Daughter gets dad’s plan, does not have to drop Medicaid

My sister and her daughter have been on Medicaid.  Her daughter’s father has recently re-surfaced and is now covering her on his health plan.  This is good news, but it may not last.    Should my sister tell Medicaid that her daughter no longer needs the help?  Will she get in trouble if the child has both a private plan and Medicaid?  If (when) the dad disappears again, could she get right back onto Medicaid?

Good News, Bad News

Dear Good News, Bad News,

Yes she should tell Medicaid about her daughter’s new plan.  And no, she will not get into trouble.  People are allowed to have both Medicaid and a private health plan.  So, her daughter will not have to give up Medicaid.

The Medicaid plan will pay after her father’s plan pays. This means that the doctor (or hospital or other service provider) will bill his plan first; then they will send the private plan’s explanation of benefits to Medicaid. You don’t need to worry about this part — the billing people already know how to do this.

If the father’s plan does go poof, she will still have Medicaid – as long as she and her mother still qualify for it.

Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.