Members and their spouses and dependents, age 19 and older, receive a member identification (ID) card. The card provides members and providers with important health plan information, including covered riders and copayments. Please note, for HIP-underwritten plans, each dependent child under age 19 will receive his or her own personal ID card.
All Enhanced Care Prime Network and Child Health Plus members will receive their own personal member ID cards.
Unique non-Social Security number-based identification numbers are issued to our members to protect their confidentiality. This practice also protects our members from potential identity theft and fraud. All Medicaid members receive their own personal member ID card that includes a unique Medicaid Client Identification Number.
Diagrams to help you quickly locate key coverage details and contact information when inspecting a member ID card appear in the “Sample ID Cards” section of this chapter.
Ask to see a member’s ID card at each appointment, emergency visit, or inpatient stay. Do not make a decision to provide care only on whether a member has a member ID card. A member ID card does not guarantee eligibility or payment of benefits. Providers should verify member eligibility on our secure website at emblemhealth.com/providers.
Note: GHI PPO members (other than City of New York) are migrating upon plan renewal to our new claims platform through the end of 2020. You will know a member has been migrated when you see an 11-digit alphanumeric member ID. The IDs start with the letter “K” followed by a unique 8-digit number. The final two digits distinguishes the subscriber from each dependent (01, 02, 03, etc.). The old IDs were all numeric and 11 digits long and didn’t start with letter "K". Please ask your patients for their current member ID card at each appointment. Please submit pre-authorization requests and claims using the applicable member ID in effect on the date of service.