Your Membership Card
You will receive a membership card for each member of your family enrolled in Hometown Health. Please contact our Customer Services Department if you misplace your card.
Effective Date: The date on which your Hometown Health plan
policy becomes effective.
Name: Member name.
PCP: Your Primary Care Physician.
Enrollee #: The member number to identify your policy.
SDS Copay: Same Day Surgery copayment.
Hospital Copay: Inpatient hospitalization copayment.
UC/ER Copay: Urgent Care Center/Emergency Room copayment.
(Benefit limit may apply.)
Office Copay: Medical office visit copayment (payable to your
Primary Care Physician or specialist at the time of service).
Rx Copay: Prescription drug copayment. Generic copayment/brand name copayment.
NOTE: Please present your Hometown Health membership card and pay any copayment due at the time you receive services. Please keep in mind that if you fail to present your membership card or notify the provider that you have Hometown Health coverage, you may be responsible for paying for the services rendered during that visit.
