Member eligibility and pharmacy overview

Actual member benefits and eligibility are determined in accordance with the requirements set forth by the state. Providers may submit claims, eligibility inquiries, claim status inquiries, and associated attachments using electronic data interchange (EDI) by being a trading partner (TP) authorized by Ohio Department of Medicaid (ODM) or by contracting with an ODM authorized TP.

Pharmacy information

Pharmacy benefits for enrolled members are managed through the ODM. Visit the Pharmacy information page for details surrounding the single pharmacy benefit manager, clinical criteria for medical injectables, and access to pharmacy resources.

Benefits partners

We work with several partners to provide our members with quality services. The Benefits partners page provides links to all our valued partners.

Provider tools & resources

Join our network

We’re glad you’re interested in joining the Anthem network. We have a diverse network of exceptional healthcare professionals who ensure our members have uninterrupted access to the support they need.