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NC Department of Health and Human Services
NC Division of
Medical Assistance
 
 

Third Party Insurance

Federal regulations require Medicaid to be the “payer of last resort.” This means that all third party insurance carriers, including Medicare and private health insurance carriers, must pay before Medicaid processes the claim. Additionally, providers must report any such payments from third parties on claims filed for Medicaid payment.

Third Party Insurance Codes

This Third Party Insurance Code list can be used to determine the name and billing address of a third-party insurance company.

Health Insurance Premium Payments

The Health Insurance Premium Payment (HIPP) program is designed for Medicaid recipients with high-cost illnesses such as, chronic heart problems, end-stage renal disease, congenital birth defects, cancer, etc.

These recipients are often at risk of losing private health insurance coverage due to nonpayment of premiums. DMA will consider the benefit of paying health insurance premiums if it is found to be cost-effective.

More information on the HIPP Program > >

Third Party Insurance Forms

Contact DMA Third Party Recovery

Contact: Dionne M. Toney
919-814-0240
Fax 919-814-0038
Email: dionne.toney@dhhs.nc.gov