Getting ready to sign up for a health or dental insurance plan during open enrollment? If so, you’ll likely receive a new insurance card. Insurance cards contain important information, provide proof of insurance, and ensure you’re charged the right amount for care. They also help your healthcare providers keep your insurance information up to date.
However, many people aren’t sure how to read an insurance card or where to find certain important numbers. In this guide, you’ll find everything you need to know about the common elements of an insurance card.
Reading an insurance card
Insurance cards may contain different information based on the insurance company and type of plan you choose. Most cards include the seven following details.
Most insurance cards include your name and policy number. If you're covered under your spouse or parent's plan, your card may include their name, too.
The policy number on your insurance card is a unique code associated with your insurance plan. Your insurance company uses your policy number to track and process insurance claims and healthcare costs. Policy numbers may also be referred to as a subscriber ID or member ID number.
Where is the policy number on an insurance card?
Typically, you can find your insurance policy number on the front of your card. It may be marked as “Policy #” or “Policy ID.” If you’re unable to locate your policy number, reach out to your insurance provider for more information.
Is a policy number the same as a member ID?
Still not sure about the difference between your policy number and member ID? These terms are often used interchangeably to refer to the code assigned to your insurance policy. As a result, you may see one term on your insurance card and not the other.
Insurance group number
If you have insurance coverage through an employer, your insurance card will likely have an insurance group number, also known as a group plan number.
Like your individual policy number, the group number on your insurance card is a code assigned to your employer’s insurance plan. Insurance group numbers help insurance companies identify the benefits included in your employer’s plan and process claims effectively.
Coverage amounts and copays
The coverage amount refers to how much of your healthcare costs your insurance company will pay. You can usually find this information on the front of your insurance card.
Coverage amounts may be listed as fixed dollar amounts or percentages, such as 25%, 50%, or 75%. Often, several amounts are listed together and may correspond to different types of treatments or office visits.
You may also see additional information regarding copays and in-network or out-of-network care. Let’s take a closer look at each.
A copay is a fixed dollar amount you’re required to pay out-of-pocket for certain types of care or treatments. Also known as a copayment, copays vary based on the type of plan you have, the kind of treatments you receive, and whether you use an in-network or out-of-network provider.
You can typically find copays listed on the front of your insurance card. For instance, you may have to pay $25 for a routine dental cleaning with an in-network provider or $50 for additional services, like X-rays, fillings, or crowns.
In-network and out-of-network coverage
Your insurance card may list two coverage percentages, based on whether you choose an in-network or out-of-network provider. In-network providers are those who have a contractual agreement with your insurance company to provide lower-cost services and treatments. Visiting an in-network provider is often less expensive than an out-of-network provider.
You can still see an out-of-network provider if you choose to do so. However, you’ll likely pay more for out-of-network care. Contact your provider for more information on in-network and out-of-network providers, along with the costs associated with each.
Depending on the type of insurance policy you have, your provider may pay for some or all of the cost of prescription medications. In this case, you may find an Rx category on your insurance card.
Not all cards have an Rx category. If yours does, it’ll list the dollar amount or percentage your insurance company will pay for each prescription. If not, you can contact your insurance company to learn more about coverage and associated costs.
An RxBin number is used to route prescription claims to the correct insurance provider. These codes make it easier for healthcare providers, clinics, hospitals, and pharmacists to identify your insurance carrier and submit a claim.
Insurance provider contact information
Finally, you can find your insurance provider’s contact information on the back or bottom of your card. This information is useful to have in case you need to:
- Ask questions about your benefits and coverage
- Find an in-network provider
- Determine if a service or treatment is covered by your policy
Are you ready for open enrollment?
Now that you’re familiar with the different elements of an insurance card, you can take on a new insurance policy with confidence. Still, it’s important to have a game plan before open enrollment begins.
With that in mind, take some time to evaluate your existing policy and priorities. Talk with your human resources representative to understand more about your employee benefits options, discuss your eligibility, and find the best insurance plans for your needs.