7.2.2 Check Member Coverage Eligibility
If you would like to check Member coverage eligibility, navigate to the Eligibility tab menu option and select Member Eligibility > Eligibility Lookup
Eligibility Lookup Process
Enter Member Information
Enter the Member's Policy and ID Numbers.
Review Results
If they are found, the details for the individuals covered under that Policy and ID Number will be displayed.
Alternative Methods to Check Benefit Eligibility
Submit and Reverse
One way to assess Member benefit eligibility is to submit and reverse a Claim in PROVIDERnet. This is only applicable to a Member's Policy that has the capability to submit Claims through PROVIDERnet.
- To learn about submitting a Claim: Section 7.2.5
- To learn about reversing a Claim: Section 7.2.8
Call Pacific Blue Cross
Member coverage and/or benefit eligibility can also be confirmed by calling Pacific Blue Cross at 1-866-366-0430.