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Members

Frequently Asked Questions


Members

What is a Member?
What is a Primary Care Physician (PCP)?
Do all family members have to choose the same PCP?
What if I become ill while away from home or in another state?
What if I travel outside of the country?
Can I have my premium payment automatically deducted from my bank account?
Can I make a premium payment for a family member who has difficulty in submitting payments on time?
Can I make my premium payment in person?
I forgot my Member Secure Services password. What do I do?

What is a Member?

A member is an individual who currently has health insurance coverage from Capital BlueCross and its affiliate Capital Advantage Insurance Company.


What is a Primary Care Physician (PCP)?

A duly licensed doctor of medicine or osteopathy who has a contract with Capital BlueCross. The PCP is the initial point of contact responsible for the member's health care. The PCP is also responsible for referring a member to a specialist within the network, when necessary.


Do all family members have to choose the same PCP?

If you're a customer, each member of your family is permitted to choose a different PCP. You do not need to limit your family members to a single PCP.


What if I become ill while away from home or in another state?

Your health care benefits travel easily across the country. Your ID card is your direct link to care anywhere in the country (except with Special Care). When you show your ID card to any participating hospital or doctor across the United States, you'll receive the same special treatment as local members. For covered services, participating providers accept our payment as payment in full, reducing your out-of-pocket expenses. With non-participating providers, you may have to pay more out of your own pocket. More than 85 percent of all hospitals and doctors throughout the United States contract with member plans of the BCBSA.


What if I travel outside of the country?

Through BlueCard Worldwide your benefits travel with you, whether you are traveling across the United States or around the globe. There is a network of participating hospitals and professional providers available to you in over 200 countries. If you are admitted to a participating hospital, all you have to do is show your ID card. If you have to see a doctor or visit a hospital that is not a participating facility, ask for an itemized copy of the bill (translated to English if possible) for the services you received. You may have to pay the provider for these services. When you get home, submit the claim for any applicable reimbursement.  For more information on BlueCard Worldwide or searching for a provider outside the U.S., you can go to BCBS.com and click on BlueCard Worldwide on the right side of the page.


Can I have my premium payment automatically deducted from my bank account?

Yes. We offer a program called Check It Out®, an automated payment option that will deduct your premium directly from your bank account. To take advantage of this free monthly service, you must complete and sign a Check It Out enrollment form. To find out more, you may e-mail your questions or call our Customer Service Department Monday through Friday, 8 a.m. and 6 p.m. at 800.962.2242.


Can I make a premium payment for a family member who has difficulty in submitting payments on time?

Capital BlueCross offers Entrust®, a free service that reminds members when their bill for health care coverage is past due. Once you are signed up for Entrust and your bill becomes past due, we will send your final billing notice to the relative, agency or other person you have chosen to act as your third party representative. This gives the third party an opportunity to contact you about sending in your premium payment immediately to avoid the cancellation of your health care coverage. The third party is not held responsible for your premium payments. To take advantage of this free service, you and the third party must complete and sign the Entrust Enrollment/Change Form. Please call 800.962.2242 for more information.


Can I make my premium payment in person?

Yes. You can make your premium payment in person at either our Allentown or Harrisburg offices Monday through Friday, 8 a.m.-4:30 p.m. You can also mail your premium payment in the envelope provided with your bill.


I forgot my Member Secure Services password. What do I do?

As long as you remember your Member Secure Services User ID, you can still access our Member Secure Services. Simply go to the Member Secure Services area to log in as you normally would. Once on the login page, enter your User ID and select the "Forgot Password?" link in the lower right corner. Enter your new password, then enter it again in the confirmation field. Answer the three Challenge Questions at the bottom of the page with the exact responses you initially provided, and select "Submit." A confirmation message should appear that your password has been successfully changed.