How To Find Out if Someone Has Health Insurance: An Expert Guide (2024)
Wondering how to verify if someone has health insurance? If you're looking into how to find out if someone has health insurance, know there are a few avenues you could take. If you're looking into whether your health insurance policy is active, start by looking at the HealthCare.gov marketplace and the documents they would have sent you. If you need to find out what health insurance someone else has, ask the human resources department of their employer. Get affordable health insurance quotes now.
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Zach Fagiano
Licensed Insurance Broker
Zach Fagiano has been in the insurance industry for over 10 years, specializing in property and casualty and risk management consulting. He started out specializing in small businesses and moved up to large commercial real estate risks. During that time, he acquired property & casualty, life & health, and surplus lines brokers licenses. He’s now the Senior Vice President overseeing globa...
Licensed Insurance Broker
UPDATED: Jan 30, 2024
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Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything insurance related. We update our site regularly, and all content is reviewed by insurance experts.
UPDATED: Jan 30, 2024
It’s all about you. We want to help you make the right coverage choices.
Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance provider and cannot guarantee quotes from any single provider.
Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance companies please enter your ZIP code on this page to use the free quote tool. The more quotes you compare, the more chances to save.
On This Page
The Highlights
- Calling the individual’s place of employment and asking the human resources office may prove difficult.
- You could ask general questions about what insurance benefits that employer grants.
- Call previous insurance companies with whom the individual had coverage.
If you need to learn how to find out if someone has health insurance, there are a few avenues to take. We will get into all of that in a step-by-step manner because we understand insurance is a complicated business.
For instance, you cannot just call up the American Medical Association and ask about John Q’s specific policy. Get a good start by typing your ZIP code into our helpful tool above to find reasonable health insurance rates from the best insurance companies in your area.
Table of Contents
How do you verify a patient’s insurance?
How do you find out if someone has health insurance? An insurance information form should ask certain questions, like what is the patient’s name and date of birth, what is the name of the primary insured, and what is the social security number of the primary insured.
According to Lockton Affinity Health, other information that would be required is their insurance carrier, their ID number, the group number, and any contact information for the insurance company. This includes the insurance company’s phone number, website, and address for submitting claims.
To find out who insures the individual, consult with the human resources department of their place of business. Should they not be able to divulge specific insurance information, inquire in a general sense about what coverage they provide employees. The latter phrasing should not prove to be a hiccup in gaining the information you need.
How to See if You Have Health Insurance
How do I check to see if I have medical? Many, if not most, individuals are insured via a Marketplace plan. If you have already paid your first premium to the health insurance company you chose via the Marketplace, chances are you have health insurance.
If you have paid this first premium, check if your health insurance is active online via the insurer’s webpage. You can also check the plan materials you would have received via mail or email to check the start date of your coverage.
Before we go into how you can check via the Marketplace itself, let’s take a look at an ad that will shed some light on how HealthCare.gov works.
A simpler step, rather than going through your chosen insurer, may just be to go through HealthCare.gov itself. All you have to do is log in to your HealthCare.gov account, click on your name in the top right, select “My Applications & Coverage,” select your completed application, and from there you’ll see a summary.
In short, there are multiple avenues you can take to find out if you have active health insurance. Let’s move on to see if a doctor can find out if you have active health insurance.
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Can a doctor lookup my insurance?
Absolutely. While you don’t necessarily need health insurance to see a doctor, doing so will not come cheap. When you enter your primary care physician’s office or your specialist’s office, you will be asked to show proof of insurance.
This may be relevant now more than ever and you can click the link to find out the answer to the question “Does health insurance cover the coronavirus?” As you can see in the table below, the differences in the cost of coronavirus testing can be significant if you are not insured.
Average Medical Costs for Possible Coronavirus Treatment in the U.S.
Coronavirus Test Procedure | Average Cost if Non-Insured or Out-of-Network | Average Cost if Insured |
---|---|---|
CBC Blood Test | $36 | $11 |
CMP Blood Test | $58 | $16 |
Flu Testing: A Virus | $43 | $16 |
Flu Testing: B Virus | $43 | $16 |
Office Outpatient Visit: 15 Min. | $149 | $74 |
Office Outpatient Visit: 25 Min. | $222 | $110 |
Office Outpatient Visit: 40 Min. | $327 | $161 |
Global Urgent Care Visit | $239 | $129 |
ER Visit: Moderate Severity | $441 | $169 |
ER Visit: High/Urgent Severity | $708 | $280 |
ER Visit: High Severity & Threat | $1,151 | $443 |
Source: FAIR Health/ CPT © 2018 American Medical Association (AMA) |
Read more: AMA Insurance Review & Complaints: Auto, Home, Life & Health Insurance
These offices deal with insurers on a daily basis and will be able to see if you are registered in the insurer’s system. While they cannot initiate the process of getting you insured, perhaps they can point you in the right direction to begin.
If we haven’t answered all of your questions today, fear not, because we’re going to be wrapping up with an FAQ section. In the meanwhile, type your ZIP code into our helpful and free tool below to find reasonable health and car insurance rates in your area.
Case Studies: Verifying Health Insurance Coverage
Case Study 1: Sarah’s Quest for Insurance Verification
Sarah is a young professional who recently started a new job. She needs to verify if her health insurance coverage is active. This case study explores the steps Sarah takes to confirm her insurance status, including checking the HealthCare.gov marketplace and reviewing the documents sent by her insurance company.
Case Study 2: Mark’s Investigation Into Someone’s Health Insurance
Mark works in the human resources department of a large company. He receives a request to find out what health insurance a new employee named Lisa has. This case study delves into the process Mark follows to gather the necessary information and provide Lisa with the details of her health insurance coverage.
Case Study 3: Emma’s Visit to the Doctor
Emma, a self-employed individual, visits a doctor’s office and needs to provide proof of insurance. This case study explores how the doctor’s office accesses Emma’s insurance information to verify her coverage and facilitate the billing process.
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Frequently Asked Questions
Does the IRS know if you have health insurance?
Yes, health insurers file annual reports to the IRS about who is covered under their various plans.
What is a verification of eligibility?
This is the process of checking a patient’s active coverage with the insurance company and then verifying whether or not his or her claims are authentic.
Why is it important to verify a patient’s insurance before the office visit?
This allows the practice to estimate and inform the patient of the amount and responsibility for payment.
Is Covered California the same as medical?
Covered California is a service that connects California residents to insurers. It’s not coverage itself but can lead to you getting a discount.
Can you pay later at urgent care?
Urgent care centers tend to offer payment plans to their patients.
Is it bad to lose your insurance card?
Yes, it can prove not only costly but also put you at risk of identity theft.
How can I go to the doctor without insurance?
You don’t need insurance to see a doctor but keep in mind you will be paying a hefty amount out of pocket.
Are you looking for free insurance quotes?
Your one-stop online insurance guide. Get free quotes now!
Secured with SHA-256 Encryption
Zach Fagiano
Licensed Insurance Broker
Zach Fagiano has been in the insurance industry for over 10 years, specializing in property and casualty and risk management consulting. He started out specializing in small businesses and moved up to large commercial real estate risks. During that time, he acquired property & casualty, life & health, and surplus lines brokers licenses. He’s now the Senior Vice President overseeing globa...
Licensed Insurance Broker
Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything insurance related. We update our site regularly, and all content is reviewed by insurance experts.