What is a pharmacy insurance card

There are different types of insurance cards that are used in different circumstances, and this article will help you find the insurance information you need. The types of insurance cards we’ll discuss are medical insurance cards, pharmacy benefit insurance cards, and Medicaid insurance cards. 

What’s the difference between a medical insurance card and a pharmacy benefits insurance card?

Some people may have one insurance card that covers them for medical expenses (like the doctor or hospital) and also includes pharmacy benefits (to cover medications), but often times these are two separate cards with different identification numbers. 

Medical card example:

Pharmacy card examples:

Pharmacies typically need a pharmacy benefits card to process a prescription for medication, which contains an RxGroup, RxPCN, and RxBIN number in addition to the Member ID number. “Rx” is another way to refer to a prescription. Medical cards usually only have a Member ID number. If your insurance only sent you a medical insurance card in the mail, you can typically find your pharmacy benefits information online or by calling your insurance (look for the phone number for Member Services on the back of your card). 

What do RxBIN and RxPCN stand for and what do they do?

RxBIN stands for Bank Identification Number, which helps the pharmacy figure out which insurance company’s prescription plan to process. RxPCN stands for Processor Control Number and is another unique identifier to help the pharmacy identify you. It’s important for the pharmacy to have this information to find your coverage and get coverage for your prescriptions. 

Do Medicaid insurance cards look different from other insurance cards?

Medicaid provides free or low-cost health coverage to millions of Americans, including people with low income, families and children, pregnant people, and people with disabilities.

Medicaid cards look different for each state and will not contain an RxGroup, RxPCN, and RxBIN number, only a Member ID number. If you have a Medicaid managed care plan, then you should still be able to access pharmacy benefits information. For people with Medicaid coverage, many states will require you to switch to a managed care plan after 30 days. Below is an example of a Florida Medicaid card and a FL Medicaid managed care card. Note that the gold Medicaid card only has a Member ID, whereas the managed care plan lists the Member ID, RxBIN, RxPCN, and RxGroup numbers. 

What if I can’t find the RxBIN, RxPCN, or RxGroup number on the card?

The first tip is to check the back of your card, it’s not always on the front! Most pharmacy cards will have all four pieces of information (Member ID, RxGroup, RxPCN, and RxBIN numbers), but there are a few exceptions of plans that do not have all four numbers and can still be accepted. 

The two most important pieces of information to provide are your Member ID and RxBIN in order for the pharmacy to find your health insurance coverage. Providing the RxGroup and RxPCN numbers can help the pharmacy find your health insurance info even faster and more accurately. 

For example, Aetna cards sometimes only have a Member ID number and a RxBIN number. 

If you only have a medical insurance card and need to find your pharmacy benefits information, you can contact your insurance for this information. For tips on how to call your insurance company, check out our article here.  

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Need additional help? If you have an account with Twentyeight Health you can reach out to contact@twentyeight health or text us at (929) 352-0060 and our customer service team will support you. You can also reach out to Member Services of your insurance company (their phone number is typically on the back of your insurance card). 

Many health insurance plans manage your prescription medications through a company called a Pharmacy Benefits Manager, or PBM. Some common PBMs are ExpressScripts, CVS Caremark, and OptumRx. In some cases you will be issued a prescription insurance card that is separate from your medical insurance card.  

When you submit a Nurx request be sure to upload the right insurance card. If you have a pharmacy benefits card please upload that. But if your pharmacy benefits information is included on your main health insurance card, upload that one. Note: If you request PrEP or STI testing you may need to upload both your medical and prescription insurance cards. 

Be sure the card you upload includes an ID number as well as numbers preceded by “RX” such as RXBIN, RXPCN and RXGRP. Some cards may not have an RXPCN or RXGRP, and that’s okay. As long as we have the RXBIN and ID number we can bill your insurance.

Here is an example of a pharmacy benefits card:

Here is an example of an insurance card: