I. STANDARD OPTION 1. If you have self only coverage and do not have Medicare A & B primary coverage, or if you have family coverage and not everyone in your family has Medicare A & B primary coverage, these are your ID cards:
PRESCRIPTION DRUG CARD

MEDICAL CARD

2. If you have self only coverage and have Medicare A & B primary coverage, or if you have family coverage and everyone in your family has Medicare A & B primary coverage, this is your ID card:
COMBINATION MEDICAL AND PRESCRIPTION DRUG CARD

This is a combination medical and prescription drug card. Use it for medical services and when you are purchasing prescription drugs.

Complete the Request ID Card Form Below if You Would like to Request Replacement ID Card(s)

REQUEST ID CARD

*First Name & Middle Initial:

*Last Name:

Phone:

*Address:

Email:

*City:

*State:

*Zip Code:

Questions or Comments:

* - You must complete all fields marked with a red asterisk (*)