How to read a MAP/MAP BASIC identification card

The presence of a member card does not guarantee coverage. Providers are responsible for verifying active coverage prior to rendering services.

Details on coverage verification can be found here. 

MAP/MAP BASIC Card Legend

1.ID#: Member’s Master Record Number.

2. Group ID: Program Group Numeric Identifier

• Medical Access Program (MAP): 53210000
• MAP BASIC: 53230000
• MAP BASIC Dental-only: 53220000

3. Group: Program Name

4. Plan: Program Plan Level (determines service line copayments*)

• MAP Plans: MAP 000/100
• MAP BASIC Plans: BASIC 000/100/150/175/200
• MAP BASIC Dental-only Plans: CUC 000/100/150/175/200

5. EFF: Coverage effective date (format: MM/DD/YYYY).

6. EXP: Coverage expiration date (format: MM/DD/YYYY)

7. Member’s name (format: first middle last name).

8. DOB: Member’s date of birth (format: MM/DD/YYYY)

9. PCP: Member’s Assigned Primary Care Clinic System

• Members may access services at other primary care facilities. 
• MAP BASIC Dental-only members do not have an assigned PCP. 

10. PCP appointment scheduling phone number.

• This field is not listed on MAP BASIC Dental-only member cards 

11. PCP/SPC/UC: Primary care (PCP), specialty care (SPC), and urgent care (UC) copayments. The copay amount to be requested from the member at the time of service.*

• MAP BASIC members do not have urgent care benefits. UC is not listed on the member card. 
• MAP BASIC Dental-only members do not have primary care, specialty care, and urgent care benefits.  

12. OP/ER/IP: Outpatient (OP), Emergency Room (ER), and Inpatient (IP) copayments. The copay amount to be requested from the member at the time of service.*

• Outpatient (OP) copays apply to services such as imaging and durable medical equipment.
• MAP BASIC and MAP BASIC Dental-only members do not have outpatient (OP), Emergency Room (ER), and Inpatient (IP) benefits. These fields will not be listed on the member cards. 
• MAP BASIC members may be eligible for Seton Charity Care for hospital-based services. 

13. RX: Form/NonForm: Formulary and Non-Formulary copayment amounts per eligible prescription to be collected from the member.*

14. DEN/SPDEN: Primary Dental (DEN) and Specialty Dental (SPDEN) copayments. The copay amount to be requested from the member at the time of service.*

15. RX BIN & PCN: Script Care pharmacy claims BIN and PCN identifier numbers.

• BIN: 019462
• PCN: CHC1

16. GPN ID: Field used for purposes not affiliated with MAP, MAP BASIC, or MAP BASIC Dental-only.

For further information regarding click here for co-payments, groups, and plans.