Frequently Asked Questions

Need answers? Find them here!

When can I enroll in a health insurance plan?

Individual & Family plans enrollment dates are between November 1, 2023 through December 31, 2023. Qualifying life event like marriage, birth of a child, or loss of other coverage, may qualify you for a Special Enrollment Period outside of these dates.

What is individual and family health insurance?

Individual and family health insurance are types of health coverage that individuals and families can purchase to help cover medical expenses. They are typically purchased outside of employer-sponsored plans and you can sign up during open enrollment.

Do I need to use the Antidote app?

Having the Antidote Health app can greatly improve how you manage your healthcare, giving you a convenient way to schedule appointments and keep track of your healthcare routines on all your devices. This app makes it simpler to organize your medical information, helping you stay in charge of your health and stay proactive. Whether it's handling appointments or quickly getting your medical records, the Antidote Health app makes things easier and enables you to effortlessly manage your health.

What should I do if the clinician doesn't join a scheduled virtual visit?

If the clinician is unable to join your scheduled virtual visit, please contact our customer support team at (888) 623-3195 to discuss next step options.

How can I contact customer support for billing-related inquiries or assistance?

You can contact our Customer Support team by visiting the "Contact Us" section of the app or member website, or by calling tel: (888) 623-3195. Antidote representatives are available to assist you with any billing-related questions or issues.

How can I view copies of my visit notes or visit summaries?

Copies of your virtual visit summaries are available in the Antidote app and online portal.

Simply go to the "Appointments" tab in the side menu and choose "Past visits." Selecting a specific visit will allow you to view its summary.

What steps should I follow to reschedule or cancel my telehealth visit?

Rescheduling or cancelling an upcoming visit is easy!

Just go to the "Appointments" tab on the side menu of the Antidote app or online member website. Then choose "Future visits" and follow the reschedule or cancel prompts from there.

Should you have trouble canceling or rescheduling your visit, you can always reach out to our support team for further help at (888) 623-3195.

Is it necessary to remain active on the Antidote app or online portal while I wait for the clinician to join my video visit?

Once you've scheduled a telehealth visit, you are not required to remain active on the app or online portal. You'll be sent a text message when your video visit is about to begin.

What happens to my premium and payments if I add or remove dependents from my plan?

If you make changes to your plan, such as adding or removing dependents, your premium may be adjusted accordingly. Contact our Customer Support team to ensure accurate billing after such changes.

How do I dispute a billing error or discrepancy in my premium charges?

If you believe there is a billing error or discrepancy, please reach out to our Customer Support team immediately. They will investigate the issue and work to resolve it promptly.

What information is included in my billing statement in the app or member website?

Your billing statement is a comprehensive summary of your billing activity and typically includes details such as the premium amount, payment due date, payment method, and a breakdown of charges.

Can I make a one-time payment for multiple months of premiums in advance?

You are able to make advance payments using the Antidote app or member website.

What should I do if I need to change my health insurance plan or coverage level?

To make changes to your health insurance plan or coverage level, contact our Customer Support team. They will guide you through the process and provide information on any associated premium or coverage adjustments.

Can I request a refund for overpaid premiums through the app or member website?

You can request a refund for overpaid premiums by contacting our Customer Support team. They will assist you in processing the refund according to our refund policy.

Is there a way to get notifications or reminders about upcoming premium payments?

Yes, you will receive a payment reminder 3 days before your due date. To receive reminders, make sure to enable Finance SMS notifications in the "Communication preferences" section, located in the "Settings & Preferences" section of the app and member website.

How can I view my billing history and monthly invoices in the app or member website?

You can access your billing history and payment invoices by going to the "Payment History" or "Monthly Invoices" section in the app or member website. This will provide a detailed record of your past transactions.

When is my health insurance premium due each month?

Your premium due date is typically the same day each month. You can find this information on your billing statement within the app or member website.

Are there any fees or penalties for late premium payments?

Late payment fees and penalties may apply, depending on your policy terms and state regulations. Check your policy documents or contact Customer Support for specific information on late payment charges.

What happens if I miss a payment for my health insurance premium?

Missing a premium payment could lead to a lapse in coverage. It's essential to make payments on time to maintain continuous insurance coverage. Contact our Customer Support team if you've missed a payment to discuss getting your account up to date, and if necessary, reinstatement options.

Can I choose a different billing date for my premium payments?

In most cases, you may not be able to change your billing date. However, you may contact our Customer Support team for assistance and we will do our best to accommodate your request.

How do I update my payment method or billing information in the app or member website?

To update your payment method or billing information, navigate to the Repay portal from the "Payment Status" section of the app or member website. There, you can edit your payment details, such as credit card or bank account information.

Is there a preferred payment method for automatic monthly premium deductions?

Yes, we recommend setting up automatic payments using a credit card or bank account for the convenience of automatic monthly premium deductions. This ensures your coverage remains active without manual payments. Please be aware that paying your premium with a credit or debit card may incur a small convenience fee.

Can I set up automatic payments for my premium in the app or the member website?

Yes, you can easily set up automatic payments by selecting "Continue to payment" in the "Payment Status" section of the app or member website. You will be redirected to Repay, our payment partner, where you can select the "Payment Plans" tab and set up automatic payments or recurring payments.

What payment methods are accepted for my health insurance premium?

We accept various payment methods, including credit/debit cards and personal checks. Check the payment section of the app or member website for a list of accepted methods.

How can I make a payment for my premium through the app or member website?

You can make a payment through the app or member website by accessing the "Payments & Billing" section. From there, you can choose your preferred payment method, enter your payment information, and submit the payment.

Do I have to use my mobile phone for my virtual visit?

Virtual visits can be done on your phone, on your computer or on your tablet--the choice is yours.

What is a virtual Primary Care Physician (PCP) visit?

A virtual PCP visit is a visit that is conducted either on your phone, computer or tablet. This enables you to consult with a provider from home or any other desired location without the inconvenience of having to travel and go into a doctor's office. We’re making getting the care you need more convenient and accessible than ever. Everyone on the Antidote Health insurance plans will have a virtual PCP.

Am I able to have in-office visits with Antidote Health insurance plans?

You may always see a clinician in person, in office, if needed or preferred. In-office visits are subject to a copay, while virtual visits have a $0 copay, or minimal copay for SafeGuard plans, and are unlimited. To compare plans, benefits and costs, go to enroll.antidotehealth.com.

Can I keep my current provider?

We have an expansive network of providers. To check if your current provider is in-network, go to our provider search tool here

How much are copayments (copays)?

A copay is a fixed amount you pay for specific medical services or prescription medications. Antidote Health insurance plans have low to no copays, and $0 or minimal cost medications. To learn more about plans and compare benefits, go to enroll.antidotehealth.com

Can I get coverage for my family?

Yes, our plans allow you to include your spouse and dependent children under a family coverage plan. We also have plans designed specifically for families that include unlimited free virtual pediatric care, as well as first pre- and post-natal visits at zero cost.

What are individual and family health insurance?

Individual and family health insurance are types of health coverage that individuals and families can purchase to help cover medical expenses.

These policies are typically purchased outside of employer-sponsored plans and you can sign up during open enrollment or if you experience a qualifying life event, such as losing your health insurance coverage.

As the names imply, individual coverage is only for one person, while family coverage is for an entire, immediate family, including, in some cases, adult children up to age 26.

When can I enroll in a health insurance plan?

You can enroll between November 1, 2023 and December 31, 2023. Qualifying life events such as marriage, birth of a child, or loss of other coverage, may qualify you for a Special Enrollment Period outside of these open enrollment dates.

How do I get a referral?

To receive a referral of any kind, you will need to first see one of our providers. By choosing "See a clinician" you can easily meet with a provider online and discuss any referral or medical needs you might have.

Can anyone use Antidote Health?

Antidote Health is a telehealth provider dedicated to providing high quality healthcare at affordable prices to everyone – regardless of insurance. Patients can use our services as long as they have an internet connection and are in one of the many states we currently serve.

Medicare and Medicaid recipients are currently not eligible to use Antidote Health telehealth services because of regulations related to those programs.

Why is it important that I log into my account, even if I don't require any health-related services?

Because you never know when the need to see your PCP will arise, it's important to register your member account in advance so that you can have a video visit as quickly as possible when you're not feeling your best.

While account registration is neither lengthy nor difficult, it does take a few minutes, so completing the process in advance will help ensure that you'll get the future care you need as quickly and as easily as possible.

Can I use Antidote Health telehealth services if I don’t have insurance?

Yes! Not only can you use the virtual health platform, it was literally designed for you! Antidote Health’s mission is to provide quality, affordable healthcare to all Americans. Period. We believe every human deserves access to affordable quality healthcare regardless of their race, location, or circumstance – including whether or not they have insurance. That’s why our plans and prices are so affordable. The only thing preventing you from trying Antidote Health is if you are not in a state we currently serve or you qualify for Medicare/Medicaid. Regulations for those programs prevent us from being able to serve Medicare or Medicaid patients.

Does Antidote Health accept insurance?

Anyone can use Antidote Health telehealth services, whether they have insurance or not. The only exception is Medicare and Medicaid recipients because of regulations related to those programs.

To see more details about the Antidote Health insurance, go here.

What medications are covered under Antidote Health insurance plans?

By going to the "Coverage & Benefits" section and choosing "$0 Drug List" you'll be able to review at anytime which prescriptions are covered by your plan.

What pharmacies are available to me?

You can view the pharmacies available in your area by going to the profile section in the app and choosing "Preferred pharmacy". You may change your preferred pharmacy anytime.

How do I check to see how much my prescription will cost?

Get an overview of the expected cost of your prescription by going to the "Coverage and Benefits" section and choosing "Formulary lookup".

How do I know if a claim has been paid?

You will receive an in-app or member website notification regarding any updates about your claims. In addition, you can always access the "Claims" section on the side menu to view the status of your claims.

Will I get my health plan documents electronically?

Members who wish to receive plan documents electonically may do so by contacting the Antidote Customer Support team.Keep in mind, however, that some documents are required by law to be sent to members as paper copies, so selecting to receive documents electronically will not pertain to those particular documents.

What is prior authorization?

Prior authorization helps prevent unnecessary procedures or tests, ultimately keeping healthcare costs in check for both the HMO and its members. The process involves your clinician seeking approval from the healthcare plan before specific medical services or treatments are covered. Your clinician plays a pivotal role in determining the medical necessity and appropriateness of these services, ensuring that you receive the best, most cost-effective healthcare possible within the HMO's guidelines. It's essential to collaborate closely with your clinician to navigate the prior authorization process effectively.

What services are covered by my plan?

The services covered by your plan can be easily found on the Antidote Health app. Go to the side menu and choose "Coverage & Benefits".

How do virtual visits work? How do I schedule one?

You can start your telehealth visit immediately or schedule it for the future. Simply sign in and select “See a Clinician.” Then follow the prompts to schedule your visit.

How do I find a doctor/ hospital / clinic?

Easily find and review the details of any of our providers by clicking "Find a provider" on the main screen or in the side menu of the Antidote app or member website.

Whom do I call with questions?

If you ever need assistance or have any questions, please don't hesitate to get in touch with us at (888) 623-3195. Our support team is here to assist you with any inquiries you may have about managing your healthcare and understanding your insurance coverage. Whether you have questions about your prescriptions, appointments, our Customer Support team is always willing to lend a hand. Your experience is important to us, and we are dedicated to ensuring that you have the support you need for a smooth and well-informed healthcare journey.

Live chat is also available for customers enrolled in certain products or services.

How do I request a new member ID card?

To request a new member ID card, contact our Customer Support team at (888) 623-3195.

How do I find out when my coverage starts?

Simply go to the Profile section available on the side menu, and you will be able to view your plan's start date.

Where do I find my member ID card?

Your member ID card will be mailed to your address on record. Additionally, you can view an electronic copy of your ID card by simply going to the Profile section available on the side menu and choosing "ID Cards." You will then be able to view a copy of your ID card.

How do I download the Antidote app?

To download the Antidote Health app, visit antidotehealth.com on your smartphone or tablet. Check the website for compatibility with your device. If compatible, you'll find download links or instructions to redirect you to the official app stores (Apple App Store for iOS or Google Play Store for Android). Click on the appropriate link, then follow the prompts to install the app. After installation, open the app, either sign up or log in, and start using its features for health tracking, appointments, and more.

Couldn't find what you were looking for?
Write us at: help@antidote.com