Third Party Liability

Medicaid third party liablity how to find any other insurance

Third Party Liability

Providers should verify whether a Medicaid recipient has other insurance prior to submitting a claim to Medicaid. Because federal Medicaid regulations require that any resources currently available to a recipient are to be considered in determining liability for payments of medical services, providers have an obligation to investigate and report the existence of other insurance or liability to Medicaid. Cooperation is essential to the functioning of the Alabama Medicaid Program.

Verifying Other Insurance

Recipients may be covered through a variety of health insurance resources.

Please ask the recipient about the following types of insurance coverage:

Insurance Coverage Scenarios                                  Health Insurance Resources

If the recipient is married or working                      Request information about possible health    insurance through the recipient's or spouse's employer

If the recipient is a minor                                             Request information about insurance the

mother, father

If the recipient is active or retired military personnel     Request information about CHAMPUS coverage

                                                                                  and a Social Security number of the   Policyholder

If the recipient is over 65 or disabled                        Request information about a Medicare HIC number;                                                                               ask if  the recipient has health insurance such as a Medicare                                                                           supplement policy, cancer, accident, or indemnity policy,                                                                                 group health insurance, or individual insurance