§ 4003 — Health insurance for persons on Medicaid

(a) No health insurer, in enrolling an individual or in making any payments for benefits to the individual or on the individual’s behalf, shall take into account that the individual is eligible for or is provided medical assistance under a Medicaid Plan of this State or any other state.

(b) Where a state agency has been assigned the rights of an individual eligible for medical assistance under Title XIX of the federal Social Security Act [42 U.S.C. § 1396 et seq.] and such individual is covered for health benefits from a health insurer, no such health insurer shall impose requirements on the state agency that are different from requirements applicable to an agent or assignee of any other individual so covered.

(c) Where a state agency has been assigned the rights of an individual eligible for medical assistance under Title XIX of the federal Social Security Act (42 U.S.C. § 1396 et seq.) and such individual is covered for health benefits from a health insurer, such health insurer, or other liable third party, must accept authorization provided by the State that the item or service is covered under the state plan (or waiver of such plan) for such individual, as if such authorization was made by the third party prior to the item or service for such item or service.

Legislative History

69 Del. Laws, c. 444, § 1 ; 84 Del. Laws, c. 257, § 1