With Open Enrollment coming to a close for most employers, two of the most common questions you will receive as an employer are: "Where is my ID card?" and "How do I seek services if I don't have my ID card?"
The good news is that there are simple answers to both of these questions! The following guide will help you advise employees on each situation.
Where is my ID Card? Once an enrollment is processed with a carrier, ID cards will arrive in the mail in about 7-10 business days. More importantly, once an enrollment is in the carrier’s system, ID cards can be accessed online or via mobile app. When an employee registers on the carrier’s website, they have immediate access to a temporary copy of their ID card that they can print out prior to receiving the physical ID card in the mail. Once registered, the employee can also download the carrier’s mobile app and access an electronic version of their ID card through their smartphone! This is also a great option for children who do not live at home.
PPO or HDHP Enrollees: If an employee is enrolled on a PPO or HDHP plan, the carrier issues two ID cards at a time, and the whole family will have the same ID number and will use the same ID cards. They do notissue individual cards for each family member.
HMO Enrollees: If an employee is enrolled on an HMO, each covered family member will have their own ID card with their own primary care provider (PCP) designation. However, the ID number for all family members will be the same.
Kaiser Enrollees: If an employee enrolls with Kaiser, each covered family member will have their own ID card with their own individual medical record number. Appointments with Kaiser can also be scheduled using a social security number if a medical record number is not accessible. If an employee has been a Kaiser member in the past, their medical record ID number with Kaiser will follow them throughout their lifetime.
Dental and Vision carriers typically do not produce personalized ID cards! Employees should not panic if they do not receive an ID card in the mail. Coverage for employees and their family members can be verified with the provider by providing the employee name, employee date of birth, employee social security number, and carrier name.
How do I seek services if I don’t have my ID card? There are a couple of options for employees who are trying to access care but do not have ID cards yet.
Have the provider (physician/pharmacy) call the insurance carrier. If an employee is using an in-network provider and has identified themselves as a member of a carrier the provider is contracted with, most providers are obligated per their provider contract with that carrier, to call the carrier and verify enrollment. If the provider calls the carrier and an employee is not yet showing enrolled in the carrier’s system, the additional options below may be appropriate.
Postpone payment. An employee can ask if the provider would be willing to wait to bill insurance once they have their ID number or card. This option works best if the employee has a close relationship with the provider. Not all providers are willing to accommodate this request, but it never hurts to ask!
Pay for the service out of pocket. An employee can pay for the service out of pocket and then submit the claim for reimbursement to the carriers via a paper claim form. If the service is for a prescription, an employee can go back to the pharmacy within 7 days of picking up the prescription and the pharmacy should be able to reimburse them directly for any overpayment made. If it’s been longer than 7 days, the employee will have to submit a claim form to the insurance carrier for reimbursement
Postpone the appointment. This is not the most desirable option, but may be one that an employee will have to resort to depending on the provider and their internal policies regarding care without insurance verification.
Kaiser has a “believe me” policy, meaning that Kaiser will allow you to schedule an appointment and see the doctor if you tell them your enrollment is in process. This is a special policy that is specific to Kaiser.
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