have the player, you will be prompted to download it for free from the Macromedia Web site.

Click "Next" below to view a BlueEssentials^SM identification card, using the Preferred Provider Plan (PPP) network