Common abbreviations printed on insurance cards — decoded.
PCPPrimary Care Provider — your regular doctor
SP / SpecSpecialist — any doctor who isn't your PCP
ER / EDEmergency Room / Emergency Department
UC / UrgUrgent Care
Ind DedIndividual Deductible — what one person pays before insurance helps
Fam DedFamily Deductible — combined deductible for everyone on the plan
Ind OOPIndividual Out-of-Pocket Maximum
Fam OOPFamily Out-of-Pocket Maximum
OONOut-of-Network
RxPrescription / pharmacy
RxBINPharmacy processing number — your pharmacy needs this to bill correctly
RxGrpPharmacy group number — identifies your specific plan to the pharmacy
RxPCNProcessor Control Number — another pharmacy routing code
BINBank Identification Number — used for claim routing
Grp / GroupGroup number — identifies your employer or organization's plan
ID / Member IDYour unique member identification number
Sub / SubscriberThe person who holds the policy (usually the employee)
Dep / DependentSomeone covered under the subscriber's plan (spouse, child)
CMSCenters for Medicare & Medicaid Services
EOBExplanation of Benefits — a summary of what was billed and paid
PA / Prior AuthPrior Authorization — approval needed before certain care
Copay / COPFixed amount you pay per visit
Coins / CoInsCoinsurance — your percentage share after the deductible
Prev / PreventivePreventive care — usually covered at no cost to you
Tier 1 / T1Generic drugs — lowest cost
Tier 2 / T2Preferred brand-name drugs — moderate cost
Tier 3 / T3Non-preferred brand-name drugs — higher cost
MH / BHMental Health / Behavioral Health
DMEDurable Medical Equipment (wheelchairs, CPAP, etc.)
SNFSkilled Nursing Facility
POSPoint of Service — a plan type, or place of service on a claim