Member ID Cards
Innovation Health
Member ID Cards
71.03.341.1 (2/14)
innovation-health.com
Quickly locate the information you need on our member ID cards For questions regarding member-specific benefits and cost-sharing information, please use the Eligibility and Benefit transaction on our secure provider website, or call the number on the back of the member’s ID card. Refer to the sample ID card below for a description of the information you may see on our member ID cards. 4
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1 — Customer name, if requested 2 — Member ID 3 — Member two-digit identifier and member name 4 — Group number (format varies depending on product) 5 — Primary insured’s primary care information, if one is selected and/or required 6 — Dependents’ two-digit identifier(s) and name with primary care information 7 — NAP program name 8 — Product Name 9 — Pharmacy information 10 — Copay and cost-sharing amounts for some health services (Member pays the dollar amounts ($) at the time of service and the percentage (%) amounts after we pay our portion of the negotiated rate. If a copay or cost-sharing amount is not listed, this does not mean the member does not have any financial responsibility.)
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1 — Web address 2 — Claims address 3 — Telephone numbers 4 — Payer number
innovation-health.com Health benefits and health insurance plans are offered and/or underwritten by Innovation Health Plan, Inc. and Innovation Health Insurance Company. Innovation Health Insurance Company and Innovation Health Plan, Inc. (Innovation Health) are affiliates of Inova and Aetna Life Insurance Company (Aetna) and its affiliates. Aetna and its affiliates provide certain management services for Innovation Health. This material is for information only and is not an offer or invitation to contract. An application must be completed to obtain coverage. Rates and benefits may vary by location. Health benefits and health insurance plans contain exclusions and limitations. Providers are independent contractors and not agents of Innovation Health or Aetna. Provider participation may change without notice. Innovation Health or Aetna do not provide care or guarantee access to health services. Not all health and dental services are covered. See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features are subject to change. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Innovation Health plans, refer to innovation-health.com. ©2014 Innovation Health Plan, Inc. 71.03.341.1 (2/14)
Member ID Cards
71.03.341.1 (2/14)
innovation-health.com
Quickly locate the information you need on our member ID cards For questions regarding member-specific benefits and cost-sharing information, please use the Eligibility and Benefit transaction on our secure provider website, or call the number on the back of the member’s ID card. Refer to the sample ID card below for a description of the information you may see on our member ID cards. 4
1
7
1
8
2
9
3 4 5
2
10
6
1 — Customer name, if requested 2 — Member ID 3 — Member two-digit identifier and member name 4 — Group number (format varies depending on product) 5 — Primary insured’s primary care information, if one is selected and/or required 6 — Dependents’ two-digit identifier(s) and name with primary care information 7 — NAP program name 8 — Product Name 9 — Pharmacy information 10 — Copay and cost-sharing amounts for some health services (Member pays the dollar amounts ($) at the time of service and the percentage (%) amounts after we pay our portion of the negotiated rate. If a copay or cost-sharing amount is not listed, this does not mean the member does not have any financial responsibility.)
3
1 — Web address 2 — Claims address 3 — Telephone numbers 4 — Payer number
innovation-health.com Health benefits and health insurance plans are offered and/or underwritten by Innovation Health Plan, Inc. and Innovation Health Insurance Company. Innovation Health Insurance Company and Innovation Health Plan, Inc. (Innovation Health) are affiliates of Inova and Aetna Life Insurance Company (Aetna) and its affiliates. Aetna and its affiliates provide certain management services for Innovation Health. This material is for information only and is not an offer or invitation to contract. An application must be completed to obtain coverage. Rates and benefits may vary by location. Health benefits and health insurance plans contain exclusions and limitations. Providers are independent contractors and not agents of Innovation Health or Aetna. Provider participation may change without notice. Innovation Health or Aetna do not provide care or guarantee access to health services. Not all health and dental services are covered. See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features are subject to change. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Innovation Health plans, refer to innovation-health.com. ©2014 Innovation Health Plan, Inc. 71.03.341.1 (2/14)
