Understand the Difference Between Applicant, Member, and Dependent

In Apizeal, it is essential to understand the different roles that individuals can have within a health insurance policy. Each role has specific implications for administration, traceability, and eligibility within the plan. Below are the key differences between an applicant, member, and dependent.

An applicant is any person who is covered by the health plan’s policy.
This includes both the primary policyholder and any family members who have active coverage.

In short, an applicant always has valid coverage and is included under the terms of the contracted plan.

A member is any individual who belongs to the family group associated with a policy, but does not necessarily have active coverage. This means a person may be listed as part of the family group but is not an applicant if they are not covered under the plan.

Dependents are minors or individuals with disabilities who have a direct dependency relationship with the primary applicant of the policy. Their inclusion is subject to the applicant’s status and the conditions defined by the health plan.

If you have any questions, feel free to contact our support team via the live chat available in your Apizeal user account. The chat is available Monday through Friday during business hours.

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