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How to Identify a Marketplace Member

BlueCross members with Marketplace and traditional individual health insurance plans have the same member ID card you have been accustomed to seeing for years.

There are a few minor differences:

  • Individual member ID cards prominently feature the provider network associated with that member’s plan in the upper right corner, in addition to the lower left corner.
  • Members with “On” Marketplace plans are in Group number 127600.
  • Members with “Off” Marketplace or traditional individual insurance plans are in Group number 129800.
ID Card

Alpha prefixes

While ID cards may show different Alpha prefixes, that information is not as relevant in identifying members as the Group numbers are. For your reference, you may see the following Alpha prefixes on member ID cards:

Essential Health Benefit (EHB) Products

Blue Network P

Blue Network S

Blue Network E

On Marketplace

Not Offered

ZXB

ZXX

Off Marketplace

ZXP

ZXS

ZXY

Multi-State Plan (On Marketplace)

ZXC

Not Offered

Not Offered


Identifying Members Who Receive Financial Assistance

You might be interested in knowing which individuals receive financial assistance with their monthly premiums. However, that interaction is between the individual and the federal government. It has no impact on the way our member is treated by a health care provider or by BlueCross.

Even though an individual purchased health insurance through the Marketplace, it does not necessarily mean they receive financial assistance.

Just as you do with your patients now, you’ll need to verify benefits and eligibility at the time of service. Doing so will also help you determine if your patient has any payment obligations. This process is the same for Marketplace members as it is for any other commercial member. It is also important to verify the member’s provider network before offering health care services.