Member Frequently Asked Questions
General Information
Yes, you can. Your full policy document is available on the Member Portal. If you’re having trouble logging in to the Member Portal, please call the number on your ID card for assistance.
Yes, they are. In compliance with the Affordable Care Act, there are no pre-existing condition exclusions in your health plan.
We’re here to help! You can always contact the support team listed on your ID card for personalized assistance. Depending on your plan, this may be our Concierge Care team or customer service. They can help you understand your benefits, find a provider, and answer any other questions you may have.
Lucent Health App
The Lucent Health app is a free mobile app that makes it easy to manage your health benefits. You can use it to view your ID card, track your spending, and get important information about your health plan, all in one place.
You can download the Lucent Health app for free from the Apple App Store or the Google Play Store. Just search for “Lucent Health.”
The Lucent Health app gives you access to a variety of helpful features, including:
- Digital ID Card: View and share your ID card right from your phone.
- Track Spending: Keep track of your deductibles and out-of-pocket spending.
- View Claims: See a history of your claims and view your Explanations of Benefits (EOBs).
- Family Access: View information for your dependents under 18 and an overview for your spouse and dependents over 18.
Creating an account is simple. Just follow these steps:
- Enter your email address.
- You’ll receive a verification code in your email. Enter that code to continue.
- You can enable Face ID or fingerprint recognition for easier login, or you can skip this step.
- Enter your Member ID and Group ID from your ID card, along with your full name and date of birth.
Yes, you can! Members who have Concierge Care and/or Lucent Health Care Management can now message with their support and care team directly through the app. You can also always reach your support team by calling the number on your ID card.
Member Portal and Digital Tools
MyLucentHealth.com is your online hub for managing your health benefits. It’s the easiest way to check what’s covered, track your claims, and access your digital ID card—all in one place.
Use the portal to:
- View, print, or download your digital ID card (Primary members can also download cards for their covered dependents)
- Track claims and view your Explanation of Benefits (EOBs)
- Download forms and plan documents
- Inquire about your prescription benefits
- Contact Lucent Health
Note: Spouses and dependents age 18+ need to create their own login at MyLucentHealth.com.
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If you can’t log in, try using lucenthealth.com/cypress instead.
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Create your account there if you haven’t already.
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If you’re still having trouble, call the customer service number on your member ID card.
Claims and Billing
An EOB is not a bill – it’s a summary of how your insurance processed a recent claim. Many members mistake the EOB for a bill, but it’s simply a summary. No payment is required unless you receive a bill directly from your provider.
Your EOB shows:
- What your provider charged
- What Lucent Health paid
- What you might owe (if anything)
You can use your EOB to:
- Make sure the visit was processed correctly
- Confirm your provider submitted the right information
- Catch errors or unexpected charges
Wait for an actual bill from your provider before paying anything. If you have questions, call the support team listed on your ID card and have your EOB ready.
This happens sometimes, and it’s usually easy to fix. Most billing issues come down to a provider mistake, like sending the claim to the wrong place or misunderstanding how your plan works.
Here’s what might have happened:
- The provider sent the claim to the wrong insurance company (claims must go to the address on your ID card).
- A prior authorization was required but not submitted or approved.
- The provider was confused by your Lucent Health ID card and didn’t call the right number for benefits or eligibility.
What to do:
- Option 1: Call your provider and confirm they have the correct claims filing address from your Lucent Health ID card.
- Option 2: Contact the support team listed on your ID card – they will look into the issue and reach out to your provider directly if needed
After you receive a medical service, your provider will send a claim to your health plan. Once the claim is processed, you will receive an Explanation of Benefits (EOB). The EOB will show you how much your plan paid and how much you are responsible for paying. You should always compare your EOB to the bill you receive from your provider to make sure they match.
It’s common to receive multiple EOBs for a single procedure. This is because different providers involved in your care, such as the surgeon, anesthesiologist, and facility, will all bill separately for their services. You will receive an EOB for each claim that is submitted.
If you have to pay for a medical service upfront, you can submit a claim for reimbursement. You will need to fill out a Health Claim Reimbursement Form and submit it with a copy of the bill from your provider and proof of payment. You can find the reimbursement form on the Member Portal or by contacting the support team listed on your ID card.
Reference-Based Pricing (RBP)
An RBP plan is a type of health plan that helps to lower the cost of your healthcare. Instead of using a traditional PPO network, an RBP plan pays for services based on a percentage of the Medicare price. This helps to ensure that you’re getting a fair price for your care. With an RBP plan, there is no “in-network” or “out-of-network” – you have the freedom to see any provider you choose. If you need help finding a doctor under this plan, the support team listed on your ID card can assist you.
Yes, you can! With an RBP plan, you have the freedom to choose any doctor or hospital that you want. You’re not limited to a specific network of providers.
If you have any trouble with a provider accepting your insurance, please contact the support team listed on your ID card right away. They will work with the provider to explain your benefits and ensure that you can get the care you need.
A balance bill is when a provider bills you for the difference between what they charge and what your insurance pays. This can sometimes happen with an RBP plan because there is no contract between the provider and the plan. However, balance billing is rare, and we have safeguards in place to protect you from unexpected costs.
If you receive a balance bill, please contact the support team listed on your ID card immediately. They will work with the provider to negotiate the bill and make sure you’re not paying more than you should. You will only be responsible for your regular cost-sharing amounts, such as your deductible and co-pays.
Flexible Spending Accounts (FSA)
An FSA is a special account you can use to save money on eligible medical expenses. It’s an employer-sponsored benefit that lets you set aside money from your paycheck before taxes are taken out. This means you’ll have more money to spend on things that matter to you.
When you contribute to an FSA, the money is taken out of your paycheck before taxes. This lowers your taxable income, which means you pay less in taxes. On average, you can save around 30% on your eligible medical expenses.
You can use your FSA for a wide range of eligible medical expenses, including:
- Health plan co-pays, deductibles, and co-insurance
- Eyeglasses and contact lenses
- Dental care
- Prescription medications
- Over-the-counter (OTC) medications (as of January 1, 2021)
- Certain medical supplies
For a complete list of eligible expenses, you can refer to IRS Publication 502.
If you have a benefits debit card, you can simply swipe it at the time of purchase. If you don’t have a debit card, you can pay for your expenses out-of-pocket and then submit a claim for reimbursement. You’ll need to provide a receipt that shows the type of expense, the amount, and the date of service.
Your full annual contribution is available to you on the very first day of your plan year. This means you can use your FSA to pay for eligible expenses right away, even before you’ve contributed the full amount from your paychecks.
The IRS sets the maximum amount you can contribute each year. For 2025, the maximum contribution is $3,300. Your employer may also set a lower limit, so be sure to check your plan documents.
Generally, you can only change your contribution amount during your employer’s open enrollment period. However, you may be able to make changes if you experience a qualifying life event, such as a marriage, divorce, birth, or death in your immediate family.
Don’t worry, you won’t necessarily lose it! You may be able to roll over up to $660 of unused funds to the next plan year. The exact rollover amount is set by your employer, so be sure to check your plan documents for details.
If you leave your job, your participation in the FSA will also end. You can only be reimbursed for eligible expenses that you incurred before your termination date. You’ll have a certain amount of time, called a grace period, to submit claims for these expenses.
Prescription Drugs
Your plan includes a prescription drug benefit that is managed by a Pharmacy Benefit Manager (PBM). You can get your prescriptions filled at a participating pharmacy or through a mail-order service. Just show your ID card to the pharmacist, and they will take care of the rest.
If you have any questions or concerns about your prescription medications, you can contact the support team listed on your ID card. They can help you understand your prescription benefits and answer any questions you may have.
There are a few common reasons a prescription might be delayed or rejected at the pharmacy, and most are part of the normal process, not a sign something is wrong with your coverage.
Here’s what might be happening:
- The pharmacy needs to verify the prescription with your doctor.
- The medication requires a prior authorization or other clinical review.
- The pharmacy may be using the wrong billing information (this is rare, but can happen if they don’t recognize your pharmacy benefit manager).
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Show your Lucent Health member ID card – it has the correct pharmacy billing information
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Ask he pharmacist to call your PBM directly
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Still having trouble? Call the support team listed on your ID card – they’ll contact the pharmacy on your behalf and help resolve the issue quickly.
Preventive Care
Your health plan covers a wide range of preventive care services at 100%, which means you don’t have to pay anything out-of-pocket for them. These services are designed to help you stay healthy and catch any potential health problems early. Some of the covered services include:
- Annual physical exams
- Immunizations
- Screenings for cancer, cholesterol, and other conditions
- Well-woman and well-child visits
For a complete list of covered preventive services, please refer to your Summary Plan Description or Summary of Benefits and Coverage.
You can schedule your preventive screenings directly with your doctor. If you have any questions about what’s covered or need help finding a provider, you can always contact the support team listed on your ID card.
Specialty Services and Programs
Case Management gives you one-on-one support from a Registered Nurse, especially helpful if you’re managing a chronic or complex health condition. The program is run by Lucent Health Care Management. If you’re a good fit, a team member may call you to explain this free benefit and offer help.
Your Case Manager can:
- Coordinate with your doctors
- Help schedule appointments
- Assist with prior authorizations
- Guide you through ongoing or complex care
Want support now? Call the support team listed on your ID card.
Lucent Health Specialty Rx helps you get high-cost or complex medications – like injectables or treatments for chronic conditions – at little or no cost.
Here’s how they help:
- Work with your doctor to reduce out-of-pocket costs
- Enroll you in manufacturer coupon, patient assistance programs, or source the medication at a lower cost
- Coordinate delivery and check to make sure you stay on track
Call Lucent Health Specialty Rx: (877) 214-2130
Teladoc gives you 24/7 virtual access to licensed doctors, therapists, and dermatologists for non-emergency care, anytime, anywhere.
How to get started:
- Download the Teladoc app, visit teladoc.com, or call 1-800-TELADOC (835-2362)
- Set up your account and complete your medical history – do this before your first visit to avoid delays
- Use Teladoc for care like cold & flu symptoms, skin conditions, mental health support, and more
Note: Not all plans have Teladoc.
