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
