Coordination of benefits

Can I have Apple Health (Medicaid) and private health insurance?

Yes, it's okay to have Apple Health (Medicaid) and private health insurance.

It's important that you tell us if you have other health insurance, because your health plan may be responsible for paying all or part of your medical bills. When you tell us about your private health insurance, it will help your provider to be paid quickly and accurately.

To tell us about your insurance or report a change,

• For Apple Health clients contact us.
• For clients enrolled in a managed care plan.

If you pay for your health insurance, we might be able to help you with the cost. You may apply using the application for Premium Payment Program.

Do you need help finding a doctor or have a question about your health coverage?

• For Apple Health clients contact us.
• For clients enrolled in a managed care plan.

Tips for using private health insurance and your Apple Health/managed care health coverage

How will having Apple Health coverage help me if I have private health insurance?

Since private health insurance policies have copay and/or deductible requirements, Apple Health or your managed care plan may cover these out-of-pocket expenses for you.

What do I need to know before I see my doctor?

Make sure you go to doctors who can bill both your private insurance and Apple Health (Medicaid) or your managed care plan.

What if my doctors won't take my private insurance and Apple Health services card?

Your insurance company can help you find doctors and providers in your area. Once you have found providers in your private insurance’s network, you can ask providers if they accept Apple Health or Apple Health Managed Care.

What if my private insurance doesn't cover a service?

Some services not covered by private insurance may be covered by Apple Health or your managed care plan. 

Do I have to pay if my private insurance, Apple Health, or my managed care plan won't cover a service?

Yes, you will have to pay if the service is not covered. Your provider should make you aware of this before you receive the service.

What if the doctor sends me a bill?

You should not receive a bill for an Apple Health covered service. If you are billed, call us right away. If enrolled in a managed care plan, contact the plan right away.

What if my private insurance ends or changes?

Contact your managed care plan and inform the plan regarding any changes. If you are not enrolled in a managed care plan, call us. It is important to let us know about any changes to your insurance coverage.

Where do I report changes to my private dental insurance?

Contact Apple Health and inform us of any changes to your private dental insurance coverage. Clients who lose or misplace ProviderOne cards can find out how to get a new one at Replace my services card.