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 Keystone First pays. Keystone First can only be billed for the amount that your Medicare or other health insurance does not pay.

You must tell both your County Assistance Office and Member Services at 1-800-521-6860 (TTY 1-800-684-5505) if you have Medicare or other health insurance. When you go to a provider or to a pharmacy you must tell the provider or pharmacy about all forms of medical insurance you have and show the provider or pharmacy your Medicare card or other insurance card, ACCESS or EBT card, and your Keystone First ID card. This helps make sure your health care bills are paid timely and correctly.