Member Tool FAQs

​If I change my PCP using the Member Tool, do I need to order a new member ID card?

No. A new member ID card with the name of your new PCP automatically generates. You will receive it in the mail in seven to 10 days.

I changed my PCP on the Member Tool, how come I don't see the change reflected on Member Tool yet?

All PCP changes are marked "pending" in Prevea360 Health Plan's enrollment department. Allow 48 hours for the new information to appear on the Member Tool.

If I change my name using Member Tool, do I need to order a new member ID card?

No. When your name change submission is approved, an ID card with your new name will automatically be generated. You will receive it in the mail in seven to 10 days from the time your Human Resources department approves the change and Prevea360 Health Plan receives the request.

How long does it take to get a replacement ID card if I request it using the Member Tool?

Generally, it takes seven to 10 working days. You can also print an Enrollment Verification from by going into the verification of eligibility services. Medical Assistance members must contact EDS Member Services at 800.362.3002 for a replacement card.

​If I submit a qualifying event change on Member Tool, do I have to provide information to my Human Resources department?

Yes. All changes made on Member Tool must be submitted to your human resources department for final approval and submission to Prevea360 Health Plan. Your human resources department may require documentation from you to process these changes. (e.g. marriage certificate, social security card, etc.).

Where do I get the member ID number to register for Member Tool?

Your Member Tool ID number is the same as the 11-digit Prevea360 Health Plan member number found on your ID card. Medical Assistance members use the 10-digit number on your ID card.

​Why can't I view claims and other information for ALL the people on my insurance plan?

You are only able to access your own information and information regarding your dependent children under age 12. Due to privacy laws, all members over age 12 must register to obtain their own user ID and password. Other members who are on your plan can register by submitting an online request.

​I forgot my password to Member Tool. How do I find out what it is?

A Forgot Your Password feature appears on the login page of the Member Tool. If you can't remember your password, it will ask you to provide your user ID, your name, and email address. If you do not remember your user ID, call the Prevea360 Health Plan Customer Care Center.

When I try to create a new account, I received a message that an account already exists. If I click on Forgot Your Password, I receive a message that my account has been disabled.

If your Member Tool account has been disabled, it must be manually enabled by calling the Prevea360 Health Plan Customer Care Center.