This plan utilizes the Blue Cross of Idaho Preferred Blue PPO network. To locate an in-network provider, visit www.bcidaho.com. Contact the provider prior to your visit to confirm their membership in the network.
Download a claim form from the link below and complete the following:
- Circle the charges on your provider’s statement that you are submitting and staple the statement
to the form. The provider’s statement must indicate: the individual provider’s name or NPI
number, a procedure code and diagnosis code for each service provided, the date the service
was furnished, and the charge for each service. Submit a separate member claim form for each
- Mail all forms to: P.O. Box 7408, Boise ID 83707-1408
Call (208) 345-4550 for any questions.
The Pharmacy Benefit Manager for this plan is Caremark CVS. Only prescriptions filled at CareMark CVS pharmacies are covered. For more information, visit the Blue Cross of Idaho website by clicking the link below or call (800) 552-8159.
Generic: $25 Copay
Preferred Brand Name:$45 Copay
Non-Preferred Brand Name and Specialty Drugs: $75 Copay
Get help while you are traveling
As a student participating in this Student Health Insurance Plan, you are automatically enrolled as a Member in the UnitedHealthcare Global Program.
UnitedHealthcare Global is a comprehensive program providing you with 24/7 emergency medical assistance—including emergency evacuation and repatriation—and other travel assistance services when you are outside your home country or 100 or more miles away from your permanent residence in your home country. Expatriates are eligible regardless of distance from home.
UnitedHealthcare Global provides you with Medical Assistance Services, Medical Evacuation and Repatriation Services, Travel Assistance Services, Worldwide Destination Intelligence, and Security and Political Evacuation Assistance Services. These services are subject to certain Conditions, Limitations, and Exclusions.
Please visit www.UHCGlobal.com and use your dedicated Group ID number (902246430) to create a personalized member ID to access the UnitedHealthcare Global brochure which includes service descriptions and program exclusions and limitations.
To download your UHC Global membership card, see below.
View a glossary of commonly used insurance terms, provided by the Department of Health and Human Services.