For Members

Is my doctor in-network?

You can quickly check if your doctor is in-network by using the public provider search.
For the full search experience, and to access other tools available from your health plan, log in to your account then click on the “Find a Doctor or Hospital” tile.

How do I log in to the member portal?

Click the Member Login button (at the top of this page), then click on “Create an Account Now” below the login. Be sure to have your RGA of Idaho member ID card available. Then, follow the on-screen instructions to complete the registration process.

If you are a spouse, domestic partner, or dependent of a subscriber (employee), follow the same steps. Just be sure to enter YOUR name and YOUR birthdate. Your Insurance ID is the Employee ID on the card.

I lost my ID card. How can I get a new one?

Log in to your account, then click “Print Your ID Card.” You will then be brought to a new window that shows your personal benefits and claims information. From the “Quick Links” menu, click “Request New ID Card” to submit an order to have a new card mailed to you. While you are waiting for your new ID card in the mail, you can also download and/or print a PDF copy of your card by clicking on “Print Your ID Card” (also from the Quick Links menu).

My doctor is not in the RGA of Idaho network or does not “take insurance.” How do I submit a claim?

From time-to-time, you may want to see an out-of-network medical, dental, or vision provider. Since these providers are not in the RGA of Idaho network, they may ask you to pay their bill upfront. If the procedure or service is covered under your RGA of Idaho health plan, you can receive reimbursement at the out-of-network rate. Click here for detailed instructions.

Where can I find out where I am with my deductible and out-of-pocket maximum?

Log in to your account, then click “View My Claims and Account Balance.” You will then be brought to a new window that shows your personal benefits and claims information. Your deductible and out-of-pocket maximum status are displayed under “Balance Summary.” Your Account Balance information can also be found at the bottom of your most recent Explanation of Benefits (EOB).

Click here to learn more about how deductibles and out-of-pocket maximums work.

How do I access my Explanation of Benefits (EOBs) online?

Log in to your account, then click on “View My Claims and Account Balance.”  You will then be brought to a new window that shows your personal benefits and claims information. From the menu on the top of the page, click “Claims.” Clicking on any claim number will bring up detailed information about that claim. After you select a claim, to view the EOB, click the “PDF Copy of your EOB” link that is displayed directly above the claim number.

Click here to learn more about electronic EOBs

How do I make a COBRA payment?

To make an online COBRA payment, please click here.

How often are Explanation of Benefits (EOBs) sent?

Hard copies of Explanation of Benefits (EOBs) are mailed monthly. If you sign up to receive electronic EOBs, they will be sent weekly if there has been claim activity. You can also view your EOBs in your member portal.

I cannot see my dependent’s claims information. How do I get access?

To comply with regulations that restrict access to a dependent’s online health information, your dependents 13 years and older must first create their own RGA of Idaho member accounts and then grant you permission to access their accounts. Once the dependent is logged in, click “View My Claims and Account Balances” from the left side of the screen. On the next screen, under the Quick Links menu, clicking on “Grant/Deny Access to my Account” will bring up a list of family members who have already set up their member accounts. From there, the dependent selects the family member(s) that they want to grant or deny access to their account.

You can always contact our Customer Care team at 1-833-670-0899 to verify basic claims information for your dependents.

Am I covered when I travel?

When you’re an RGA of Idaho member, you can have the peace of mind knowing that wherever you are—across the country or around the world—you’ll be able to access your health plan benefits. Click here for more information.

What is the out-of-pocket maximum (OOPM) or out-of-pocket limit?

The out-of-pocket maximum is the most you will pay for covered healthcare services in a given plan year.  After you reach your out-of-pocket maximum, your plan begins to pay 100% of the cost of covered services.  This limit never includes your premium or healthcare that your plan does not cover. Log in to review your health plan benefits and to see what your out-of-pocket maximum is for covered in-network and out-of-network healthcare services.

What is an Explanation of Benefits (EOB)?

Commonly referred to as an “EOB,” the Explanation of Benefits is a document generated each time RGA processes a claim submitted by you or your healthcare provider. The EOB is not a bill. It simply explains how your health plan benefits were applied to that particular claim.

Still confused? Click here to learn how to read your EOB.

What is co-insurance?

Co-insurance is the percentage you pay for covered healthcare services after your deductible has been met. For example, if your co-insurance is 20% for an office visit, and that visit costs $100, your health plan would pay $80 and you would pay $20. Log in to review your health plan benefits and to see what your co-insurance is for covered in-network and out-of-network healthcare services. 

What is a deductible?

The deductible is the amount you pay for covered healthcare services before your health plan starts to chip in.  For example, if your deductible is $1000, your plan will not pay anything until you’ve met your $1000 deductible. Log in to review your health plan benefits and to see what your deductible is for covered in-network and out-of-network healthcare services.