What You Need
to Know about
Member
Identification
Cards
January 2014
1
This guide will give you an overview of the various BlueCross BlueShield of South
Carolina and BlueChoice HealthPlan member identification (ID) cards, the symbols
on these cards and how to use the information on the ID cards.
When members arrive at your office or facility, remember to ask to see their
current member identification cards at each visit. This will help you to identify the
product the member has and get health plan contact information. It will also help
you with claims processing.
Remember, ID cards are for identification purposes only. They do not guarantee
eligibility or payment of your claim. You should always verify patient eligibility by
using My Insurance ManagerSM on our websites, www.SouthCarolinaBlues.com or
www.BlueChoiceSC.com.
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State Health Plan
State Health Plan (SHP) Network
The State Health Plan product uses the State Health Plan Network. Providers that do not participate in
the State Health Plan Network are considered out of network. These plans are easily identifiable by the
Public Employee Benefit Authority (PEBA) logo and the ZCK or ZCS alpha prefix.
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BlueCross BlueShield of South Carolina
Preferred Blue® Network
Federal Employee Program (FEP)
The Federal Employee Program (FEP) uses the Preferred Blue Network. Providers that do not participate
in the Preferred Blue Network are considered out of network. Basic plan members do not have out-ofnetwork benefits while the standard plan operates as a PPO. These plans are easily identifiable by the
Federal Employee Program product name and identification numbers beginning with the letter “R.”
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BlueCross BlueShield of South Carolina
Preferred Blue Network
BlueCross BlueShield Large Group PPO
The Preferred Provider Organization (PPO) products use the Preferred Blue Network. Providers that do
not participate in the Preferred Blue PPO are considered out of network. These plans have many
prefixes and benefits vary.
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BlueCross BlueShield of South Carolina
Preferred Blue Network (PPO)
BlueCross BlueShield Small Group PPO
The PPO products use the PPO Network. Providers that do not participate in the PPO are considered out
of network. Verify the network by looking for the Preferred Blue Network name and the PPO suitcase on
the card. The current PPO Small Group contract is identified by the ZCY alpha prefix. It does not have the
Preferred Blue Network name. The ZCY prefix may also represent an individual PPO policy. The private
local marketplace (exchange) product is identified by the ZCV alpha prefix. The federally facilitated
marketplace (exchange) product is identified by the ZCR alpha prefix. The PPOB symbol indicates the
member got the coverage through the federal exchange.
ZCY123456789999
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Medicare Advantage Plans
Medicare Advantage Network
The Medicare Advantage product uses Medicare Advantage Networks. Providers that do not participate
in any of these available networks are considered out of network. Networks include health maintenance
organization (HMO), medical savings account (MSA), private fee-for-service (PFFS), point of service (POS)
and network sharing preferred organization (MA PPO). You can identify the applicable network by
looking at the indicator on the bottom of the card. These plans are easily identifiable by the Medicare
BlueSM and Medicare BlueSM Saver product names as well as the ZCT alpha prefix.
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BlueCross BlueShield of South Carolina
BlueCross Exchange Network
Blue EssentialsSM Individual (EPO)
The Blue Essentials product covers individuals and uses the BlueCross Exchange Network (Blue Essentials
Network). Providers that do not participate in the BlueCross Exchange Network (Blue Essentials
Network) are considered out of network. This is a separate network from traditional PPO. Verify the
network by looking for the Blue Essentials Network name on the card. The private local exchange
product is identified by the ZCU alpha prefix. The federally facilitated exchange product is identified by
the ZCF alpha prefix. The multi-state plans are identified by the ZCQ alpha prefix. The PPOB symbol
indicates the member got coverage through the federal exchange.
January 2014
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BlueChoice HealthPlan
BlueChoice® Network
Open Access (PPO)
Carolina Advantage, Advantage Plus
BlueChoice HealthPlan Open Access plans use the BlueChoice Network. Providers that do not participate
in the BlueChoice Network are considered out of network. Referrals are not required for members to
see specialists within the network. These plans are identifiable by the ZCL alpha prefix paired with the
Carolina Advantage and Advantage Plus logos.
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BlueChoice HealthPlan
BlueChoice Network
Commercial Network High Deductible Open Access (PPO)
BlueChoice HealthPlan High Deductible Open Access plans use the BlueChoice Network. Providers that
do not participate in the BlueChoice Network are considered out of network. Referrals are not required
for members to see specialists within the network. These plans are identifiable by the ZCL alpha prefix
paired with the Carolina Advantage HDHP, Advantage Plus HDHP, and Consumer Driven Health Plan
logos. Members have a health savings account (HSA), health reimbursement account (HRA) or similar
account to help in meeting deductibles and other approved health care expenses.
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BlueChoice HealthPlan
BlueChoice Network
Commercial MyChoice Individual (PPO)
BlueChoice MyChoice Individual plans use the BlueChoice Network. Providers that do not participate in
the BlueChoice Network are considered out of network. Referrals are not required for members to see
specialists within the network. These plans are identifiable by the ZCL alpha prefix paired with the
MyChoice Individual Coverage, MyChoice Individual Coverage CDHP or MyChoice Open Access logos.
January 2014
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BlueChoice HealthPlan
BlueChoice Network
MyChoice Individual (PPO)
BlueChoice MyChoice Individual plans use the BlueChoice Network. Providers that do not participate in
the BlueChoice Network are considered out of network. Referrals are not required for members to see
specialists within the network. These plans are identifiable by the ZCL alpha prefix paired with the
MyChoice Open Access HDHP or MyChoice Open Access Value Plan logos.
January 2014
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BlueChoice HealthPlan
BlueChoice Network
MyChoice (Primary Choice Plans – HMO)
The BlueChoice HealthPlan MyChoice product uses the BlueChoice Network. Providers that do not
participate in the BlueChoice Network are considered out of network. These products are identifiable by
the MyChoice Individual Coverage logo. Members are required to select a primary care physician (PCP)
and get referrals from their PCPs before seeking the services of a specialist. Primary Choice members do
not have out-of-network benefits.
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BlueChoice HealthPlan
BlueChoice Network
Business Advantage (Small Group PPO)
The Business Advantage Plans use the BlueChoice Network. Local providers that do not participate in the
BlueChoice Network are considered out of network. The private local exchange product is identified by
the ZCL alpha prefix paired with the Business Advantage logo. The federally facilitated exchange product
is identified by the ZCG alpha prefix. The PPOB symbol indicates the member got coverage through the
federal exchange.
January 2014
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BlueChoice HealthPlan Medicaid
BlueChoice HealthPlan Medicaid Network
The BlueChoice HealthPlan Medicaid product uses the BlueChoice HealthPlan Medicaid Network.
Providers that do not participate in the BlueChoice HealthPlan Medicaid Network are considered out of
network. Members are required to also carry their State-issued Healthy Connections ID card (also
pictured here).
January 2014
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BlueChoice HealthPlan
BlueChoice Exchange Network
MyChoice Advantage Individual (EPO)
The MyChoice Advantage product uses the BlueChoice Exchange Network. Local providers that do not
participate in the BlueChoice Exchange Network are considered out of network. This is a separate
network from traditional BlueChoice. Verify the network by looking for the MyChoice Advantage
product name on the card. The private local exchange product is identified by the ZCJ alpha prefix. The
federally facilitated exchange product is identified by the ZCX alpha prefix. The PPOB symbol indicates
the member got coverage through the federal exchange.
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