I lost my carefirst card

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Providers may decide to terminate from a plan network at any time. A provider terminating from a plan is not considered a qualifying event that would allow coverage to be canceled or changed. Employees must wait until the next Open Enrollment period to make any changes to plans.

Lexington St. All rights reserved. Skip to navigation Skip to content. Human Resource Services. How the Plans Work Once enrolled in a medical plan, the employee will receive identification cards in the mail to be used every time medical services are received. When a Provider Terminates from the Plan Network Providers may decide to terminate from a plan network at any time.

When you receive you card, you will want to look it over and confirm that all information included on the card is correct. If any of the information is incorrect please contact us or , and a new, corrected card will be issued. It is important to carry this ID card with you at all times as you are required to show the card before receiving medical or pharmaceutical services of any kind.

If at any time you lose your enrollee ID card, and would like to request a new one, please click on the link below. Designed and Powered by Inroads. Powered by QuikWeb Developer. Thank you for your help. Report incorrect info for www.

Help us stay up to date. Use this form to let us know about corrections and we'll follow up. Alliance Enrollees. Home Your ID Card. Email A Friend Print.

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In addition, many members have a right to an independent external review of any final appeal or grievance decision. Refer to your Evidence of Coverage for more specific information regarding initiating an external review, a final appeal determination or a complaint.

If you need language assistance or have questions, call the Member Services telephone number on the back of your member ID card. Get a Quote. Skip Navigation. Login Register.

Have questions about health insurance? Explore our Insurance Basics pages. Need Insurance? Log In or Register. We know healthcare can be complicated.

To learn more, choose a topic from the list below. Expand All Collapse All Covered benefits. All of our plans include core health benefits, including: Office visits Maternity and newborn care Prescription drugs Laboratory tests and X-rays Preventive and wellness care Dental and vision for children under age 19 Emergency services Hospitalization Behavioral health and substance use disorder Physical, speech and occupational therapy.

Common non-covered benefits. Finding a primary care provider. Finding a specialist, behavioral health or hospital resource. After office hours or emergency care. Out-of-area care and benefit coverage. How to submit a claim. You can submit your claim one of two ways: Mail your claim form To print and mail your claim form, log in to My Account, select the My Documents tab, choose Forms. Choose the form for your type of claim and fill in the required information.

Then, mail the form using the directions included. If you do not have internet access, you may request a paper claim form by calling Member Services at the telephone number on the back of your member ID card. Submit your claim form online CareFirst also offers online claims submission for medical, dental and behavioral health claims.

From your computer or mobile device, log in to My Account and select Claims. Enter the requested information, upload the required documents and submit. Understanding the review process. The medical review process includes, but is not limited to: Preservice review The preservice review serves as a check to assure that members receive the right service in the right setting at the right time.

Requests for review include high-cost, complex inpatient, experimental, cosmetic, and outpatient services. The preservice review also helps ensure services are provided by in-network providers. Your doctor must initiate your authorization request.

All admissions are reviewed and categorized by severity level. The urgent review process continues until the member is approved to go home.

Concurrent review decisions are made within 24 hours. Post-service review Members may be eligible for a post-service review. CareFirst collaborates with facility administrators, medical clinicians and members to determine needs based on medical criteria and member benefits. Decisions must be made within 30 calendar days of the initial request.

Pharmacy procedures. Generics are dispensed when available unless your provider determines that a brand-name drug is necessary for your overall health. There may be cost-sharing implications for choosing non-preferred brand medications when generics are available.

You should always check with your doctor to make sure a generic alternative is right for you. Prior authorization from CareFirst is required before you fill prescriptions for certain drugs. Your doctor may need to provide some of your medical history or laboratory tests to determine if these medications are appropriate.

Without prior authorization from CareFirst, your drugs may not be covered. Step therapy is a program designed to help you save on prescription drug costs. You can also reach out to the DC Health Link as noted below:. They will be able to give you your member ID number in case you need to receive care or want to sign up for My Account.

Separate Deductible: Although the entire family deductible must be met, once each family member meets his or her individual deductible amount, they can start receiving benefits. Each family member cannot contribute more than the individual deductible amount.

Aggregate Deductible: The family deductible must be met before any member can begin receiving benefits. The deductible may be met by one member or any combination of family members.

For security reasons, you will be locked out of My Account after five unsuccessful attempts. If you are still having trouble, call My Account Technical Support at The BlueCard program will put you in touch with these local network providers. Benefits are covered for emergency services received from doctors who do not participate with a BCBS plan.

However, you may be financially responsible for balances over the allowed benefit. When you need care, simply show your member ID card and the hospital or doctor can submit the claims. However, if payment is required up-front, contact Member Services to obtain a claim form for consideration and reimbursement of charges.

Yes, you will receive the highest level of benefits for emergency care whether you visit an in- or out-of-network provider. After CareFirst receives your claim, we will submit the claim on your behalf to the local BlueCross BlueShield plan where you received healthcare services.

Whether you submitted the claim via email or My Account, please allow this process to take up to 30 days. The DC Health Link will be providing various informational outreach and training sessions during open season. Your Health Benefits Officer can provide the dates, times and locations of these events.

DC Health Link is also available online or by phone noted below:. You can also follow them on Twitter and YouTube. To make any changes, you will need to contact your Health Benefits Officer. During the year, you may experience a "qualifying life event" that can make you eligible for a Special Enrollment Period to enroll in health coverage. Examples of qualifying life events include moving to a new state, certain changes in your income, and changes in your family size for example, if you marry, divorce, or have a baby.

If you experience a qualifying life event, contact your Health Benefits Officer to update your benefits information and enrollment.

If you have been unsuccessful in contacting the DC Health Link via phone or web, we recommend that you advise your Health Benefits Officer and allow them to intervene on your behalf. In most cases, these are high-cost prescription drugs that may require special handling, administration or monitoring and may be oral or injectable medications.

Here is a list of specialty drugs PDF. Most medications administered by a provider are not dispensed by a retail pharmacy such as CVS or Walgreens. Your healthcare provider will usually supply and administer the medication when you come for your appointment, then bill your insurance company. Non-preferred brand drugs often have a generic or preferred brand drug option where your cost-share will be lower. If you fill a non-preferred brand drug when a generic alternative is available, you will pay the non-preferred brand copay or coinsurance plus the cost difference between the generic and non-preferred brand drug, even if your doctor states Dispense as Written DAW on the prescription.

There is an exception process if you need the brand-name drug to be covered for medical necessity reasons. Your doctor may submit a brand exception request. To view this form, visit our Drug Forms. With mandatory generics, you save the most by using generic drugs when available versus brand-name drugs. If you decide to purchase a brand-name drug when a generic is available, you will pay the non-preferred brand copay plus the cost difference between the generic and brand-name drug.

When you get a prescription from your provider, make sure it states it is for a month supply and the contraceptive being prescribed is FDA approved. If a copay is due, you will be expected to pay the appropriate copay for the entire month supply. If you use a non-participating pharmacy you will be responsible for the full cost of the prescription and will need to submit a Claim Form for eligible reimbursement. For more information, visit our Drug Tools page. Frequently asked questions.

Prescription Drug Benefits. Expand All Collapse All Q.