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Hmo insurance card sample. Co pay for visits to primary care provider 7. Humana group medical plans are offered by humana medical plan inc humana employers health plan of georgia inc humana health plan inc humana health benefit plan of louisiana inc humana health plan of ohio inc humana health plans of puerto rico inc. Co pays for emergency and urgent care 9. Quick guide to blue cross and blue shield member id cards.
If tdi is indicated on the id card the member s claims are subject to tdi rules regulations. February 2017 colorado 22 can a member see a pcp within the member s specific network e g. Sample health insurance id card. Blue essentials hmo blue advantage hmo bav blue premier hmh myblue health bft.
While the face of the card resembles that of the traditional hmo membership card the back of the card will display the group practice. Primary care provider pcp name and phone number 5. Member id number 2. About providence health services.
Prescription drug plan information 10. Co pay for specialty care 8. Kaiser permanente signature kaiser permanente select. Mapmg physician as his or her pcp and is covered by hmo insurance the member will receive a white id card with a blue stripe.
License 00235 0008 humana wisconsin health organization insurance corporation or humana health plan of texas inc. Blue advantage plus sm hmo.
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