Blue Cross Care Card

The Blue Cross of Jamaica Limited health insurance system is based on a prepayment programme. The system establishes relationships with providers, i.e., doctors, dentists, optical providers, pharmacies, medical laboratories and hospitals, to provide health care services to subscribers of Blue Cross® health plans.

Blue Cross® Provider Access System (PAS) and began the issuing of Electronic Care Cards to its subscribers in August 2000. This made it possible for participating providers to check their balances on certain benefits as well as to determine if the subscribers are eligible for the services. The participating provider also uses the electronic data interchange system to submit claims online to Blue Cross®. Once the subscriber is eligible for benefits, on presenting Blue Cross® Care Card to a participating service provider, the subscriber will only be required to pay the agreed co-payment amount and sign the completed provider form.

HOW THE CARE CARD WORKS

When you visit a Blue Cross® participating provider for health care service:

• Present the card to the health care provider.
• The provider will swipe the card through the Point of Service machine.
• It dials into the PAS computer system, which gives the provider access to your eligibility information and the balance left on your card e.g. prescription drug balance.
• If you have enough money left on your card, the transaction will be approved. The provider will get that notification and a slip will be printed. You must sign that slip.
• If the transaction is denied, that is, you have exhausted the maximum on that benefit, the system will give that message. You will be required to pay the provider the full amount for service.
• If you visit a non-participating provider, you will have to pay the provider in full for service. Ask the provider to complete and sign a claim form for you and be sure to obtain a receipt for the amount that you have paid. This can then be submitted to Blue Cross® for reimbursement of the eligible amount paid.

FEATURES OF THE CARE CARD

The electronic health card states your name, your policy and member numbers, your group name and number, the effective date of your health plan as well as the expiration date of the card.

BENEFITS OF USING THE CARE CARD

This electronic card improves the efficiency of the service provided to you when you use your Blue Cross® health insurance.

• It reduces the waiting time at the health care provider’s office.
• No manual update of the health card is required. (For certain procedures, the subscriber may be required to complete a paper claim.)
• You will be able to obtain service from providers as soon as you are added to our database.

REPLACING YOUR CARE CARD

If you need to replace a lost, stolen or damaged card, contact the Blue Cross® Customer Service Centre.

HOW TO CARE FOR YOUR CARD

Help to avoid damage to the magnetic strip on your card:

• Keep your card away from cell phones.
• Avoid resting it near magnetic objects.

HOW TO PREVENT FRAUD

• Do not lend your card to anyone.
• Ensure that your health provider returns your card.
• Tender your card for health care services ONLY.