In 1934, FDR signed the Social Security Act into law. One of the law's statues specifies "... that the State or local agency administering such plan will take all reasonable measures to ascertain the legal liability of third parties ... to pay for care and services" offered to Medicaid beneficiaries.
Basically, it denotes that Medicaid becomes the payer of last resort (PLR), a term also named third party liability (TPL), or the Coordination of Benefits (COB). Essentially, Medicaid pays last, and if a Medicaid member possesses other insurance policies, such as insurance through his/her employer, that insurance provider pays first then Medicaid pays any remaining costs.
As much as 10 percent of the Medicaid members throughout the country keep additional insurance beyond Medicaid, which is deemed TPL. Varieties of TPL include employee insurance, Workers' Compensation, Medicare, COBRA health insurance from previous employment, casualty insurance, dental insurance, eye insurance and insurance to cover prescription costs.... Read More
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