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Checking Ambetter Member Eligibility

Date: 02/09/18

Thank you for serving our Ambetter from Sunflower Health Plan members. In 2018, our Kansas Ambetter service area includes coverage for residents in Johnson and Wyandotte counties. However, the national Ambetter network includes select providers located in other states, including nearby Missouri where Ambetter from Home State Health also offers plans on the Marketplace.

Checking Ambetter Eligibility

  • If you are in our Ambetter from Sunflower Health Plan network, you are in network for any Ambetter member living across the US.
  • The member’s Ambetter ID card will indicate if your patient is an Ambetter from Sunflower Health Plan member. If you see the Sunflower logo, you should see your patient in the portal. If you see Ambetter from any other health plan, please refer to the bullet point below.
  • If you are seeing an Ambetter member who resides in another state, they may not show up in the secure portal that you are accessing through Sunflower Health Plan. For example, a provider located in Kansas who is logged in to the Sunflower Health Plan secure provider portal to check eligibility may not be able to view an Ambetter member who resides in Missouri.
  • See if you want to see which states have Ambetter plans.
  • To check eligibility for an out-of-state Ambetter member, call our customer call center at 844-818-1633 to verify eligibility and benefits.

We are working on a national provider portal accessibility solution and will update providers when it’s resolved. Thank you for your patience.  For questions about this bulletin or other topics, please call Provider Services at 1-844-518-9505.