Benefits lookup on plans

Use the benefits lookup to see how a plan covers a service before care happens. It answers questions like "Is this code covered?", "What will the member pay?" and "Does this need a pre-cert, and who do I call?"

If you are a provider, you can access tools for benefits lookup for a coverage by following this guide: https://yuzu.health/docs/guides/check-benefits-and-eligibility

Overview

This is not a guarantee of benefits. The final result comes from the claim. Find the lookup on the “Benefits” tab on the plan.

Use the lookup to find:

  • Benefit that the code falls under, and the member's cost share for each tier

  • Whether the service needs a pre-cert, and the plan's UM vendor and phone number

  • Exclusions

  • Networks, with a link or phone number to check whether a provider is in network.

  • Telehealth vendor, if the plan has one

  • Buy-and-bill drugs if the plan has a list

Search for a procedure code to see the benefits and limitations

If a code does not return a benefit, this does not mean it is not covered. Contact us for more information.

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