Updated: 4.8.25
After selecting your healthcare plan, your insurance company should send you a packet of educational materials that summarize your plan coverage and plan specifics. This information is important for you, as a healthcare consumer, to digest and keep in a safe place for future reference. If you do not understand these documents, call your insurance provider with your questions. If your company has secured a free healthcare advocacy line, such as through your benefits broker, this is also a great option to get your questions answered.
Your health insurance ID card is an important piece of this packet from your provider. Your Health Insurance ID Card is proof of your insurance. If you did not receive this card, call your provider to request a one.
Most health insurance ID cards include the following information:
1. Member. This is usually printed on the front of your card and includes your name and sometimes a dependent as well.
2. Member ID. This number identifies you and tells your provider how to bill your health plan. If your spouse or children are also on your coverage, your member numbers may look very similar.
3. Group Number. This number is also used to identify you and tell your provider how to bill you, as well as track the specific benefits of your plan.
4. Deductibles: These amounts reflect the health costs you are responsible for before the health plan starts sharing costs in both in-network and out-of-network situations.
5. Out of Pocket (OOP) Maximums: The out-of-pocket max is the most you will pay in a given year for all covered services. This is a combined total of deductible, coinsurance and copayments made for any one individual. Once the out-of-pocket max has been met, all covered services are covered with no additional cost share.
6. Phone numbers. Questions about finding a provider, what your coverage includes, how much you will pay for a service or how to navigate billing and payments? A member services number will be listed on your card for you to call for help.
Additional Health Insurance Terminology
Participating Provider: A care provider (Doctor, Geriatrician, Internist, Nurse Practitioner, Physician Assistant, Gynecologist, or Pediatrician) who is a part of your health insurance plan’s network of providers and have a negotiated discount on select services, which will save you money!
Healthcare Advocate: A Healthcare Expert who (in compliance with HIPPA) assists you in navigating your healthcare needs whether it be problems with a claim, billing discrepancies, understanding your explanation of benefits, or any other questions you have regarding your healthcare.
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