Federal law and regulations require states to ensure Medicaid beneficiaries use all other resources available to them to pay for all or part of their medical care before turning to Medicaid. The State Medicaid program pays only after the third party has met its legal obligation to pay.

A third party is any individual, entity, or program that is, or may be, liable to pay for any medical assistance provided to a Medicaid beneficiary under the approved state Medicaid plan. Third parties may include:

• Medicare
• Private health insurance
• Employment-related health insurance
• Medical support from absent parents
• Casualty coverage resulting from an accidental injury such as automobile or property insurance (including no-fault insurance)
• Court judgments or settlements from a liability insurer
• State workers' compensation
• First party probate-estate recoveries; and/or
• Other federal programs (e.g., Indian Health, Community Health, and Migrant Health programs), unless excluded by statute.

Medicare Buy-In
Tips, hints and information for providers on purchasing Part A and Part B Medicare premiums for Medicaid beneficiaries.

Health Claims Processing  
Tips, hints and information on processing suspended claims with other insurance information and claim adjustment report information.

Medical Subrogation Process
Information for attorneys and beneficiaries on notifying the State regarding lawsuits and other actions against third parties to recover Medicaid expenses.

Birth Expense Reporting
Information, FAQs and links on the process used to recover birth expenses paid by Medicaid for children born out-of-wedlock.

Health Insurance
Private Health Insurance and Medicaid.

Estate Recovery
Information, FAQs and links for Estate Recovery

Related Links: 

Social Security Act

Michigan Compiled Laws/Public Acts