Eligibility and Benefits

Our eligibility and benefits tools help you verify member eligibility, determine benefits, view care plans and get digital ID cards.

What Would You Like to Do?

To see more information on any of these areas, click on the plus sign (+) next to their title.

Use Eligibility and Benefits (on Link) to quickly:

  • Check UnitedHealthcare member eligibility and policy dates
  • Get digital ID cards and patient information
  • View detailed benefits information
  • Confirm copay, coinsurance and deductible amounts
  • Determine if additional coverage exists
  • Find out if referrals, notifications or prior authorization are needed for the member’s plan

Learn more about Eligibility and Benefits (on Link)

Use Eligibility and Benefits (on Link) to:

  • Search benefits by category, including vision
  • Get a copy of the digital ID card
  • Check coverage limits and therapy accumulators
  • Verify the care provider’s network and tier status for the member’s plan
  • View cost share amounts and balances

Learn more about Eligibility and Benefits (on Link)

Digital ID cards provide more detailed benefit information and make photocopying unnecessary. Patients may email their digital ID card from a smart device, or you can use Eligibility and Benefits (on Link) to view it online and download it to your system. Obtaining it from Eligibility and Benefits (on Link) gives you detailed benefit information beyond what can be found on the traditional member ID card. For example, you can find the member’s copay, coinsurance and deductible amounts as well as the accumulated deductible.

Learn more about Eligibility and Benefits (on Link)

Some plans require members to select a PCP. Look up a member in Eligibility and Benefits (on Link) to view their current PCP and get contact information for patient care coordination.

Learn more about Eligibility and Benefits (on Link)

A care provider’s participation and tier status may vary across networks and members’ plans, so it’s important to check this information regularly. The easiest way to check your participation status with a particular plan is to look up the member in Eligibility and Benefits (on Link).

Learn more about Eligibility and Benefits (on Link)

Care Conductor lets you view a member’s plan of care, enter notes or comments regarding the plan, access a member’s health assessment and acknowledge that you have reviewed it and view notes history

Looking for Medicaid and Medicare Special Need Plans (SNP)?

Most Medicaid and Medicare SNP Plans can view a member’s Assessments, Care Plans and Clinical Documentation via the CommunityCare tool: 

Care Conductor lets you view a member’s plan of care, enter notes or comments regarding the plan, access a member’s health assessment and acknowledge that you have reviewed it and view notes history.

Looking for Medicaid and Medicare Special Need Plans (SNP)?

Most Medicaid and Medicare SNP Plans can view a member’s Assessments, Care Plans and Clinical Documentation via the CommunityCare tool: 

Care Conductor lets you view a member’s plan of care, enter notes or comments regarding the plan, access a member’s health assessment and acknowledge that you have reviewed it and view notes history.

Looking for Medicaid and Medicare Special Need Plans (SNP)?

Most Medicaid and Medicare SNP Plans can view a member’s Assessments, Care Plans and Clinical Documentation via the CommunityCare tool: 

Care Conductor lets you view a member’s plan of care, enter notes or comments regarding the plan, access a member’s health assessment and acknowledge that you have reviewed it and view notes history.

Looking for Medicaid and Medicare Special Need Plans (SNP)?

Most Medicaid and Medicare SNP Plans can view a member’s Assessments, Care Plans and Clinical Documentation via the CommunityCare tool: 

Care Conductor lets you view a member’s plan of care, enter notes or comments regarding the plan, access a member’s health assessment and acknowledge that you have reviewed it and view notes history.

PreCheck MyScript Solution: Check Pharmacy Eligibility & Prior Authorization

Check current prescription coverage and price, including out-of-pocket prescription costs for UnitedHealthcare members at their selected pharmacy with the PreCheck MyScript Solution within your EMR or on Link.

  • Get information on lower-cost prescription alternatives, if available, to help save members money.
  • See which prescriptions currently require prior authorization and electronically request prior authorization if needed.
  • Request prior authorization and receive status and results.

Learn More about PreCheck MyScript Solution