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Report Third Party Insurance

Report Third Party Insurance

The Division of Medicaid (DOM) by law is intended to be the “payer of last resort”; that is, all other available third party sources must meet their legal obligation to pay claims before the Medicaid program pays for the care of an individual eligible for Medicaid or CHIP. Medicaid/CHIP recipients and providers are required to report any third party health-related insurance coverage to the Division of Medicaid. Any changes must be reported within ten days of the change.

How to Report Third Party Insurance

Changes or updates to your health insurance information may be reported in a variety of ways, including by phone, postal mail, fax and online forms. It is advised that you do not email forms or submit online forms with protected health information or personally identifiable information, to protect your confidentiality in accordance with the Health Insurance Portability and Accountability Act of 1996.

  1. Complete the Insurance Update Form.
  2. Submit the completed form by fax, postal mail or call in changes.

Phone: 601-359-6095
Fax: 601-359-6632

Complete the form and mail it to:

Mississippi Division of Medicaid
Office of Recovery
Walter Sillers Building
550 High Street, Suite 1000
Jackson, MS 39201-1399