What Does a Subscriber Mean When It Comes to Health Insurance?

For many people, the health insurance world is downright puzzling. With unfamiliar terms like “deductible” and “subscriber,” you may wonder what it all means and how the words relate to your policy. We’re breaking down the meaning of “subscriber” on an insurance policy to help you get a better understanding.

What is a Health Insurance Policy?

A health insurance policy is issued by an insurance company, offering coverage for specific treatments and procedures. Of course, no one plans to get injured or sick, but it can happen at any time. To protect yourself from the high costs associated with medical care, you need health insurance that will cover your treatments. Your policy typically covers essential health care needs that relate to treating illnesses and injuries, as well as maintaining your health and preventing future problems.

Health insurance companies create contracts for members, who enter into agreements to pay an agreed-upon amount each month. This amount is known as the premium. In exchange, the company agrees to pay for certain procedures and treatments, such as office visits, hospital stays, and surgeries.

Related: How Health Insurance Claims Are Processed

What is a Subscriber on an Insurance Policy?

The individual who enters into the agreement with the insurance company is known as the subscriber or member. Another term for this person is the policyholder. Also, If you buy a policy directly from an insurance company, you would be considered the subscriber.

Some plans also include beneficiaries, which are different from subscribers or policyholders. The term typically only applies to coverage like life insurance, where a beneficiary receives a payout after an event occurs. An insurance policy can have multiple beneficiaries but only one subscriber or policyholder.

Do Others Have Coverage, aside from the Subscriber?

Another term you might hear when discussing health insurance subscribers is “insured.” A policy can generally insure more than one individual, and all additional covered members are referred to as “the insured.” On a health insurance policy, the insured might include the subscriber’s immediate family, such as their spouse and child(ren).

Related: 3 Common Misconceptions about Health Insurance

What You Need to Know about the Subscriber

If you’re not the subscriber on your health insurance plan, you’ll need to bring certain information about that individual when seeking medical treatment. When something gets billed to the insurance company, it will include the name and details of the patient. However, it’s difficult for the company to locate that patient in the system if they aren’t the one subscribed to the policy. The billing information should also include the details of the policyholder, such as their name and date of birth.When you visit a medical office or hospital, you will need to provide this information so it can be added to the insurance details in your patient record. Make sure you know the subscriber’s full name (as it is registered with the insurance company) and their date of birth.

If you have any questions about your health insurance policy, you can always reach out via the number printed on your member ID card. A representative can assist you, whether you need information about your coverage and benefits or you want to better understand what certain terms mean in relation to the policy.