Utah Medicaid

Attention Utah Medicaid pharmacy providers and members

The Utah Medicaid pharmacy vendor, Change Healthcare (CHC), experienced a network and system outage on February 21, 2024. CHC determined this security incident impacted Medicaid members’ personal information held on the network.

Members: CHC is in the process of mailing letters to Utah Medicaid members who may have been affected. We want Medicaid members who may receive a letter from CHC to know that it is not a scam. For more information, CHC has set up a toll-free number 1-866-262-5342 and an informational website.

Providers: Beginning Tuesday, October 15, 2024, the Medicaid fee for service point of sale system and PRISM provider administered drug will turn on prior authorization editing.The Medicaid Pharmacy Program will begin accepting prior authorizations via fax for pharmacy point of sale drugs and PRISM provider-administered drugs. Technical information for pharmacies is available in the Provider FAQ

Learn more about the Change Healthcare system disruption to Utah Medicaid in past press releases: 3/12/24, 3/8/24, 2/29/24, 2/24/24, & 2/22/24)

Members

Helpful links and information for Medicaid members
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Healthcare providers

Helpful provider resources
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Managed care

Learn more about managed care
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PRISM

Helpful PRISM resouces for providers
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Common Questions

What is Medicaid?

Medicaid is a state/federal program that pays for medical services for low-income pregnant women, children, individuals who are elderly or have a disability, parents and women with breast or cervical cancer. To qualify, these individuals must meet income and other eligibility requirements.

Who is Eligible for Medicaid?

Medicaid is a program that covers medical expenses for certain groups of people who have limited income and resources. To learn more about the eligibility requirements, click here.

How to Apply?

You can apply for medical assistance today. You will need to complete an application and provide some documents, like a birth certificate. Click here opens in a new tab to start the online application.