Patient Eligibility Verification
Starting May 1, 2023, DHHS began issuing a new Medicaid card to replace the old Utah Department of Health (UDOH) card for newly enrolled Medicaid members. Each new Medicaid member will receive their own card. Existing members should continue to use their old UDOH Medicaid card. Please accept both DHHS and UDOH Medicaid cards. Learn more in the New Medicaid Card FAQ for Providers opens in a new tab.
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.
In order to be in compliance with HIPAA, we must assure that only those that have the right to this information have access. A provider will have to register with the State of Utah by creating an account. If not currently logged in, you will be redirected and prompted to log in. Due to security, there is a 20-minute inactivity timeout feature on the Eligibility Lookup Tool.