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Reporting Other Insurance Coverage

Third Party Liability

You may have Medicare or other health insurance. Medicare or your other health insurance is your primary insurance. This other insurance is known as “third party liability” or TPL. Having other insurance does not affect your Medical Assistance eligibility. In most cases, your Medicare or other insurance will pay your PCP or other provider before PA Health and Wellness pays. PA Health and Wellness can only be billed for the amount that your Medicare or other health insurance does not pay. You must tell both your CAO and Participant Services at 1-844-626-6813 (TTY:711)

You must let us know if:

  • You have other health insurance now
  • You get new other health insurance
  • Your other insurance ends
  • Any information about your other insurance changes

Giving us this information helps make sure your health care claims are paid correctly and on time.