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Healthcare plan identification (ID) cards - Chapter 2, 2021 UnitedHealthcare Administrative Guide

As we move toward eliminating physical ID cards and conducting contactless transactions to support health and safety protocols, members may not have access to physical ID cards. You may find UnitedHealthcare-specific member information that will help you identify the member’s health benefit plan on Link.

You may download and keep a copy of both sides of the health plan ID card for your records. Possession of a physical ID card is not proof of eligibility.

Quick Tip: Member ID Cards

You can view current ID cards for most members when you verify eligibility using UHCprovider.com/Link.

Commercial health ID card legend

Example Commercial Health ID Card (front and back). Details in text following image
  1. UnitedHealthcare brand: This includes UnitedHealthcare, All Savers, UnitedHealthcare Level Funded, UnitedHealthcare Oxford Level Funded, Golden Rule, UnitedHealthcare Oxford, UnitedHealthOne, UMR and UnitedHealthcare Shared Services (UHSS).
  2. Member Plan Identifier: This is a customized field to describe the member’s benefit plan (i.e., Individual Exchange, Tiered Benefits, ACO).
  3. Payer ID: Indicates claim can be submitted electronically using the number shown on card. Contact your vendor or clearinghouse to set up payer in your system, if necessary.
  4. Primary Care Provider (PCP) name and phone number: Included for benefit plans that have PCP selection requirements. For Individual Exchange Members “PCP required” is listed in place of the PCP name and number. This section may also include Laboratory (LAB), Preferred Lab Network (PLN) and Radiology (RAD) participant codes.
  5. Copay information: If this area is blank, the member is not required to make a copay at the time of service.
  6. Benefit plan name: identifies the applicable benefit plan name.
  7. Referral requirements identifier: Identifies plans with referral requirements. Requires PCP to send electronic referrals.
  8. For members section: Lists benefit plan contact information and, if applicable, referrals and notifications information.
  9. For providers section: Includes the prescription plan name.

Medicare Advantage (MA) Health Care ID Card 

Example Medicare Advantage Health ID Card (front and back). Details in text following the image.

MA ID Card Legend

  1. Payer ID: Indicates claim can be submitted electronically using the number shown on card. Contact your vendor or clearinghouse to set up payer in your system, if necessary.
  2. Dental benefits: Included if routine dental benefits are part of the benefit plan and/or if the member purchased an optional supplemental dental benefit rider.
  3. PCP name and phone number: Included for benefit plans that require a PCP selection.
  4. Prescription information: If the benefit plan includes Part D prescription drug coverage, the Rx Bin, PCN and Group code are visible. If Part D coverage is not included, this area lists information for Medicare Part B Drugs.
  5. Copay information including PCP, specialist, and ER copays. Some special needs plans do not list copay information. Select plans in New York and Minnesota have 2 copayments for PCPs and for specialists. Select Erickson plans have 2 copayments for PCPs.
  6. Referral requirements identifier: Identifies benefit plans with referral requirements. Refer to the Medicare Advantage (MA) Referral Required Plans section in Chapter 6: Referrals for more detailed information. If the benefit plan does not require referrals “No Referral Required” appears on the back of member’s ID card.
  7. Benefit plan name: Identifies the applicable MA benefit plan name.
  8. Plan ID number: Identifies the plan ID number that corresponds to Centers for Medicare and Medicaid (CMS) filings.
  9. For members: Lists benefit plan contact information for the member.
  10. For providers: Lists benefit plan contact information for the care provider.