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 delayed your access to a smooth and easy office visit or your ability to refill or get a new prescription. Don’t fear. There is a way.
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 get 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 number.
Companies like Aetna and UHC even have mobile apps that will display your ID card once you are registered on their member sites.
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 number changed. You may need to request your BIN number from your HR Rep in charge of benefits or your broker. What’s a BIN number? 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 and claims.
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.
TIP: Request to only pay your “contractual” rate from Aetna, BCBS, Cigna, Humana, United Healthcare, Kaiser, etc.
Most doctors offices know their contractual rate. If they don’t, offer to only pay 60% of the charges. Most office visits get reimbursed 60% or less than their billing rates.
Most pharmacies have a rule that they will re-file and 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 number within a few days.
Some pharmacies will actually do this for you up to seven days later. But they all can do it at least 48 hours.
TIP: 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 ID information.
This should save you 30% or so.
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 number. They look your benefits up at the provider’s office.
TIP: 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.