Eligibility and pharmacy overview

Member eligibility and member rosters

 

Care providers can view member rosters and other reports using the Provider Online Reporting tool accessed through Payer Spaces on the Availity platform. You must have an Availity account and be assigned to the Provider Online Reporting tool to use it. Contact your organization’s Availity administrator if you need access.

 

 

To check member eligibility and benefits:

  1. From the Availity homepage, select Patient Registration from the top navigation.
  2. Select Eligibility and Benefits.

Access benefits and pharmacy information

Pharmacy information

 

Access pharmacy information, formularies, Preferred Drug Lists (PDLs), prior authorization information, and other related resources.

Pharmacy prior authorization forms

 

Access the necessary forms that follow the Texas Vendor Drug Program Clinical Criteria for pharmacy prior authorizations.

Benefits partners

 

The Benefits partners page provides links to all our valued partners to supply our members with quality services.

Interested in becoming a provider in the Wellpoint network?

 

We look forward to working with you to provide quality service for our members.

 

Join our network