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group number on insurance card

group number on insurance card

group number on the insurance card

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Understanding your health insurance card:

You should always keep your health insurance card in a safe, but accessible place. Most people carry their health insurance cards in their wallets or purse. Your insurance ID card is like a passport or driver’s license, it gives you access to care and coverage.
Knowing what these common terms and abbreviations on insurance cards mean can help you speed through the forms you have to fill out at the doctor’s office. Let’s go through them together. Look at the example card and your own card. There should be similar parts.

Name of the insured: If you are the policyholder your name will appear here. If one of your family members is the main policyholder it will have their name above yours.

Member ID Number: identifies you, the insured.


Group number: Identifies your employer plan. Each employer chooses a package for their employees based on price or types of coverage. This is identified through the group number. If you purchased your insurance through the health exchange you might not have a group number.

Plan number: health insurance companies have many plan options. This tells you which one you’re on.

Plan type/plan name: There are many different kinds of insurance plans. Common types are HMO (Health Maintenance Organization), PPO (Preferred Provider Organization), EPO (Exclusive Provider Organization), an HDHP (High Deductible Health Plan).

Payment information: Many health insurance cards show the amount you will pay (outofpocket) for common visits such as primary care, emergency, specialists. It is usually listed as a fixed rate, or copay, or as a percentage. Most copays are due at the time of visit.

MassHealth is health insurance for some children and disabled adults and low-income people.

There are different kinds of MassHealth, including:   

  • Standard
  • Limited
  • Family Assistance

Personalized card: such as BMC Healthnet Plan, Tufts Family, Neighborhood Healthplan, or others, use this for doctors’ visits

On the back of the card, there is more useful information! The number to call the insurance company if you have questions about your insurance coverage is there.

Be sure to know the dates to renew or change your coverage. This time of the year when you can make changes is called “Open enrollment.” It is usually in the fall, though you may be able to make special changes at other times. If you have no insurance, be sure to sign up during open enrollment or you could pay a fine!

Other things about health insurance: 

Learn the ins and outs of what is covered in your insurance handbook. When you sign up for insurance either through your job or through the health connector they will send you a handbook. This handbook will describe what plan you have selected and what it covers. READ IT!
Get familiar with your health insurance website. Take a moment and click through the website to see where handy information is. This is another place to find out what is covered in your insurance and what doctors accept your insurance.

Update your insurance company if you have any significant changes such as :
an address, phone number, or how much money you’re making.

If you have a question call them! They have people on staff to help and answer questions you might have. The number is usually on the back of your insurance card as well as on the website.

Insurance companies don’t pay unless something is “medically necessary”. Talk to your care team and insurance about why you need a medication, service, or equipment so they have a clear picture of what is needed and why it makes a difference in your health and quality of life.

HDAP

See if HDAP (HIV Drug Resistance Program) is something you need. It helps residents of Massachusetts pay for their HIV medication and monthly insurance premiums if they have any.
HDAP can help pay for

Medication copays
private health insurance premiums

If you purchased a plan through the connector
HIVresistance testing (genotype and virtual phenotype lab tests)
postexposure prophylaxis (PEP) for potential nonoccupational
exposure to HIV; Preexposure prophylaxis (PrEP) if your nonHIV partner is interested
Talk to your case manager if this is something you might qualify for

Medical Bills

Find ways to pay if your insurance doesn’t. Talk to patient financial services, the billing company, or the hospital. If you have medical bills plan a payment schedule. There are people that are there to help you.

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Your BCBS ID Card Contains Vital Health Insurance Information

Some items go everywhere with us. Our phones, keys, driver’s licenses, and credit cards are kept at our fingertips at all times. It’s easy to see why. Those items are unique to each of us and provide access to the things we need. When it comes to healthcare services, that item is your Blue Cross Blue Shield (BCBS) ID card.

Keep it in a safe, easily accessible place like your wallet. Your card contains key information about your health insurance coverage that is required when you need care or pick up a prescription at the pharmacy. Keeping your card in a secure location will also help protect you from medical identity theft.

If you have misplaced or haven’t yet received your BCBS ID card, a temporary ID card may be available online.

When your BCBS ID card arrives in the mail, take a moment to look for these five things:

1. Double-Check Details

Check your new card to ensure details like the spelling of your name and the type of plan you selected are correct. (See item #2 below to learn how to contact your BCBS company to address any errors.)

2. Key Contact Information

Your BCBS ID card has important contact information to help you reach your BCBS company. Look on the back of your card to find the phone numbers for customer service and eligibility questions. You can also use our directory to find your BCBS company’s website. There you can log into your account and find out more about how to contact the company that provides you service.

3. Your Member ID Number

You’ll need this information when receiving medical services at the doctor or pharmacy, or when calling customer service for assistance. If your group number is available, you’ll find it directly below your member number.

4. Your Plan Type

If you forget or aren’t sure what type of health insurance plan you have (like an HMO or PPO), you can find out on your BCBS ID card. If you have an HMO, your card may also list the physician or group you’ve selected for primary care. Determining whether a provider is in-network is an important part of choosing a primary care physician.

5. Your Co-Pays

Your BCBS ID card may include a list of the co-pay amounts you can expect to pay for common services

Who gets an ID card?

Primary members, their spouses, and dependents age 18 and older get cards. HAP does not send physical ID cards to members under 18 years of age.

All members, including dependents under 18, can access a digital ID card. These are available via our HAP OnTheGo mobile app or by logging in at hap.org. When taking children under 18 for services, parents should show their own cards. Or, they can show their child’s digital ID card.

What does the information on my card mean?

Your member ID card contains two types of information. On it, you’ll find:

  • The contacts you may need to call for help or information.
  • Some numbers that identify your plan or coverage. Those numbers give your doctor’s office or pharmacist the information they need to file a claim for your care.

ID number – Identifies you as a HAP member and is the primary information providers use to get claims processed. It’s also the number you’ll use to register at your hap.org account.

Group ID – How we identify your employer group if you have health coverage through work.

Prescriptions are processed through a company that administers HAP’s drug benefits. This company is called a pharmacy benefits manager or PBM. Rx is short for a prescription. The Rx numbers on your card tell your pharmacy how to process your claim so your prescriptions get paid correctly.

Rubin – Stands for a bank identification number, but it doesn’t actually involve a bank. It’s the number that tells the pharmacy database which PBM should receive your claim.

RxPCN – Stands for the processor control number. It’s another number used to locate your pharmacy member profile under the PBM system.

RxGroup – Each PBM has many groups. This number tells the pharmacy which group you’re in so they can process your prescription payment correctly.

RxID – For members who have Medicare part D, this is your pharmacy member number in the PBM’s system. It’s used to allow the pharmacist to process claims.

Your card also has information about the type of plan you have and your provider network.

Thank you for your consideration.

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