New Medicaid Member Card

The new wallet-sized cards will not have eligibility information listed on them. Instead, they will have the member’s name, Medicaid ID number, and date of birth.  The back of the card has helpful contact information and websites for both providers and members. 

Before providing services to card holders, you will need to verify you patients’ Medicaid eligibility.  There are two ways to help you do so:

1. The Eligibility Lookup Tool: https://medicaid.utah.gov/eligibility

2. AccessNow: 1-800-662-9651

The Eligibility Lookup Tool is a website that allows a provider to electronically view a member’s Medicaid eligibility and plan enrollment information.  The Eligibility Lookup Tool will also tell you if the patient is restricted to a specific provider and if the patient is responsible for co-pays.

To verify your patient’s eligibility on the portal you will need the information off of the Medicaid card which includes member’s name, Medicaid ID and date of birth.  A provider must also have a Provider ID (NPI or API) known to Medicaid.

Pharmacies that bill Medicaid through the Medicaid pharmacy Point-of-Sale (POS) system will still receive messages pertaining to the following:

1. Individuals not Medicaid eligible

2. Individuals enrolled in an Accountable Care Organization (ACO), in which the POS message will continue to give the ACO Bin # and plan ID information

    

For more information about the new Medicaid card, please see the Frequently Asked Questions.  The Eligibility Lookup Tool Quick Start Card is another helpful reference in using the Eligibility Lookup Tool to verify your patients’ Medicaid eligibility.  Finally, a sample of the new Medicaid card will help you know what to expect in July.