WHEN YOU HAVE OTHER HEALTH INSURANCE AND MEDICAID
CHOOSING PROVIDERS
You should always choose providers in your other health insurance provider network for
services covered by your other health insurance. You may continue to see your other
health insurance provider, even when those providers are not in your Medicaid Health
Plan provider network. When possible, if you are choosing new providers, you may want
to choose providers that are in your other health insurance provider network and also
in your Medicaid Health Plan provider network. GENERALLY, WHEN YOU CHOOSE
PROVIDERS IN BOTH NETWORKS FOR MEDICAID HEALTH PLAN COVERED
SERVICES, YOU CANNOT BE BILLED.
Under limited circumstances, you may be responsible for a portion of the payment. See
pages 10-11 for details and billing examples.
There are some services which are covered by your Medicaid Health Plan, but may not be
covered by your other health insurance. For example, private duty nursing, personal care
assistance and incontinence supplies are covered by your Medicaid Health Plan, but may
not be covered by your other health insurance. WHEN YOU USE MEDICAID HEALTH
PLAN PROVIDERS FOR THESE SERVICES/SUPPLIES, YOU CANNOT BE BILLED
FOR THE BALANCE.
HEALTH INSURANCE CARDS
When you enroll in a Medicaid Health Plan, you will receive a Medicaid Health Plan
identification (ID) card. All Medicaid Health Plan ID cards will list a Medicaid Health
Plan primary care provider (PCP). YOU SHOULD CONTINUE TO SEE YOUR OTHER
HEALTH INSURANCE PCP, REGARDLESS OF THE INFORMATION ON THE
MEDICAID HEALTH PLAN ID CARD, EVEN WHEN THE OTHER HEALTH INSURANCE
PCP DOES NOT PARTICIPATE WITH THE MEDICAID HEALTH PLAN. You are only
required to see your Medicaid Health Plan PCP when the needed service is not covered
by your other health insurance, but is covered by your Medicaid Health Plan.
If you have other health insurance and Medicaid, we recommend you show all health
insurance cards anytime you visit a doctor, hospital, pharmacy, lab or other service
provider. However, if you have other health insurance and Medicaid, AND YOU CHOOSE
NOT TO SHOW A PROVIDER YOUR MEDICAID HEALTH PLAN ID CARD, YOU MAY
BE HELD RESPONSIBLE FOR ANY APPLICABLE CO-INSURANCE PAYMENTS FOR
THE SERVICE RENDERED. By showing both cards, you should not be responsible for
any payments; however under limited circumstances, you may be responsible for a portion
of the payment. See pages 10-11 for details and billing examples.
WHEN YOU HAVE MEDICAID AND OTHER INSURANCE
9