5 Tips for surviving without your ID Card
Each year when your Health Plan changes, there is a small (or large) period of time where you may not have an ID handy.
Either the year end rush of the Insurance provider or the post office has put a cramp on your access to smooth and easy Office Visit or your ability to refill or get a new prescription. Don’t fear, there is a way.
Step 1. Register
Yes, sounds super simple right? Well, it really is.
Go to your health plan’s website and register as a new member. Once logged in, you can print a Temporary ID card.
If you are having trouble getting stuck needing the Member ID on your yet to arrive ID card–look closely on the insurance company website–there is typically an option to provide your Social Security Number in lieu of your Member #.
Step 2. Double Check, did you even need it?
If there was no change to your insurance company, your member ID typically stays the same.
Your old ID card might not display the most current benefits info—but when the Doctor’s Office or Pharmacy verifies your benefits–it somehow still magically works.
The one caveat here, is if your RX Bin # changed. You may need to request your BIN # from your HR Rep in charge of benefits or your broker.
What’s a BIN #? It’s simply the number on your ID card that tells the pharmacy claims system who is reimbursing them for the drugs–and where to send the approval/claims.
Step 3. Keep all Receipts
Sometimes there are unavoidable pitfalls. The most frequent one is that your personal information is not uploaded yet into the Insurance Provider’s Membership & Eligibility database.
This happens very, very often between January 1st and January 15th.
There are simply too many transactions at the end of each year, and it takes some time to process your Open Enrollment or your Companies Enrollment files.
You can submit your claims for reimbursement if you paid out of pocket during this time of limbo.
Request to only pay your “Contractual” rate from Aetna, BCBS, Cigna, Humana, United Healthcare, Kaiser, etc….
Most Dr’s offices know their contractual rate, but if they don’t —-offer to only pay 60% of the charges. Most Office Visits get reimbursed 60% or less than their billing rates.
Step 4. 48 Hour rule @ the Pharmacy
Most pharmacies have a rule that they will re-file & refund any difference between what you pay as a “Cash Pay” patient versus your insurance Copay. They will re-file if you can provide your ID # within a few days.
Some pharmacies will actually do this for you up to 7 days later–but they all can do it at least 48 hours.
Don’t pay the full cash price while you are in limbo. Go ahead and give the pharmacy an RX discount program like the one from freshbenies or GoodRx while you wait for your Health Plan’s ID information.
This should save you 30% or so, and save you from the hurt.
Step 5. Dental and Vision plans are typically “Paperless”:
Don’t sit at home delaying your Dental or Vision visits while you wait patiently for an ID card.
Most Dental and really almost all Vision plans are “Paperless” ID.
All you have to know is your social security number, date of birth and your Plan ID#—they look your benefits up at the provider’s office.
TIP #3: Know your benefits ahead of time.
Vision providers are notorious for up-selling or not honoring the plan copays and discounts. Don’t get taken advantage of.
Example: If your vision plan gives $130 allowance for frames—–do the math, don’t pay more than $70 for a $200 pair of frames.
About the author: An avid learner and resourceful leader with a passion for problem-solving, Bret is a calming force in the chaos and fast-paced evolution of health insurance, employee benefits, and the growing burden of regulatory compliance. He helps people develop the confidence to see beyond the problem at hand and start to re-imagine their goals. Whether he’s helping a client or a colleague, Bret believes a successful interaction is one that allows us all to dream a little bigger when we’re done.
About Generous Benefits: Generous Benefits (www.generousbenefits.com) focuses on solutions that improve the community you serve.