Peek inside your wallet right now — what’s inside? Chances are, there’s some cash, some receipts, maybe a particularly memorable cookie fortune … and a whole lot of cards. These membership cards, credit cards, and submarine sandwich punch cards tend to simply become “objects” that we occasionally have to dig out, and possibly scan or swipe. But how much information is on the card itself?
In high school and college, I had student ID cards, but they essentially only served as keys— to get into school buildings or my dorm, or sometimes to help me get student discounts. If I were to look at any of my student ID cards for useful information, I’d likely be disappointed — unless I somehow woke up in a Jason Bourne movie and forgot what my name was or what my face looked like.
Your Highmark Member ID card, unlike most other cards you carry in your wallet every day, doesn’t have your photo or a magnetic strip. Its function is purely informational. After all, health insurance is both complex and customizable — which is why we outfit our ID cards with lots of important, personalized information. Knowing how to read your card helps you to better understand your plan coverage and costs.
With that in mind, using the ID card visual below, we’ll walk you through some of the information you may see on your own Highmark ID card. Keep in mind that the card below is a sample. It’s unlikely that your card looks exactly like this. It may have a different brand name (this card is for a Highmark Blue Shield plan) and/or plan name (which would appear in the upper right), for example. If you’re a Highmark Medicare Advantage or HMO or HDHP member, your card will definitely vary from this one.
We customize each ID card to give members exactly the information they need, which is why we have 600 variations of the Highmark health plan Member ID card.
You can’t fly internationally without a passport, and your Highmark Member ID card functions similarly when it comes to health care — providers will usually ask for it as soon as you check in at the pharmacy, doctor’s office, or hospital, before they render any services.
Lots of information about your health plan is on the front of the Highmark Member ID card, and understanding it is just as important to you as it is to your doctor, especially in terms of preparing for health care costs.
Health Plan Company Name: In the upper left of your Member ID card, you’ll see the logos of your health plan company — in the example above, it’s Highmark Blue Shield. Other health plan companies under the Highmark Inc. umbrella include Highmark Blue Cross Blue Shield, Highmark Blue Cross Blue Shield West Virginia, and Highmark Blue Cross Blue Shield Delaware.
Plan Name: There’s no plan listed on this sample card, but the upper-right section of yours will list the name of the Highmark insurance plan you’re signed up for. Don’t remember much about your specific plan? You can always log into your member site to find more detailed information about it.
Member Name & ID Number: In addition to your full name, the front of the ID card also lists your Highmark Member ID number. It’s a 12-digit number for non-Medicare/under-age-65 members. It’s a 13-digit number for Medicare members. Don’t worry: You don’t have to memorize the number— that’s why we give you a card, after all. All numbers have a 3-digit alpha prefix in front of them.
This ID number is the most important reason to have your ID card with you whenever you communicate with your health care provider or receive health care services (or when you call our Member Service team for help). It lets providers and their billing departments easily identify you within their billing systems as a Highmark member and also ensures that you get charged the correct co-payment amount. In the past, many insurance ID cards actually listed the member’s Social Security Number, but this practice was discontinued for privacy and security reasons.
Group Number: If your health insurance is part of your job’s benefits package or you’re part of a family plan (or on your parents’ plan, if you’re under 26), you’ll see a Group Number underneath your name and ID number. If you signed up for a Highmark plan as an individual (such as those run through federal or state health insurance exchanges), you’ll also have a Group Number on your ID card. Each member group — whether it’s an employer group, professional association or another kind — has its own unique ID number. That means everyone insured under that plan will have the same group number (but will always have different individual member numbers).
BS Plan: This is your plan’s Blue Shield Association number. The BCBSA is an association of independent Blue Cross and Blue Shield plans.
RxGrp & RxBIN: These numbers help pharmacists to process prescriptions (Rx) for each individual member.
Co-Payment Amounts (Office Visit, Specialist Visit, Emergency Room): For office, specialist, and emergency room visits, co-pays are set amounts that you usually must pay immediately, at the “point of care” (doctor’s office or emergency room, for example) right before or after you receive care. Think of co-pays as small down payments for medical services.
The co-pays on this card are all listed as $0. If you have co-pays in your plan, your co-pay amounts will be listed there.
Some providers may not always collect the co-pay during your visit, however; you may receive a bill by mail later. And do note that different procedures and services might be billed for separately, such as diagnostic tests and surgery.
Later on, you’ll receive an Explanation of Benefits (EOB) from Highmark — a printed copy by mail, or an alert via e-mail, if you’ve signed up on your Member site to be “paperless” — that explains what you need to pay (or have already paid) versus what the plan paid your provider directly for the service. You also will receive a bill from the provider for any charges that your plan doesn’t cover.
Remember that Highmark doesn’t bill you for medical services. Only providers do that. If you have questions about a provider bill you receive, it’s best to call the provider first. Questions about an EOB or claim can be directed to Highmark Member Service.
The back of your Highmark Member ID card lists contact information for important services and resources you’re entitled to as a Highmark member, including Member Service, Blues on Call (health coaches), mental health hotline phone numbers, and more:
Here, on the left, is helpful additional information specific to the person’s plan. Do you see the note about in-network versus out-of-network care? It’s always a good idea to confirm that a provider is in your network and that any care they provide will be covered before you make an appointment or receive services. Member Service can help you with that; your plan website’s provider directory also is a good resource.
On the right, you’ll also see instructions for yourself and for providers on where and how to file health plan claims by mail. You’ll also find the web address for the plan’s website, where you’ll find lots more helpful information on our services and plans, how to stay healthy, find providers, and more.
Unlike most cards in your wallet, there’s lots of important information on both sides of every Highmark Member ID card. We didn’t just design it as a tool that health care providers can use to bill you correctly. It’s an easily accessible resource for all things related to your insurance plan.
After all, it’s called a “plan” for a reason: It helps you adequately prepare for health care and its costs, and ensures that any medical services are processed quickly and smoothly — with your Highmark Member ID Card in-hand, everything will, indeed, go according to plan.
If you have a member service question that involves personal health or insurance information, do not use the "comments" feature; please call the number on the back of your Member ID card.