Sample Medicare Plus Blue PDP ID Card

Front of card            Back of card

• Switch to PPO card
• Switch to MPSERS card
• Switch to UAW Retiree Medical Benefits Trust card

Legend

• Member name – Each Medicare Plus Blue PPO and Prescription Blue PDP member gets a card in his or her own name.
• Contract number – Identifies the member record in our files for health care services. XYL=MA PPO; XYA=PDP
• If the member has prescription drug coverage, information for pharmacy to file a drug claim.
• Customer Service phone numbers – If you have questions about coverage or claims, call the appropriate Customer Service number.