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Look up Medicaid & Medicare status

Use carrier portals to check statuses.

Sabreena Singh avatar
Written by Sabreena Singh
Updated this week

A built-in Medicare history and Medicaid status lookup tool is coming soon. In the meantime, you can perform these lookups via carrier portals – we’ve provided instructions for several carriers below.

If you do not have access to CMS Marx, use the links below to go directly to each carrier’s broker portal, or scroll down for step-by-step guides.

Note: United and Aetna tend to provide the most accurate information. And Medicaid status only populates if a carrier has DSNPs in the state.

United

Step 1: Log into your Jarvis broker portal.

Step 2: Click on Sales Tools and select Medicare & Medicaid Eligibility Lookup

Step 3: to see Medicare Eligibility, enter Date of Birth and Medicare Number (MBI).

Step 4: You'll see the following Medicare Eligibility information returned

  • Medicare eligible Y or N

  • Part A, B and D effective dates and end dates

  • MBI Number

  • LIS (Low-Income Subsidy) effective date and percentage

  • Current plan ID. (Google the Plan ID to identify which plan it is)

  • Current Part D coverage

Step 5: To see Medicaid Eligibility switch to that tab, and enter the required fields:

  • State

  • Zip Code

  • County

  • Name

  • Date of Birth

  • Proposed Effective Date

  • Medicaid Number or SSN

Tip: Most of this information will pre-fill if you check Medicare Eligibility first
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Step 6: You'll see the following Medicaid Eligibility information returned

  • First & last name

  • Medicaid number

  • Medicare eligible

  • Medicaid level

  • Waiver type

  • LIS for proposed effective date

  • Integrated / Other DSNP Eligible Plans

Aetna

Step 1: Log into your Aetna Think Agent account:

Step 2: Click on Sales

Step 3: Click on Check LIS Eligibility

Step 4: Enter the required fields marked with a red asterisk - First and Last Name, Date of Birth, and Medicare Number

Step 5: You will see the following Medicare / LIS Eligibility Information

  • Start and End Date

  • Copay Level

  • Premium Subsidy

  • Medicaid Coverage

Step 6: Click on Check Medicaid Eligibility

Step 7: Medicaid Eligibility

Enter the required fields:

  • First and Last Name

  • Date of Birth

  • Gender

  • Medicare Number

  • Medicaid Number

  • Medicare State

Step 8: You will see the following Medicaid Eligibility Information

  • Beneficiary First and Last Name

  • Medicaid ID

  • Medicare Benefit Type

Humana

Step 1: Log into your Humana Broker Portal

Step 2: Under Quote & Enroll, Scroll down and click on Eligibility Verification

Step 3: Medicare Eligibility

Enter the required fields: Date of Birth, Entity, Gender, and Medicare ID

Step 4: You'll see the following Medicare Eligibility Information:

  • Status + Status Message

  • Medicare ID

  • Beneficiary Name, Gender, DoB, DoD

  • Mailing and Residential Address

  • Part A, B, and D Start and End Dates

  • LIS Start and End Date, Level, and Percentage

Step 5: Medicaid Eligibility -

Enter the required fields marked with a red asterisk -

Note: Some of the information will pre-populate if Medicare Eligibility is checked first

  • Plan Year

  • State

  • First and Last Name

  • Date of Birth

  • Gender

  • Medicare and Medicaid Number OR just SSN

Step 6: You will see the following Medicaid Eligibility Information

  • Current Medicaid Eligibility Status

  • Medicaid ID

  • Medicaid Level

  • MCO (Managed Care Organization) Name

  • 2025 - DESNP Plan Eligibility Guide (plan details by state and what the member qualifies for based on Medicaid Level)

Cigna

Step 1: Log into your Cigna Broker Portal

Step 2: Scroll down to Tool and Select Medicare / Medicaid Eligibility

Step 3: Medicare/Medicaid Eligibility

Enter the required fields: Medicare Beneficiary Identifier (MBI) and Date of Birth.

Step 4: You will see the following Medicare / Medicaid Eligibility Information:

Medicare

  • First and Last Name

  • MBI

  • Date of Birth

  • Gender

  • State and County

  • Part A, B, and D Start and End Dates

  • Enrollment Data

  • LIS - Low Income Subsidy Data

Medicaid

  • Medicaid Status - Y or N

  • Start and End Date

Anthem

Step 1: Log into your Anthem Broker Portal

Step 2: Click on Tools & Resources + mProducer

Step 3: Scroll to Quick Links and click on Medicare / Medicaid Eligibility Check

Step 4: Medicare Eligibility

Enter the required fields:

  • First and Last Name

  • Check Effective Date

  • Date of Birth

  • Medicare Number

Step 5: You will see the following Medicare Eligibility Information

  • Transaction ID

  • Proposed Effective Date

  • Part A and B Effective Date

  • Current Contract -PBP - Segment

  • Drug Gap in Months

  • LIS Effective Date and Level

Step 6: Medicaid Eligibility

Enter the required fields:

  • First and Last Name

  • State

  • Date of Birth

  • Check Effective Date

  • Medicare Number

  • Medicaid Number or SSN

Step 7: You will see the following Medicare Eligibility Information

  • Transaction ID

  • DSNP Verification, Note: Save this - Needed for the application

  • DSN Verification Code Expiration Date

  • Proposed Effective Date

  • Medicaid Eligibility Determination Date

  • Medicaid ID

  • Medicaid Level

Devoted

Step 1: Log into your Devoted Broker Portal

Step 2: Click on Eligibility

Step 3a: You may need to click on Add New Prospect Eligibility Query

Step 3b: Enter the Zip code and State

Step 3c: Under Select Eligibility Check Type, Select Both Medicare and Medicaid

Notes:

  • DSNP Plan must be offered in that state + Member must be located in one of the states offered by Devoted

  • You can also just look up Only Medicare or Only Medicaid

Step 4: You will need the following Medicare / Medicaid Eligibility Information, once entered click Check Eligibility

  • First and Last Name

  • Birth Date

  • Gender (Optional)

  • MBI

  • Medicaid Number

Note: Review and accept the attestation - if you have permission from the member

Step 5: If information is available you will see a pop-up, Potential Prospect Matches Found. Click Create New Prospect + View Eligibility Results if info matches

Step 6: View Eligibility Results

  1. If Member has Medicare / Medicaid, Y or N

  2. Demographics

    1. MBI, Name, Address, DoB

  3. Medicare Status

    1. Part A and B Start Dates + Eligibility Start Dates

  4. Medicaid Status

    1. Medicaid ID

    2. First and Last Name + DoB

    3. Eligibility Start Date

    4. Dual Category Code (Level)

    5. Coverage Status

  5. Plan Info

    1. Future, Current, and Prior Info

  6. Cost Assistance

    1. Eligible for LIS, Y or N

    2. Start + End Date

    3. Level

    4. Copayment Level

  7. Uncovered Month

  8. Additional Details, Employer Group Health Plan, Y or N

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