The following are third-party resources for Medicaid Payments:

• Employers who provide health insurance
  
• Unions or other entities who provide membership-based health insurance
  
• Public health service or military health care benefits or other state and federal programs (unless excluded by statute)
  
• Workers' compensation carriers and/or providers
  
• Fraternal and benefit societies or churches that provide health care coverage
  
• Insurance purchased or endowed as part of a college fee
  
• Long-term health care insurance

States must take all reasonable measures to determine any liable third-party, and many have established administrative personnel or units to assure that all of the resident's private medical resources have been accessed and exhausted before a Medicaid claim is paid. After the resident's third-party resources are identified, states typically allow health care providers to collect the bills directly from the third-party resource before submitting the Medicaid claim under the "cost avoid" method. A state may also choose to allow its Medicaid agency to pay the medical bills then attempt to recover from the obligated third party in limited circumstances under the "pay and chase" method.

Notably absent from the list of third party resources are the resident's relatives, including adult children. The state agency cannot seek Medicaid reimbursement from a non-spouse's income or resources.

Copyright 2010 LexisNexis, a division of Reed Elsevier Inc.