How to Call Your Insurance Company

2 min read

Contacting your insurance can be stressful; we’re here to help make it simple and empower you to take charge of your health.

How do I know what number to call?

The number is often found on the back of your insurance card called “Member Services”. If you don’t have a physical card, you can check your online portal or simply google the name of your insurance plan (ex. Search “Aetna customer service phone number”). If you call early in the morning, there will likely be less of a wait time.

What should I expect when I call?

The customer service representative from the insurance company will ask you some basic information to confirm your identity and look up your account, such as your name, date of birth, or ID number on your insurance. If you’re on a parent’s insurance plan, or your partner’s, they may also ask for the name and date of birth of your primary cardholder (aka your parent/partner who is responsible for paying for the insurance).

What should I have on hand when I call?

If possible, it’ll be helpful to have your most up-to-date insurance card on hand. It can also help to have a pen and paper handy, in case you need to write down any information!

What types of scenarios should I call my insurance?

  • Your insurance expired: If your current insurance has expired and your new information hasn’t arrived in the mail yet, you can call your insurance and ask for your updated processing information. The pharmacy will likely need the updated Rx BIN, PCN, Group and ID numbers for the account in order to process your insurance.
  • You need a pharmacy insurance card: Health insurance plans typically manage your prescriptions through a Pharmacy Benefits Manager (PBM). If you only have a medical insurance card and the pharmacy needs your pharmacy processing information, this is something your insurance may be able to provide over the phone. You can ask for the Rx BIN, PCN, Group and ID numbers. For example, you may have a medical insurance card from Aetna, but your prescription benefits are through CVS Caremark.
  • You have multiple insurances, but need to make one of them your primary insurance: The pharmacy may receive a rejection that your insurance is denying coverage because you have a different primary insurance plan. Some people have multiple insurances, but only one of them is your primary insurance. You'll need to call your insurance and let them know which is your primary coverage so they can update it in their system.
  • Your insurance isn’t covering refills with Twentyeight (or the pharmacy of your choice): Even if you’ve gotten refills through us in the past, it’s possible your insurance may stop covering refills after a few deliveries, which is called a “mail order” rejection. This often happens when the pharmacy filling your prescription is not in your insurance's 90-day network. You can call your insurance and ask to opt out of their mail order program to allow your pharmacy to continue dispensing your prescription.
  • Date of birth or gender mismatch: If the pharmacy tries to bill your insurance and it seems the date of birth listed for you is incorrect, you'll need to call your insurance and let them know that it needs to be changed to reflect your actual date of birth. This should allow the pharmacy to bill your insurance and dispense your prescription.
  • Contraceptives are not covered: If the pharmacy receives a rejection that no brands of birth control are covered under your insurance, call your insurance and ask to opt into contraceptive benefits, which should allow them to cover your birth control.
  • Vacation or lost package override: If you’re traveling and need your birth control ahead of time, or you lost your pack(s) and need a replacement, you can request an override through your insurance. For vacation, they’ll want to know the dates you’re traveling and if you’re leaving the country. You typically only have a certain number of overrides per year depending on your plan.
  • Your insurance is requiring a copay when you haven’t had one in the past: If your insurance starts requiring an unexpected copay, you can always reach out to them to clarify! They should be able to provide context about your elevated copay, and may be able to direct you towards other options that could be covered for $0.
  • You’re on your parent’s insurance and want to keep your info as private as possible: Depending on your insurance company, other individuals on your plan may have varying visibility into the services billed to your insurance, so if you're worried about your parents seeing your birth control on a statement, it's best to call your insurance first to inquire. Here's a great article from Bedsider to help you navigate talking to your insurance company.
  • You want to check if your preferred brand would be covered: Your insurance can be a great resource to advise what brands would be covered! Your insurance may also publish their formulary (aka list of covered brands) online, so you could also try googling your insurance company’s most up-to-date formulary
  • You want to get COVID tests reimbursed by your insurance: Commercial insurance companies should now provide reimbursement for up to 8 at-home rapid tests for each person on your plan per month. If you’re having trouble submitting for reimbursement online, you can call your insurance to ask for support getting money back for tests you’ve purchased.

Still having trouble with your insurance?

If you’re having trouble reaching someone, or still troubleshooting an issue with your insurance, don’t forget you still have the choice to pay out of pocket for medication while you sort out the problem.

If English is not your first language and you’re having trouble understanding certain forms or medical information, you can contact your insurance and ask to speak to someone in your preferred language to receive assistance. Live chat may be another option on their website.

If you have an account with Twentyeight Health, don’t hesitate to reach out to our customer service team at contact@twentyeighthealth.com for assistance.

With the participation of
Dr. Eddie Garcia

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