Sorry, Medicare Eligibility lookup is currently unavailable
Sorry, Medicaid Eligibility lookup is currently unavailable. Please contact the Producer Help Desk for assistance.
Contact PHD at this time for SEP verification.
The results below only indicate Medicaid Eligibility, you must also do the following prior to submitting an enrollment.
- Ensure consumer is also Medicare eligible. This can be completed by using the Medicare Eligibility Search tool located above.
- Provide the consumer with the LIS Summary table.
- Review plan details with the consumer. Important plan information including cost sharing can be found in the Medicare Product Portal.
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
Cost Sharing Plan Information:
When a consumer has partial or inactive Medicaid eligibility you must inform the prospective member of the potential co-pay/co-insurance amounts they could incur if they enroll in a cost-sharing plan without having a level of Medicaid that would help cover plan costs.
For additional information please refer to the job aid for cost-sharing plans or call the Producer Help Desk at 888-381-8581.
Chronic Condition Eligibility
In order to enroll a consumer in a UHC Complete Care (CSNP) the consumer must have Medicare AND a qualifying chronic health condition such as a cardiovascular disorder and/or chronic heart failure.
In addition, it is highly recommended that CSNP eligible consumers enrolling into a CSNP with 20% coinsurance/cost sharing should also have state Medicaid to cover the plans coinsurance/cost sharing.
Please confirm the consumer meets these requirements before enrolling them in one of these plans.