Understanding My Insurance Card

Your insurance card has many important pieces of information on it that help determine what is covered and what your financial responsibility is. While this information can vary depending on what your coverage is, most cards have some common information on it.

1. Subscriber name and Subscriber ID refers to who the primary insured person is, and the number that our office will need to file the claim.
   1. This section may also show Member name and Member ID if your coverage includes others, such as family members.
2. Plan type: Many insurance payors are made up of different plans that include different coverage options. Let your clinic know what plan you see listed on your card.
3. Group numbers: Some cards may include group names or numbers. This information will be important to share with the clinic.
4. Date issued/Effective From: This date indicates how long you and any listed members have been covered under the insurance plan.
5. Copay/Deductible/Prescription cards: Most cards will have a section that includes what you can expect to pay at the doctor’s office. These fees can vary depending on if your visit is to an in-network or out-of-network provider, or if you are seeing a primary care doctor or a specialist.
6. Insurance Contact Information: This information is likely on the back of your card, and should include an address where we can mail your claim, as well as various phone numbers including Customer Service, that can help answer questions about your insurance.

Understanding My Medicare Card

When you’re enrolled in Medicare, you’ll get your Medicare card in the mail. If you’re automatically enrolled, you’ll get your Medicare card in the mail three (3) months before your 65th birthday or your 25th month of getting disability benefits. Your Medicare card shows that you have Medicare health insurance. It shows whether you have Part A (Hospital), Part B (Medical) or both, and it shows the date your coverage starts. Listed below in an example of the new Medicare card.

• Name: Refers to who the insured person is (yourself only).
• Medicare Number: Medicare Beneficiary Identifiers (MBIs), are unique and randomly generated. (Your new Medicare card will no longer have your Social Security Number (SSN) listed.)
• Entitled: Indicates your level of coverage.
• Coverage starts: This date indicates how long you have been covered under the insurance plan.
• Insurance Contact Information: This information is likely on the back of your card and should include an address where we can mail your claim, as well as various phone numbers including Customer Service, that can help answer questions about your insurance.

Medicare has different parts that help cover specific services:

• Medicare Part A (Hospital Insurance): Part A helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care.
• Medicare Part B (Medical Insurance): Part B helps cover doctors’ services and outpatient care. It also covers some other medical services that Part A doesn’t cover, such as some of the services of physical and occupational therapists, and some home health care.
• Medicare Part D (Prescription Drug Coverage): Medicare prescription drug coverage is available to everyone with Medicare. To get Medicare prescription drug coverage, people must join a plan approved by Medicare that offers Medicare drug coverage.

Things to know about your Medicare card

• Your card has a Medicare Number that’s unique to you, instead of your Social Security Number. This helps to protect your identity.
• If you’re in a Medicare Advantage Plan (like an HMO or PPO), your Medicare Advantage Plan ID card is your main card for Medicare—you should keep and use it whenever you need care. And, if you have a Medicare drug plan, be sure to keep that card as well. Even if you use one of these other cards, you also may be asked to show your Medicare card, so keep it with you.

Effective – April 2018