What insurance can you look up on Availity?

You can check patient eligibility and benefits for hundreds of nationwide commercial, state, and federal health insurance payers through the Availity Essentials Portal.

Types of Insurances Supported

• Major Commercial Payers: Large national and regional health insurance companies (such as Anthem, Florida Blue, Humana, and Aetna).
• State and Federal Programs: State Medicaid programs and Medicare administrative regions.
• Self-Insured Plans: Employer-sponsored plans connected through participating clearinghouse networks.

How to View the Full List

• Payer List: You can search the active directory of participating companies using the official Availity Payer List PDF.
• Portal Access: Log into Availity Essentials to search the live, searchable directory of connected payer IDs. Note that individual payer enrollment or specific contracts may be required before submitting transactions for certain non-sponsoring plans.

To check insurance coverage, log in to the Availity Essentials portal and open the Eligibility and Benefits Inquiry tool under the Patient Registration menu.

Steps to Verify Coverage

• Log in: Go to Availity and sign in with your provider username and password.
• Open tool: Select Patient Registration from the top navigation menu, then click Eligibility and Benefits Inquiry.
• Select organization: Choose your specific organization if you manage multiple practices or locations.
• Choose payer: Select the correct insurance company or health plan from the drop-down list.
• Enter patient details: Input the patient's member ID, date of birth, and first/last name.
• Add service details: Choose the provider, place of service, date of service, and benefit type (such as Health Benefit Plan Coverage).
• Submit: Click the Submit button to run the real-time request.
• Review results: Read the returned response to check active coverage status, copay amounts, deductibles, coinsurance, and referral requirements.
• Save or print: Download a PDF or print the summary for your front desk or billing records.

Many major health insurance companies and health plans use Availity Essentials as their multi-payer provider portal or clearinghouse for eligibility, claims, and prior authorizations.

Major Insurance Companies Using Availity

• Blue Cross Blue Shield (BCBS): Many state plans (such as BCBS Illinois, BCBS Texas, Florida, and others) use Availity as a primary or exclusive portal.
• Anthem / Elevance Health: Uses Availity Essentials for provider transactions across multiple states.
• Aetna: Integrates with Availity for provider data management and verification.
• Humana: Uses Availity for administrative and clinical workflows.
• Highmark: Utilizes Availity Essentials for online provider tools.
• Ambetter / Centene: Many regional Ambetter plans (such as Ambetter from Superior HealthPlan) transition their provider portals to Availity.
• American Family Insurance Group
• Delta Dental: Various state branches (such as New Jersey, South Carolina, and Washington).

You can learn more about how Availity Payers work or check the complete, updated directory directly inside the Availity Essentials portal.

Yes, many Blue Cross Blue Shield (BCBS) plans use the Availity Essentials portal for provider transactions.

How BCBS Uses Availity

Healthcare providers use Availity Essentials to interact with various regional BCBS independent licensees (such as in Illinois, Texas, Montana, and Tennessee) at no charge for standard web transactions.

Common tasks performed through Availity for BCBS include:

• Eligibility and Benefits: Checking co-pays, deductibles, co-insurance, and active coverage status.
• Authorizations and Referrals: Submitting, updating, and checking status for prior authorizations (HIPAA 278).
• Claims and Payments: Submitting professional/institutional claims, checking real-time claim status, and reviewing remittances.
• Payer Spaces: Accessing BCBS-branded resources, fee schedules, and policy guidelines.

Exceptions to Note

• Not all BCBS state plans or specialized services operate identically. Some separate behavioral or specialty vendors (like Carelon or eviCore) manage their own independent authorization portals rather than Availity.
• You must have an active, registered account with Availity and select the specific state's BCBS plan as a payer partner to access these tools.

Yes, Aetna uses the Availity Provider Portal as its primary platform for provider transactions.

What You Can Do on Availity for Aetna

• Check Eligibility: Verify patient benefits and coverage details.
• Manage Claims: Submit claims, check claim status, and view Explanation of Benefits (EOB) documents.
• Handle Authorizations: Submit and check the status of prior authorizations and referrals.
• File Appeals: Submit disputes, appeals, and grievances.

Covered Lines of Business

• Commercial and Medicare: Managed through the standard Availity payer space.
• Medicaid and DSNP/MMP: Managed through the "Aetna Better Health" instance on Availity.