Frequently asked questions

Every Antidote Health member is assigned a dedicated virtual PCP, ensuring personalized and consistent care.  

A virtual PCP visit is an appointment to see this provider using your phone, computer, or tablet. You can receive care from the comfort of your home or any other location, without the need to travel to a doctor's office.

Yes! Antidote Health is all about healthcare on your terms, so if you need or prefer to have an in-office visit with a provider, you can. In-office visits with Tier-1 providers have a $0 copay for the first 12 visits/plan year; with Tier-2 providers, it varies on the plan. You always have a $0 copay to see an Antidote virtual provider. Refer to plan details for specifics.

We understand the relationship between a patient and their provider. If your current provider is in our-network, then you may continue to see them at our in-network prices. If they are out-of-network, then you will need to choose another provider. We have a large network. Search the provider directory

Yes, you may cover your spouse/partner and dependent children, until age 26.

You can enroll during the annual Open Enrollment Period, which runs from November 1 - January 15, in most states. Outside of that, you can enroll during the Special Enrollment Period if you have a qualifying life event.

For 2025 plans, many referral requirements have been lifted. You still need referrals for complex care. Always start with your Antidote virtual provider first for a referral.

Since you never know when you might need to see your Antidote Virtual Primary Care Provider (PCP), it's important to register your member account ahead of time. By doing this now, you'll be ready to have a video visit as soon as you need care.  

Account registration is quick and straightforward but taking a few minutes to complete it in advance will ensure you can access care without delay when you're not feeling your best.  

Antidote Health has a drug list that includes many brand name and generic drugs. Plus, depending on your plan, we have the $0 Core Rx and $0 Advanced Rx drug lists. Search medications

In your Antidote Member Portal or in the Antidote App, you will receive notifications regarding claim status changes. You can also review all claims in the “Claims” section of your account.

When possible, we prefer to send health plan communications electronically, however you have a choice. When logging in to your Antidote Member Portal, make sure to check your communication preferences. Please note that some documents are required by law to be sent as paper copies.

Prior authorization helps prevent unnecessary procedures or tests, ultimately keeping healthcare costs in check for both the insurance company 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 insurance company’s guidelines. It's essential to collaborate closely with your clinician to navigate the prior authorization process effectively.

You can start a virtual visit in real-time or schedule it for the future. Most appointments happen within 20 minutes. Simply sign in to the Antidote Member Portal or into the Antidote App, select “See a clinician” and follow the prompts to schedule your visit.

Search our provider directory to see in-network providers and facilities. For members, the best experience is when you are logged into the Antidote Member Portal or the Antidote App. Search the provider directory

Before becoming a member, you can search for local-network pharmacies on our website. For members, the best experience is when you are logged into the Antidote Member Portal or the Antidote App. Search for pharmacies

You can contact Member Support at 888.623.3195. Our team is available daily 8am - 8pm ET to answer your questions about prescriptions, appointments, understanding your coverage and more. Live chat is also available for members.

Yes, you will receive an ID card in the mail to your address on record, typically before your health plan starts. If you misplace it during the year, you can contact Member Support to request a new ID card. Digital ID cards are available in the Antidote App within the “Profile” section.

Even before your plan starts, you can log in to your Antidote Member Portal account or log in to the Antidote App. Go to the “Profile” section to see your plan’s start date.