Pharmacist Provider Enrollment

Pharmacists electing to provide services covered by Medicaid should complete the following steps to request enrollment with UnitedHealthcare Community Plan.


  • In compliance with federal requirements in the 21st Century Cures Act, most states require all providers to first enroll with their state Medicaid program, as applicable.
  • If you are not currently enrolled with the state Medicaid program, visit the following link for more information: State Medicaid Enrollment Resources
  • Once enrolled with Medicaid, please complete and submit this form to initiate the process with UnitedHealthcare
  • This form may be used for up to 3 pharmacists per pharmacy location; however, there is no limit to the number of pharmacists per location. To request enrollment for additional pharmacists, please complete additional form submissions as needed.
  • Within 3-5 business days, you should receive a secure email from UnitedHealthcare requesting any additional documents required for enrollment.
  • When all the required documentation is submitted and reviewed for completion, UnitedHealthcare will send a provider contract via DocuSign for electronic signature.
  • Once your contract has been completed, and you are enrolled as a provider, visit Get Connected on our UHC.provider.com website to learn how to create a One Healthcare ID and a UnitedHealthcare Provider Portal Profile.


For questions or concerns related to Community Plan Pharmacist Provider Enrollment email us at: uhccs_pharmacy@uhc.com