Third-Party Insurance

Federal regulations require Medicaid to be the “payer of last resort,” meaning that all third-party insurance carriers must pay before Medicaid processes the claim. This includes Medicare and private health insurance carriers. Providers must report payments from all third parties on Medicaid payment claims.

Third Party Insurance Code Spreadsheet

Health Insurance Premium Payments

The Health Insurance Premium Payment (HIPP) program is a program that may pay for the cost of your health insurance premiums, when the cost to the Medicaid Program for the health insurance premium are less than Medicaid’s total cost of care.   

Under HIPP Program guidelines, medical services must be covered by the recipient’s private insurance first, while Medicaid covers remaining expense.

Third-Party Insurance Forms

Online Submission for Health Insurance Information Referrals

Health Insurance Premium Payment (HIPP) Application (DMA-2069)

Instructions for Request for Medicaid Payment (DMA-2073-I)

Third-Party Recovery (TPR) Accident Information Report (DMA-2043-i)

Instructions for Third-Party Recovery (TPR) Accident Information Report (DMA-2043-I-ia)

Insurance Company Code Request Form (DMA-2053-ia)

Request for Medicaid Payment(DMA-2073)

Third-party (TPR) Health and Accident Resources (DMA-2041)

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