Health Insurance ID Cards
Summary
Your health insurance ID card is your proof of insurance. You use it when you visit the doctor, hospital or other provider. But, it is also a quick reference that tells you how much you may have to pay. Understanding your card can help you plan your healthcare expenses and get the care you need.
Most ID cards include:
Personal information. This includes your name and member ID number. If you are covered through your job, it also includes your employer’s name and/or group number.
Your insurer’s name and contact number. Keep your card handy in case you need to contact your insurer. You will generally need to give your member ID number when you call.
Your plan type. Types of plans can include an HMO, PPO, POS, EPO and others. Your plan type tells you the steps you follow to receive care. For instance, in an HMO, a primary care physician (PCP) coordinates your care. You need a referral from your PCP before you can see a specialist. Your PCP’s name will often be listed on your card.
What benefits are covered. These may include medical, dental, vision and prescription drug benefits (look for the Rx symbol).
Your costs. These may include your deductible, coinsurance and copays. (See cost sharing.) You may see different costs for in-network and out-of-network providers. Seeing doctors outside your plan’s network will most often cost you more.
Using Your Health Insurance ID Card
- Review your ID card as soon as you get it. If there are mistakes, ask for a new card.
- Make sure the costs on your card reflect what you know about your coverage.
- Show your card at the doctor’s office each time you get care. Make sure you’re charged the copay listed on your card. (Yearly health exams and other preventive services are free to patients under many plans.)
- Keep all your cards together. You may have more than one. For example, you may have separate prescription or dental coverage. Or, you may be covered by more than one plan. For instance, you and your spouse may have coverage through different plans.
Your Action Plan: Use Your Health Insurance ID Card For Quick Reference
- Review your health insurance ID card as soon as you receive it. If there are any mistakes, contact your plan to request a new card with the correct information.
- Compare the cost-sharing features listed on your card to your summary of benefits and make sure it reflects your understanding of your coverage.
- If you do not receive your health insurance ID card in a reasonable timeframe, contact your insurer.
- Show your health insurance ID card at the doctor’s office when you receive care. Make sure your doctor’s staff charges you the copay listed on your card. If you are there for a preventive visit, ask whether the copay is waived. This is because check-ups and other preventive services are now free to patients under many plans.
- Before you receive care, make sure you know your plan’s rules, and how much your care will cost. Do you need a pre-authorization, or a referral for certain visits? Is your provider in your network?
- If your benefits change, your plan will send you a new card. Don’t ignore it. Make sure you’re using your most current card when you go for your visits.