How to Find Out if Someone Has Health Insurance

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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D. Gilson is a writer and author of essays, poetry, and scholarship that explore the relationship between popular culture, literature, sexuality, and memoir. His latest book is Jesus Freak, with Will Stockton, part of Bloomsbury’s 33 1/3 Series. His other books include I Will Say This Exactly One Time and Crush. His first chapbook, Catch & Release, won the 2012 Robin Becker Prize from Seve...

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Leslie Kasperowicz holds a BA in Social Sciences from the University of Winnipeg. She spent several years as a Farmers Insurance CSR, gaining a solid understanding of insurance products including home, life, auto, and commercial and working directly with insurance customers to understand their needs. She has since used that knowledge in her more than ten years as a writer, largely in the insuranc...

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Reviewed by Leslie Kasperowicz
Farmers CSR for 4 Years

UPDATED: Mar 2, 2021

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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.

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 ProcedureAverage Cost if Non-Insured or Out-of-NetworkAverage 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)
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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.

Frequently Asked Questions: How to Find Out if Someone has Health Insurance

If you aren’t ready to buy health insurance, check out some common questions below.

#1 – 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.

#2 – 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.

#3 – 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.

#4 – 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.

#5 – Can you pay later at urgent care?

Urgent care centers tend to offer payment plans to their patients.

#6 – Is it bad to lose your insurance card?

Yes, it can prove not only costly but also put you at risk of identity theft.

#7 – 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.

References:

  1. https://locktonmedicalliabilityinsurance.com/verifying-patient-insurance-benefits/

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