Direct answer: The member ID identifies you. The group number identifies the employer or plan group. The plan name or plan ID identifies your exact benefits. The Rx BIN, PCN and RxGroup route prescriptions to the right pharmacy processor. On Medicare Advantage and Part D cards, a code such as H1234-005 is the plan's CMS contract number and plan number.
Front of the card
| Field | What it means | Who asks for it |
|---|---|---|
| Member ID (Subscriber ID, ID number) | Your unique number in the insurer's system. May end in a suffix such as -01 or -02 for each covered person | Every provider, pharmacy and customer service line |
| Member name | The covered person. Must match your legal name and date of birth on file | Providers checking eligibility |
| Group number | The employer or group your policy belongs to. Individual plans may show a standard group code or none | Providers and billing offices |
| Plan name / plan ID | The specific benefit design. Two plans from the same insurer can have different networks and copays | Providers checking your network; you, when checking directories |
| Plan type (HMO, EPO, PPO, POS) | The network rules that apply | You, before you book a specialist |
| Effective date | The date coverage starts | Providers, when you have a visit near a plan change |
| Copay grid | Common copays such as primary care, specialist, urgent care and ER. It is a shortcut, not your full benefits | You |
| Contract number (Medicare Advantage/Part D) | The CMS contract and plan number, for example H1234-005 | Medicare Plan Finder, pharmacies, agents |
Back of the card
| Field | What it means |
|---|---|
| Rx BIN | Six-digit number that tells the pharmacy which processor handles the claim |
| Rx PCN | Processor control number that routes the claim within that processor |
| RxGroup | Identifies your drug benefit design |
| Member services phone | Your line for benefits, claims and network questions |
| Provider services phone | The line offices use to verify eligibility and get authorizations |
| Claims address / payer ID | Where providers send claims |
| Nurse line or telehealth | Included on some cards |
If the card has no Rx BIN, PCN or RxGroup, the plan may handle drugs through the medical member ID or a separate pharmacy card. Call member services before you go to the pharmacy counter.
What is the contract number on an insurance card?
On a Medicare Advantage or Medicare drug plan card, the contract number is the plan's CMS identifier. It is a letter followed by four digits, often with a three-digit plan number, such as H1234-005.
- H: most Medicare Advantage plans
- R: regional PPOs
- S: stand-alone drug plans
- E: certain employer plans
You can use that code to find the exact plan on Medicare Plan Finder. On employer and individual cards, "contract" or "policy" number may refer to the insurance contract instead. Give the office the field they ask for.
How cards differ by coverage type
- Marketplace (individual/family) plan: Member ID, plan name and metal level, plan type, pharmacy routing numbers. The same insurer can sell several networks, so the plan name matters.
- Original Medicare card: Issued by CMS. It shows your 11-character Medicare Beneficiary Identifier and your Part A and Part B start dates. It has no group number and no pharmacy routing numbers.
- Medicare Advantage card: Issued by the private plan. It shows the plan's member ID, plan name, contract number, and usually pharmacy routing numbers. Medicare.gov says to use your plan card when you are in a Medicare Advantage plan. Keep your Medicare card in a safe place.
- Medicare Supplement (Medigap) card: Issued by the Medigap insurer. You show it together with your red, white and blue Medicare card. Medigap cards do not include drug coverage.
- Stand-alone Part D card: Issued by the drug plan, with its own member ID and pharmacy routing numbers.
- Dental and vision cards: Usually separate cards with their own member IDs and networks.
What to check the day your card arrives
- Name, date of birth, effective date and plan name are correct for each covered person.
- Photograph both sides.
- Create your account on the insurer's member portal.
- Search your primary care doctor, specialists, hospital and pharmacy under the exact plan name on the card.
- Call member services if anything does not match what you enrolled in.
Red flags to call about before you use the card
- The plan name or metal level differs from what you picked.
- The effective date is wrong.
- A dependent is missing or has the wrong date of birth.
- The primary care doctor printed on an HMO card is not the one you chose.
- There are no pharmacy numbers and you take regular prescriptions.
Polk County network checks
Card fields tell you which plan you have. They do not tell you whether a specific office takes it. Before a first visit:
- Call the billing office and give the plan name and plan ID from the card.
- Ask whether they accept that plan this year.
- Ask which hospital they admit to.
Large local systems such as Lakeland Regional Health, Watson Clinic and Orlando Health, whose Lakeland Highlands Hospital opened in July 2026, can be in network on one plan and out of network on another from the same insurer.
If you lose your card
You do not need the plastic card to get care. Download the digital ID from the member portal or app, and request a replacement. A provider can verify coverage with your name, date of birth and member ID. For a lost Original Medicare card, request a replacement through your Medicare account or Social Security.
Quick reference: what to give whom
| Who | What to give |
|---|---|
| Doctor's office | Photo of both sides of the card, plus your date of birth |
| Pharmacy | Member ID, Rx BIN, PCN and RxGroup |
| Hospital registration | Card, photo ID, and any referral or authorization number |
| Medicare Plan Finder or an agent | Contract and plan number (Medicare Advantage/Part D) |
Card arrived and something looks off? Call David (863) 640-3102
Related reading
- HMO vs PPO vs EPO
- Deductible vs out-of-pocket maximum
- Check prescriptions before you enroll
- Post-enrollment review
- What to do if a health plan denies a claim
Common questions
What is the most important number on a health insurance card?
The member ID. Providers, pharmacies and customer service use it to find your policy. It may end in a suffix, such as -01 or -02, that identifies each covered person.
What is the contract number on an insurance card?
On a Medicare Advantage or Medicare drug plan card, it is the plan's CMS contract identifier: a letter followed by four digits, often with a three-digit plan number, such as H1234-005. On employer and individual cards, a contract or policy number refers to the insurance contract. Give the office the field it asks for.
What is the difference between member ID, group number and plan ID?
The member ID identifies you. The group number identifies the employer or plan group. The plan ID identifies your specific benefit design, which sets your network and cost sharing.
What are BIN, PCN and RxGroup on an insurance card?
They route prescription claims. The BIN tells the pharmacy which processor handles the claim, the PCN routes it within that processor, and the RxGroup identifies your drug benefit.
Why does my Medicare card look different from my Medicare Advantage card?
They come from different issuers. CMS issues the Medicare card with your Medicare Beneficiary Identifier. A Medicare Advantage plan issues its own card with its member ID, plan name and contract number. Medicare.gov says to use the plan card when you are in a Medicare Advantage plan.
What should I do the day my new insurance card arrives?
Check names, dates of birth, effective date and plan name. Photograph both sides, set up the member portal, and confirm your doctors and pharmacy under the exact plan name on the card.
What if I lose my health insurance card?
You can still get care. Use the digital ID card from the insurer's portal or app and request a replacement. A provider can verify coverage with your name, date of birth and member ID.
We do not offer every plan available in your area. Currently we represent 8 organizations which offer 65 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
Company inventory note: The counts above reflect the licensed company inventory for the 2027 plan year in the Lakeland/Polk County service area, confirmed for ZIP 33812, as of October 1, 2026. They are not CMS counts or statewide Florida totals. Counts and available products vary by ZIP code, service area, plan year, and current company authorization. Confirm the ZIP code and current approved platform inventory before relying on these figures. Plan availability, benefits, networks, formularies, pharmacies, and costs are subject to the applicable plan documents and service area.