Healthcare Claims

Medicaid requires recipients to tell ORS if they have another type of health insurance. You can do that by contacting ORS.

What ORS Does When a Medicaid Recipient Has Other Insurance Coverage

ORS shares updates about insurance coverage with the Utah Department of Workforce Services. This process keeps this part of your Medicaid records up to date.

ORS also works with insurance companies in certain ways. 

We contact insurers to confirm that a Medicaid recipient has coverage.

We also file some claims directly with insurance companies. We do this when we believe the insurance company is responsible to pay a healthcare claim, not Medicaid. In those cases, the law requires the insurance company to pay ORS directly. These payments then help to pay other Medicaid benefits.

What ORS Does Not Do

ORS does not work with Medicaid or insurance companies to get them to pay doctors, hospitals, or other healthcare providers.

ORS does not make other kinds of changes to your Medicaid records. We can only make changes to information about your other insurance. To change your Medicaid dental or health plan, contact your Health Program Representative at (844) 238-3091 or (801) 538-6155.

ORS does not determine Medicaid eligibility. For questions about eligibility, contact the Department of Workforce Services at (866) 435-7414.

ORS does not discuss individual benefits. For questions about benefits, contact your health plan. Utah has four health plans associated with Medicaid:

If you have questions about benefits or are not enrolled in one of the health plans, contact the Department of Health at (844) 238-3091.

How to Update Your Insurance Information with ORS

If your insurance information has changed, contact ORS at (801) 536-8798. Tell our representative that you want to update your Medicaid record with information about other insurance.

What Employers Need to Do

ORS sometimes contacts employers to see whether they offer their employees health insurance. We may send separate notices for Medicaid and for child support.
If you receive one of these notices, fill it out and send it back by the deadline. If you have questions, contact ORS at the number on the form.