Membership Information

Membership Information
Rights & Responsibilities

Rights & Responsibilities

Our first priority is always our members. As a Blue Cross of Idaho member, you have certain rights and responsibilities. Learn more about them here.

Best Available Evidence

Best Available Evidence (BAE)

Through the Best Available Evidence (BAE) policy, sponsors must set the right cost-sharing for low-income members when they have evidence that the member’s information is not correct.

NOTE: This link will open a new window and take you away from the Blue Cross of Idaho Medicare website.

Medical Coverage Decision

Medical Coverage Decision

As a Blue Cross of Idaho member, you have the right to ask us to pay for items or services you think should be covered as part of your plan. Learn how to request a coverage decision, which is also sometimes called an organizational determination.

Making an Appeal

Making an Appeal

If you disagree with a coverage decision made by Blue Cross of Idaho, you have the right to appeal. Learn more about the process, as well as how to designate a representative to help you.

Grievances or Complaints

Grievances or Complaints

If you have a problem with one of our healthcare provider networks, pharmacies, quality of care you received, or even about us, you have the right to file a grievance or complaint. Learn more about the grievance and complaint process.

Ending Your Membership

Ending Your Membership

If you choose to end your membership with Blue Cross of Idaho, you can do so voluntarily. Your membership may also be ended involuntarily for a number of reasons. Learn more here.

last update 10/15/2019

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