A health care card allows the cardholder to get a discount on prescription medicines under the Pharmaceutical Benefits Scheme. Many health care cards cover the cardholder’s family that including the cardholder, partner, and children. A health care card work quite similarly to a debit card and it works as proof that you have been covered by a health insurance policy that you have purchased.
All health care cards have a policy number and each policy has a unique number. You will find this number on the health care card. This policy number allows other people to verify whether the policy is valid or not. You will find the policy number on the front of the health care card. Usually, the policy number is marked as “Policy ID” or “Policy #.”
What Information Is Available On Health Care Card?
A health care card contains a lot of information and the policyholder needs to have a clear idea about this information. Most health insurance cards contain identification information including –
1. Carrier and Contact Information
2. Names of Covered Individuals
3. Member ID/Policy Number
4. Group Number
5. Plan Type/Plan Name
6. Payment Information
7. Medical Network
8. Prescription Benefits
a) Formulary
b) Prescription Costs
c) Pharmacy Network
d) Rx BIN
Carrier And Contact Information
The health care card contains information related to the carrier and its contact information. You will find the name of the insurance company on the card and how you can contact them. You will find contact information like website address, customer service phone number, etc. usually you will find this information on the back of the health care card.
Names Of Covered Individuals
On the front of the card, you will find the name of the policyholder and covered individuals. If you are the policyholder then you will find your name on the front of the card. If there are other covered individuals on your policy like your spouse or children then their name will also be on your health care card. If you are not the policyholder then your name and policy holder’s name may show in separate fields on the card.
Member ID/Policy Number
You will find the member id/policy number on the front of the card. This is a unique ID number that the health care providers can use to verify coverage and arrange payment for services. Moreover, the policy number is used to look up specific members and answer questions about claims and benefits. The insurance company uses the policy number to keep track of the medical bills of the policyholder.
Group Number
If an employer purchases a health plan for its employees then the plan will have a group number. The group number identifies the specific benefits that the employees will get from the plan. Usually, the healthcare providers use the group number and the policy number to file claims for your care. However, if you purchase the health insurance through a healthcare exchange then you won’t find the group number on the health care card.
Plan Type/Plan Name
There are various types of health insurance plans available and the plan you choose will be displayed on your health care card. It will help the healthcare providers file claims properly according to the plan that is on your card. For some specific plan types, the plan type will be listed on the ID card in a short format like HMO. Here HMO means Health Maintenance Organizations. The most common types of plans are –
1. HMO (health maintenance organizations)
2. PPO (preferred provider organizations)
3. EPO insurance plans (exclusive provider organizations)
4. HDHP (high deductible health plans)
Payment Information
Many health insurance cards contain the payment information that shows the exact amount you will be paying for common visits to your primary care physician (PCP), specialists, urgent care, and the emergency department. The information might be available at a flat rate or a percentage of the cost. If there are two payment information on your card then the lowest one is your cost when you see an in-network provider and the highest one is your cost when you see an out-of-network (OON) provider.
Medical Network
If your insurance company provides out-of-area coverage through a different health care provider network then the name of the medical network will be available on the health care card. You can use this type of network if you need access to healthcare when you are on vacation, out of town or you are on a business trip.
Prescription Benefits
If your health insurance plan includes prescription benefits then you will find related information of prescription benefits on your health care card. The information includes –
1. Formulary: It is the list of prescription drugs that the insurance company will cover for you. Many insurance companies have different formularies under different plans. So the information on the health care card indicates which formulary is for you.
2. Prescription Costs: Most formularies are divided into three tiers and each tier contains different types of drugs. Moreover, the tier has a different price than you have to pay when you will buy medicine from participating pharmacy.
3. Pharmacy Network: Different insurance companies cover different pharmacy networks. So your health care card will contain information about the pharmacy network for your health insurance.
4. Rx BIN: The pharmacist will use the Rx BIN number to process the prescription of the health care cardholder. The Rx BIN number indicates which company will reimburse the pharmacy for the cost of the prescription.
How To Use The Health Care Card
You can use your health care card on any health care provider or pharmacy that accepts Visa® debit cards. However, before using the card you have to activate the card by calling customer care and then following the instructions. Once you activate the card you can easily use the card. Now follow the steps below:
1. First, you have to swap your health care card on the card machine
2. Now you have to choose your credit
3. Then, you have to provide your PIN
4. Finally, save the receipt of your payment in case of feature use
FAQs About Health Care Card
1. Where Can You Use Your Health Care Card?
You can use the health care card in various places like the doctor’s offices, dentist’s offices, pharmacies, vision centers, health-care merchants, etc. Other services or places you can use the health care card are:
1. Ambulance Services
2. Chiropractor
3. Counseling Services
4. Dental, Medical Lab
5. Dentist, Orthodontist
6. Drug Proprietors
7. Health, Med Services
8. Hearing Aid Sales
9. Hospital
10. Nursing, Personal Care
11. Optician
12. Optometrist
13. Orthopedic Goods
14. Osteopathic Physician
15. Pharmacy
16. Physicians
17. Podiatrist, etc.
2. Can I Use My Health Care Card With The Pharmacy Mail Order Program?
Yes, you can use your health care card with the pharmacy mail-order program. In order to do so, you have to provide your account number from your card to the pharmacy vendor.
3. What Is The BIN Number On The Insurance Card?
For insurance cards, BIN stands for Bank Identification Number. A BIN is a six-digit number that tells the database of the pharmacy which Bank/insurance company will receive the claim for the prescription of the health cardholder.
4. What If My Insurance Card Has No Group Number?
It is very common not to have a group number on the health insurance card. So, if your insurance card has no group number then it means you have purchased your insurance through a state exchange or directly from an insurance company. Usually, a health insurance card will have a group number when an employer buys an insurance policy for his employees.
5. What Is The Medicaid Policy Number?
A Medicaid policy number is a 9-digit number that doctors and pharmacies use for billing. You will find this number on your Texas Benefit card.
6. Is Bin Number The Same As The Group Number?
No, the BIN number is not the same as the group number. All health care cards have BIN numbers but not all of them have group numbers. Your healthcare card will only have the group number if your employer buys the insurance for you.
7. Can You Use Your Insurance Without A Card?
Yes, you can use your health insurance without a card. But, in that case, either you have to use your SSN instead of the policy number or you have to directly contact your insurance company.
8. Should I Carry My Health Insurance Card With Me?
You have to show your health care card when you are getting health care service or buying medicine from drug stores. So if you want to avail of medical services immediately then it is wiser to carry the health care card with you.
9. What Is The Insurance Issue Date?
The insurance issue date is the date when your insurance contract is created and you are under the coverage of a policy.
10. Is Subscriber Number The Same As Member ID?
Yes, the subscriber number is the same as the member ID. In fact, the subscriber number is another name of member ID. Some health care cards use subscriber numbers while others use member ID but both have the same meaning and use.
References:
1. https://www.fairhealthconsumer.org/images/en/Health-ID-Insurance-Card-Example.pdf
2. https://campinghiking.net/insurance/what-is-the-policy-number-on-insurance-card/
Last Updated on February 3, 2022 by
Magalie D. is a Diploma holder in Public Administration & Management from McGill University of Canada. She shares management tips here in MGTBlog when she has nothing to do and gets some free time after working in a multinational company at Toronto.
