Frequently Asked Questions

Need answers? Find them here!

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.

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

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

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.

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.

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.

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.

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.

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