Eligibility and Benefit Questions



Customer Navigation

Eligibility and Benefit Questions


At this time, only Subscribers can access their online Member Guide. After you log in to the customer portal, navigate to Customer Resources > Document Center > Search your Documents. Select the Document Type of Member Guide/Benefit Booklet from the drop-down listing and change the From date to a date before your effective date and click Search.

For WPS Administrative Services customers: Your member guide is referred to as the Plan Document. After you log in to the customer portal, navigate to Deductibles and Benefits > Benefit Information. Select the Summary of Plan Document.

We display the most current eligibility data on file. Just log in to your Customer account, select Benefit & Claim Information, and then select the Plan Benefits link. The policy effective date is located under the Benefits section of the page.

For WPS Administrative Services customers: Navigate to Enrollment Information on your dashboard and select View Your Enrollment Info. Your effective date will be listed under Original Effective.

It could be that you have a future effective date. You will need to enter that date (or a later date) when using your online account tools.

For WPS Administrative Services customers: You will not be able to log in to your customer account until after your effective date.

The drug benefit will display as Not Applicable (N/A) because it is covered under your medical benefit.

For WPS Administrative Services: Navigate to Prescription Benefits in your customer account. This will refer you to your Pharmacy Benefit Manager to contact with questions on your benefit.

Please contact the Customer Service line listed on your customer ID card to resolve your questions on benefit information. Monday-Friday, 7:30 a.m.-5 p.m. (CT).

   

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