All health insurance cards should have a policy number. When you get a health insurance policy, that policy has a number. On your card, it is often marked “Policy ID” or “Policy #.” The insurance company uses this number to keep track of your medical bills.
If you have health insurance through work, your insurance card probably has a group plan number. The insurance company uses this number to identify your employer’s health insurance policy. As an employee, you are covered by that policy. Not all insurance cards have a group plan number.
You might see another list with 2 different percent amounts. The first percent, which is normally larger, shows how much the insurance company pays doctors and other health care providers who are considered “in network.” “In network” means that the insurance company has an agreement with this group of providers. The second percent amount is the amount your insurance company pays doctors and other health care providers who are “out of network.” Your insurance company does not have an agreement with providers who are outside the insurance company’s network.
You are allowed to see providers who are “out of network,” but you will have to pay them more than you would to a provider who is “in network.” When you see any health care provider, you will have to pay the amount that the insurance company does not cover. To find out if a provider is “in network” contact your insurance company.
Finally, you might see a dollar amount, such as $10 or $25. This is usually the amount of your co-payment, or “co-pay.” A co-pay is a set amount you pay for a certain type of care or medicine. Some health insurance plans do not have co-pays, but many do. If you see several dollar amounts, they might be for different types of care, such as office visits, specialty care, urgent care, and emergency room care. If you see 2 different amounts, you might have different co-pays for doctors in your insurance company’s network and outside the network.
If you do not see your coverage amounts and co-pays on your health insurance card, call your insurance company (use the number on the back of your card). Ask what your coverage amounts and co-pays are, and find out if you have different amounts and co-pays for different doctors and other health care providers.
Your health insurance company might pay for some or all the cost of prescription medicines. If so, you might see an Rx symbol on your health insurance card. But not all cards have this symbol, even if your health insurance pays for prescriptions. Look at your own card for an Rx symbol. Sometimes, the Rx symbol has dollar or percent amounts next to it, showing what you or your insurance company will pay for prescriptions.
If you are not sure whether your health insurance pays for prescriptions or how much it pays, call the number on your insurance card to find out.
