Private health and insurance details
A private page for health details and insurance plans. Add member numbers and keep card copies behind it.
Download the PDF
How to use it
- With your parent’s okay, fill in their name, doctor, allergies, and health plan details.
- Copy each card’s member number and the phone number for help.
- Put copies of the front and back of each insurance card behind this page. Ask the nurse about any health details you are not sure of.
- Keep this page out of public view. Share it only with the people who need it to help with care.
What staff ask for at every visit
Clinics, urgent care, and hospitals may ask for the same facts each time: your parent’s full name and date of birth, known allergies, health problems listed by the doctor, and insurance details. With your parent’s okay, keep them on one page so you do not have to recall them under pressure.
Use their own records, cards, and bottles. If you are not sure of something, write “need to check” and ask the clinic instead of guessing. Note any help with hearing, sight, language, walking, or speaking, so staff can plan for it.
Copy both sides of each current insurance card: Medicare, Medicaid, private health and drug plans, and any extra coverage, also called supplemental insurance. Keep plan names, member numbers, and help-line numbers together. Date the page when you check it, and keep it private, with the medicine list.
