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. Here’s an explanation of what a subscriber is on an insurance policy.
WHAT IS A SUBSCRIBER ON A HEALTH INSURANCE POLICY?
A subscriber is the primary account holder on your health insurance plan.
When you purchase a health insurance policy from an insurance company, you become the subscriber. Some people also refer to the subscriber as the policyholder.
The health insurance subscriber is responsible for paying the monthly premium, understanding their coverage, and paying for medical services when necessary.
DO OTHERS HAVE COVERAGE, ASIDE FROM THE SUBSCRIBER?
Another term you might hear when discussing health insurance subscribers is “the insured.” A health insurance policy can generally insure more than one individual. 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). You might also hear these people referred to as “members.”
Here’s an example. Ted has a family of 5. His wife and three children all need health insurance coverage in addition to Ted.
His employer provides health insurance at a reduced cost. Because Ted is the employee, he is the one purchasing a policy from the insurance provider. This makes him the subscriber.
Ted also purchases coverage for his wife and three children. They are on the same policy as Ted, but he is still the subscriber.
His wife and children are members or the insured.
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 health care facility or pharmacy 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.
FIND HELP AND A NEW HEALTH INSURANCE PLAN
If you are confused by health insurance terms and what your responsibilities are and what coverage you have, reach out for assistance.
Contact our Member Services team with any questions you have, and a friendly, knowledgeable team member can assist you. You can call 800-538-5038 weekdays from 7 a.m. to 8 p.m. and Saturdays from 9 a.m. to 2 p.m.
Ready to sign up for a health insurance plan? Select Health plans offer medical, dental, and vision options with a robust network of providers. Browse plans here.
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