Virginia Hipp Program Insurance
Jan 30, 2017. The Commonwealth of Virginia has two Medicaid related premium assistance programs that are administered by the Department of Medical Assistance Services (DMAS): o the Health Insurance Premium Payment (HIPP) For Kids Program which is a premium assistance program for those members under.
Health Insurance Premium Payment (HIPP) Programs Virginia has two Medicaid related premium assistance programs that help pay for employer-sponsored health insurance. You or a member of your family must first be enrolled in a Medicaid program to be eligible to apply for the HIPP programs. The Health Insurance Premium Payment (HIPP) For Kids Program Is a premium assistance program for Medicaid enrolled children under the age of 19 who are eligible for or enrolled in qualified employer-sponsored coverage. The Health Insurance Premium Payment Program When determined to be cost effective, this is a cost saving program for Medicaid members and reimburses some or all of the employee portion of the group health insurance premium for members who have employer sponsored group health insurance available to them through their own or their family member’s employment. All applications for premium assistance are first evaluated for the HIPP for Kids program. If it is determined that the eligibility criteria for the HIPP for Kids program are not met, the application is automatically evaluated for the HIPP program. Program Information Click for more information about the HIPP programs or contact our toll-free helpline at 1-800-432-5924.
West Virginia Bureau for Medical Services (BMS) offers the Health Insurance Premium Payment (HIPP) program to Medicaid recipients to assist those recipients who have high healthcare costs and are eligible for employer group health insurance. When it is determined cost effective, BMS reimburses the primary insurance premiums for Medicaid recipients.
Health Insurance Premium Payment (hipp) Program Virginia
The HIPP program also assists recently unemployed individuals by paying COBRA benefits from former employers. Most employers are required under COBRA to offer continued health benefits for 60 days after employment is terminated. After an individual chooses to continue with COBRA benefits, the plan may be renewed for an additional 18 months. Applicants must have group health insurance available which covers at least one person who is Medicaid-eligible in the State of West Virginia. The Omnibus Budget Reconciliation Act of 1990 mandated that states pay group health insurance premiums for Medicaid-eligible individuals if the insurance plans are determined cost effective.* As a result of this mandate, BMS implemented the West Virginia HIPP Program in 1996 to reimburse the commercial insurance premiums for Medicaid recipients when cost effectiveness requirements are met.
Cost effectiveness means that the costs of health insurance premiums, co-insurance and deductibles must be less than the member’s Medicaid healthcare costs and meet HIPP program requirements. Local welfare office case workers primarily submit referrals to the HIPP Unit for evaluation of the cost effective determination. A Medicaid recipient may also submit an application directly to the HIPP Unit. Emphasis is placed on the reimbursement of group health insurance premiums for cost effective private policies, conversion policies, and COBRA extensions.