---
title: "Request Eligibility Verification"
method: POST
path: "/Eligibility"
tags: ["eligibility"]
---

# Request Eligibility Verification

`POST /Eligibility`

Submit a real-time eligibility and benefits verification request for a dental insurance subscriber. Returns coverage details, deductibles, maximums, and benefit information from the payer.

## Request body

- EligibilityRequest
  - `payer` object, required
    - `id` string, required — Payer ID from the Payer List endpoint
  - `provider` object, required
    - `npi` string, required — Provider's National Provider Identifier (10 digits)
    - `tax_id` string, required — Provider's Tax Identification Number (9 digits)
  - `subscriber` object, required
    - `first_name` string, required — Subscriber's first name
    - `last_name` string, required — Subscriber's last name
    - `member_id` string, required — Subscriber's insurance member ID
    - `dob` string, required — Date of birth in MM/DD/YYYY format
    - `group_number` string, required — Insurance group number
  - `dependent` object — Optional dependent information for dependent eligibility checks
    - `first_name` string
    - `last_name` string
    - `member_id` string
    - `dob` string — MM/DD/YYYY format
    - `group_number` string
  - `version` 'v1' | 'v2', required — API version. Use "v2" for the current version. Version "v1" is deprecated and returns a legacy response format.

## Response `200`

Eligibility verification results

- EligibilityResponse — Eligibility response wrapped in a WunderGraph data envelope. The actual eligibility data is under data.apidental_post_eligibility.
  - `data` object
    - `apidental_post_eligibility` object — Eligibility verification results. Contains patient, subscriber, payer, provider, plan, limitations, deductibles, maximums, coinsurance, active_coverage, and not_covered sections. Structure varies by payer.
      - `patient` object
      - `subscriber` object
      - `payer` object
      - `provider` object
      - `plan` object
      - `limitations` object[]
      - `deductible` object[]
      - `maximums` object[]
      - `coinsurance` object[]
      - `active_coverage` object[]
      - `not_covered` object[]

## Other responses

- `400` — Bad request - invalid payer ID, missing required fields, or upstream payer error
- `401` — Authentication required - invalid or missing API key
- `402` — Payment required - no active subscription or payment method
- `403` — Forbidden - API key is disabled
- `429` — Rate limit exceeded

## Changes

- **2026-03-15** `d7d63efc6c52` — 1 breaking, 3 info
  - request property `version` was restricted to a list of enum values
  - added the new `v1` enum value to the request property `version`
  - added the new `v2` enum value to the request property `version`
  - added the optional property `data` to the response with the `200` status
- **2026-03-15** `edf62bde9815` — 13 info
  - api operation id `checkEligibility` removed and replaced with `requestEligibility`
  - the request property `dependent/dob` became optional
  - the request property `dependent/first_name` became optional
  - the request property `dependent/group_number` became optional
  - …9 more
- **2025-08-13** `bcef4c02a343` — 19 breaking, 1 info
  - the request property `dependent/dob` became required
  - the request property `dependent/first_name` became required
  - the request property `dependent/group_number` became required
  - the request property `dependent/last_name` became required
  - …16 more
- **2025-08-13** `a78763c41d47` — 15 info
  - api operation id `checkEligibility` removed and replaced with ``
  - added the new optional request property `dependent`
  - the request property `payer` became optional
  - the request property `payer/id` became optional
  - …11 more
- …earlier changes not shown

[Full history](https://skmtc.dev/api-dental/apis/api-dental-sdk/changes/Eligibility/post.md)

---

[API](https://skmtc.dev/api-dental/apis/api-dental-sdk.md) · [All operations](https://skmtc.dev/api-dental/apis/api-dental-sdk/llms.txt) · [OpenAPI document](https://skmtc-service-production.skmtc.workers.dev/v1/apis/api-dental/api-dental-sdk/revisions/d7d63efc6c52/schema)