Medicare & Medicaid Eligibility Lookup

Eligibility Lookup

Sorry, Medicare Eligibility lookup is currently unavailable

Sorry, Medicaid Eligibility lookup is currently unavailable

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First Name (Optional)

First Name is required

Last Name (Optional)

Last Name is required

Date of Birth

DOB is required

You must enter a valid Year

You must enter a valid Month

You must enter a valid date

Proposed Effective Date

Proposed Effective Date is required

You can only enter the current year for a proposed effective date

You must select a valid month

Medicare Number (MBI)

Medicare Number is required

Medicare Eligibility

Medicare Eligible?	{{medicareResultsModel.medicareEligible}}
MBI (Medicare Number):	{{medicareResultsModel.medicareNumber}}
Part A Effective Date:	{{medicareResultsModel.medicarePartAEffDate}}
Part A End Date:	{{medicareResultsModel.medicarePartAEndDate}}
Part B Effective Date:	{{medicareResultsModel.medicarePartBEffDate}}
Part B End Date:	{{medicareResultsModel.medicarePartBEndDate}}
Part D Effective Date:	{{medicareResultsModel.medicarePartDEffDate}}
Part D End Date:	{{medicareResultsModel.medicarePartDEndDate}}
LIS for Proposed Effective Date?	{{medicareResultsModel.lisForProposedEffDate}}
LIS Percentage:	{{medicareResultsModel.lisPercentage}} What is this?
Has the quarterly Maintaining Dual / LIS SEP Election been used?	{{medicareResultsModel.lastUsedDualDate}}
Current Plan Type:	{{medicareResultsModel.planTypeIndicator}}
Current Drug Coverage:	{{medicareResultsModel.drugTypeIndicator}}

Contact PHD at this time for SEP verification.

State

Please select a State

Zip Code

A valid 5 digit zip code is required

County

Please select a County

First Name

First Name is required

Last Name

Last Name is required

Middle Initial

Middle Initial Required

Gender

Please select a gender

Date of Birth

DOB is required

You must enter a valid Year

You must enter a valid Month

You must enter a valid date

Proposed Effective Date

Proposed Effective Date is required

You can only enter the current year for a proposed effective date

You must enter a valid month

Medicaid Number{{eligibilityModel.medicaid.ma_state == 'LA' ? "/CCN" : ""}} {{medicaidNumberRequired ? "" : optionalLabelText}} SSN {{alternateIdOptional ? optionalLabelText : ""}}

Medicaid Number{{eligibilityModel.medicaid.ma_state == 'LA' ? "/CCN" : ""}} SSN

Medicaid Number is required

SSN is Required

Medicare Number (Optional)

Permission to verify the consumer's Medicaid Status?

Yes No

Ensure consumer is also Medicare eligible before enrolling in a Dual Special Needs Plan.

First Name:	{{medicaidResultsModel.chcResponse.chcfirstName}}
Last Name:	{{medicaidResultsModel.chcResponse.chclastName}}
Medicaid Number:	{{medicaidResultsModel.chcResponse.chcmedicaidId}}
Has the quarterly Maintaining Dual / LIS SEP Election been used?	{{medicaidResultsModel.lastUsedDate}}
LIS for Proposed Effective Date?	{{medicaidResultsModel.lisProposedEffDate}} What is this?

Available Plans	Eligible (Yes/No)	Consumer's Medicaid Level
{{planname}} ({{val.contract}}-{{val.pbp}}-{{val.segmentId}})	{{eligLevel2String[$index]}} {{val.specialCondition}}	{{eligLevel3String[$index]}}

Available Cost-Sharing Plans	Medicaid Status
{{planname}}({{val.contract}}-{{val.pbp}}-{{val.segmentId}})	{{resolveConditions(val,medicaidResultsModel.medicaidActive)}} {{val.specialCondition}}

Important Cost-Sharing Plan Info

Chronic condition eligibility information

This area at the bottom of the results page is for disclamer/notes that are AEM content authorable to display on the Medicare results UI page If AEM content author creates a message in AEM to be displayed to agents

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