9 of Your Frequently Asked Insurance Questions Answered
April 1, 2021
(Updated July 2023)
Keeping track of your health care costs and managing your health insurance can be complicated. That is where BlueCross BlueShield of South Carolina’s online portal, My Health Toolkit®, comes in.
“My Health Toolkit isn’t just for members who are actively using their benefits. While it’s a great resource for reviewing your coverage, claims and deductibles, you also can use it to connect with us and to take advantage of tools and resources to support you no matter where you are on your health care journey. And you can log in from anywhere with the My Health Toolkit app,” says Karen Kraft, digital experience director.
Every day our customer service advocates answer calls from members with questions about their health plans. Answers to the most common questions are in My Health Toolkit.
Here are just a few of those questions and where to find the answers in the portal.
How do I find information on how BlueCross paid my claim?
You can look at claims and Explanations of Benefits in My Health Toolkit. An Explanation of Benefits, or EOB, is a statement that shows how we processed your claim for health care services. Watch this short video to find out how your doctor's visit becomes an EOB.
What are my deductible and out-of-pocket amounts?
When you log in to My Health Toolkit online or through the mobile app, you will find your deductible and out-of-pocket amounts at the top of the page. Your deductible is the amount you pay toward costs of covered health care services each year before your health insurance kicks in. Another common question is how much of your deductible or out-of-pocket you have met. This along with overall amounts, is in My Health Toolkit. Understanding the lingo of health insurance can be tricky. Here's a quick explanation of what deductible means.
How do I obtain an ID Card or additional ID Cards?
You can access a digital ID card in My Health Toolkit any time. You can also request up to four at a time to be mailed to you. Our most common member questions are about ID cards.
How do I find doctors covered by my insurance?
You can do this in a number of ways. You can sign in to My Health Toolkit on the website. Under the Resources tab, there’s a link for Find Care. In the mobile app, there’s a Find Care icon in the bottom right corner. In the Members section of the website at www.SouthCarolinaBlues.com, you can choose Find a Doctor to access online provider directories.
How do I request a review of a processed claim?
Review and appeal information is on your EOB. You can access your EOBs through My Health Toolkit. You can also review claims and check claims status in the portal. If you have more than one claim and need help understanding all the information, this is a good place to review all your claims at once.
How much is it going to cost me for a specific service or procedure?
You can sign in to My Health Toolkit on the website. Under the Resources tab, there’s a link for Find Care. Select Procedure Costs. Costs for a medical procedures — ultrasound, checkup, X-ray or joint replacement, for example — can vary by hundreds of dollars. Estimates help you avoid surprises when the bills come. It is important to note that cost information might not be included for all plans. You can learn more about cost estimates and how to avoid surprises with billing.
How do I add or remove dependents on my policy?
Adding dependents to your policy varies by plan. If you get benefits through work, for instance, you need to reach out to your employer or benefits administrator. Remember that some plans have certain times when you can add dependents to your plan. People usually need to add dependents after the birth of a child.
You make changes to your plan the same way you purchased coverage. For example, if you signed up on the Health Insurance Marketplace, you would make the change there. Reach out to the agent you worked with if you signed up through an agent.
What are my benefits for a specific service or treatment?
You can look up details about your coverage in My Health Toolkit. On the website, look under the Benefits tab for Eligibility and Benefits. The term “benefits” refers to everything your health insurance plan covers. Under this tab, you will find information on your preventive care benefits. These include things such as mammograms, routine physicals and immunizations.
Do I have benefits for telemedicine? If yes, what are the benefits and how does the process work?
You can find this information in My Health Toolkit. Through the Find Care option in the mobile app, there’s a button on the next screen to set up a video visit. With telehealth, you can talk to a doctor without leaving your home. Blue CareOnDemand allows members to video chat with a doctor anytime.
If you have questions My Health Toolkit doesn’t answer, you can always call Customer Service at the number on the back of your ID card.
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