MedicaidMember Card

July 2014

Medicaid Member Card

• Medicaid and PCN members received a new wallet-sized plastic Medicaid card starting July 2014

• Each Medicaid member received their own card• Members no longer receive the color coded, full paper cards that

showed monthly eligibility information• The card lists the member’s name, Medicaid ID number, and

date of birth• Replacement cards are only issued when a card is lost or

damaged and a new card is requested FRONT BACK

New Medicaid Member Card

• Members need to show their Medicaid card BEFORE getting medical care

• Providers need to verify identity • Eligibility should be verified before any service is provided• Members have a phone number to check eligibility

o In the near future, they will also have a web tool to check eligibility

• Providers have AccessNow and an electronic Eligibility Lookup Tool located on the Medicaid website

All benefits, claims, and eligibility contact information is on the back of the new card.

Information for MEMBERS

• Members received a Benefit Letter in the mail– Letter contains plan information– A new letter is sent when there are changes– Keep this letter for your records

• Members can also call the Medicaid Member Services hotline to check eligibility: 1-844-238-3091

• If a card is lost or damaged, members can call the Department of Workforce Services for a replacement: 1-866-435-7414

Information for PROVIDERS

• The Eligibility Lookup Tool enables providers to view:– Member demographics– Member eligibility (including the past 36 months)

– Eligibility for the next month (after benefit issuance which is 6 business days before the end of the month)

– Plan enrollment information– Provider restrictions– Patient co-pays– TPL and other health insurance

• Information from the Eligibility Lookup Tool can be printed for record keeping

• Providers can still call AccessNow: 1-800-662-9651

Eligibility Lookup Tool

Eligibility Lookup Tool is located on website: medicaid.utah.govHome: Health Care Providers>Eligibility>Eligibility Lookup Tool

Also available in Provider Quick Links on the Health Care Providers page

Additional Resources

• To help ease the transition for both Members and Providers, there are resources online including:

– FAQs

– Trainings

– Reference Tools

Visit medicaid.utah.gov for more!