Frequently Asked Questions


12 Important Terms to Know



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If you would like to request the printed copy of any or all of our plan notices or materials, call Member Services at 800-538-5038.

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TOPICS

TYPE

Member Account

How do I update my address if I am enrolled directly through Select Health?
How do I update my address if I enrolled through HealthCare.gov?
How do I update my address if I enrolled through Your Health Idaho?

Medicaid

Who do I call if I have questions?
How can I learn more about my health benefits?
How do I update my address or phone number?
How do I appeal a claim?
How can I learn more about my pharmacy benefits?
How can I get an exception for drugs not covered under my pharmacy benefits?
When do I need preauthorization?
Why was my claim denied?

Plan Termination

How do I terminate my Select Health Individual and Family policy?
How do I terminate my Select Health Individual and Family policy if I enrolled through Your Health Idaho?
How do I terminate my Select Health Individual and Family policy if I enrolled though HealthCare.gov?
My Individual and Family policy is showing as terminated—how can I reinstate it?

Premium Payment

Are all my previous Individual and Family policies shown on my account, or just my current policy?
Can I link my account with a family member's account to have the convenience of paying it all at once?
Can I pay a different amount other than the amount showing due?
How can I print a receipt of the payments I have made?
How do I change my saved credit card information?
How do I enroll to receive paperless premium statements?
How do I set up autopay for my Individual and Family policy?
How long does it take for my Individual and Family premium information to update once I make my payment online?
If my rate changes, will automatic payments continue?
I’m on an Individual plan. What can I do to lower the cost of my premium?
When do I need to set up autopay for my Individual and Family policy?
When is my Individual and Family plan payment due?
Why can't a parent have access to make a premium payment a child's online SelectHealth account?
Why can't I see my Individual & Family premiums if I am on the same policy as my spouse?
Why is my last payment not showing on my current statement?
Are there any grace periods for premiums?

Claims

Where can I make my payment for claims? How do I make a payment on my claims?
How do I submit claims for reimbursement?
When I log in to my member account, my claim shows as pending or pended. What does that mean?

Definitions

What is an Explanation of Benefits (EOB)?
What is a Coordination of Benefits (COB)?
What is an allowed amount?
What is a subscriber?
What is a deductible?
What is coinsurance?
What is a copay?
What is an out-of-pocket (OOP) maximum?
What is a premium?
What is preauthorization?
What is a primary care doctor?
What are excess charges?
What are Benchmark Plans?

Online Tools

How do I sign up for paperless communications?
What can I do with online tools?
Does Select Health have a mobile app?

ID Cards

Can I download a copy of my ID card?
Why does my ID card only show my name? Can I get an ID card for my dependents?

Tax Information

Why is Select Health requesting the social security number of someone on my policy?
How can I access the 1095-A form for tax preparation?
How can I access the 1095-B form for tax preparation?
How can I access the 1095-C form for tax preparation?
Where can I find my 1095-A Form?
Where can I find my 1095-A Form if I purchased my plan on HealthCare.gov?
Where can I find my 1095-A Form if I purchased my plan on Your Health Idaho?

Eligibility

Do I qualify for a Special Enrollment Period (SEP)?
How do I cancel my medical/dental policy? How do I make changes to my medical/dental policy? How do I add my baby to my plan?

Pharmacy

How do I fill a prescription?
Can I get a 90-day supply of my medication?
How do I obtain drugs that are not the Select Health Drug Lists?
Which drugs or medications are covered by my plan?
How much will my prescription cost?
Why wasn’t my drug covered?
What is a generic drug?
What is a formulary? What is a prescription drug list?
What is step therapy?
What are quantity limits?

Drug Exception Time Frames and Enrollee Responsibilities

I’m on an Individual plan. What is my formulary and how does it work?

Member Rights and Privacy Practices

What are my rights and responsibilities as a member?
How does Select Health protect my privacy?

Out of Network Liability

What if I received services from an out-of-network provider?

Recoupment of Overpayments

What happens if I overpay my premium?

Retroactive Denials

What happens if my policy is canceled but I had claims pending?

Medical Technology

How does Select Health make coverage decisions about new technologies and services?

Access to Rural Healthcare

I live in a rural area. Can I see a doctor who is not on my network?

Preauthorization

What is the preauthorization process?
What are some examples of procedures that may require preauthorization?
Why is it important to receive preauthorization?