A quick look at
your health plan ID card
Remember to show your ID card whenever you visit your health care provider.
It has key information about you and your coverage.
Member ID and
group number
You’ll need these numbers
when you contact us or
register online.
FRONT
Member/
dependents
Anyone covered
by your plan will
be listed here.
Health Plan (80840)
911-87726-04
Member ID: 123456789
Member:
SUBSCRIBER SMITH
Group Number:
PCP:
Payer ID 87726
FIRSTNAME LASTNAME
PCP Phone: (999) 999-9999
Copays:
Office: $25
UrgCare: $75
Rx Bin:
Rx PCN:
RX Grp:
ER: $100
Spec: $50
610279
9999
UHEALTH
Referrals Required
[UnitedHealthcare network]
DOI-0501
Primary care
provider (PCP)
Some plans require
you to choose a
PCP. Your PCP
may be listed here.
9997590
Underwritten by [Appropriate Legal Entity]
Co-pays
If your plan has
co-pays for certain
services, you can see
the amounts here.
This card does not guarantee coverage. To
provider; visit the websites, email or call. R
Referrals
For Members:
www.myuhc.c
Advocate4Me
required
Check your
For Providers: www.UnitedHealth
benefit
plan
Medical
Claims: PO Box 740800
documents
to see which
Pharmacy Claims: OptumRx PO Box 2
services
Forrequire
Pharmacists: 888-290-5416
a referral from
your PCP.
Your network
Always seek
care from
providers in
your network.
BACK
Printed: 01/15/16
726-04
Contact us
9
Group Number: 9997590
Look for our
phone
number,
Payer ID 87726
email address
Rxand
Bin: website
610279
Rx PCN: 9999
RXinformation
Grp: UHEALTH
in this area.
Referrals Required
[UnitedHealthcare network]
Underwritten by [Appropriate Legal Entity]
This card does not guarantee coverage. To verify benefits, view claims, or find a
provider; visit the websites, email or call. Referrals required for certain services.
For Members:
www.myuhc.com
[email protected]
999-999-9999
For Providers: www.UnitedHealthcareOnline.com 877-842-3210
Medical Claims: PO Box 740800, Atlanta GA 30374-0800
Pharmacy Claims: OptumRx PO Box 29044 Hot Springs, AR 71903
For Pharmacists: 888-290-5416
These are just samples. Your card will be personalized with your plan information.
Certain details may appear in different areas on your card.
Lost your ID card? Go to your member website to print a copy or order a new one.
The information provided here is for general informational purposes only and not intended
to be nor should be construed as medical or other advice. You should consult your own
doctor and/or an appropriate professional to determine what may be right for you.
INL1603.04
© 2016 United HealthCare Services, Inc.