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Margaret: If you guys live in PA. I think you should qualify for it under

MR. I would check it out at http://www.dpw.state.pa.us/oa/oaRdHippQa.asp

Liz

Liz

> <<HIPP is Health Insurance Premium Plan where the state pays for the wage

> earner & the child's insurance premiums whether it be directly to the

> company

> or directly to the wage earner. We are in PA. so I don't know if it is

> available elsewhere.>>

>

> Hi, Everyone...Liz...is it through your MH/MR case worker or CBHMP?

> That's

> the one thing about this site....all the parents give helpful hints to

> all

> the others!!! How and who qualifies for it? Take care,

> Everyone.

> Margaret

>

>

>

>

>

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Here is another link for it as well..

http://www.dpw.state.pa.us/oa/oaRdHippQa.asp

Liz

> <<HIPP is Health Insurance Premium Plan where the state pays for the wage

> earner & the child's insurance premiums whether it be directly to the

> company

> or directly to the wage earner. We are in PA. so I don't know if it is

> available elsewhere.>>

>

> Hi, Everyone...Liz...is it through your MH/MR case worker or CBHMP?

> That's

> the one thing about this site....all the parents give helpful hints to

> all

> the others!!! How and who qualifies for it? Take care,

> Everyone.

> Margaret

>

>

>

>

>

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Share on other sites

Margaret: The link didn't work...I cut & pasted the info for you..

Health Insurance Premium Payment Program

Employer Group Health Plan Overview

The Omnibus Budget Reconciliation Act of 1990 (OBRA '90) required all states

to enact a program to identify cases in which enrollment of a Medicaid

recipient in a group health plan is cost effective. An individual's

enrollment in a group health plan is considered cost effective if the

expenditures in Medicaid payments are likely to be greater than the cost of

paying the premiums and cost sharing obligations under an employer group

health plan for those services. Enrollment in a cost effective employer

group health plan is a condition of Medicaid eligibility, except for an

individual who is unable to enroll on his/her behalf. The Bureau of

Financial Operations within the Department of Public Welfare was given the

responsibility to implement this initiative, which is called the Health

Insurance Premium Payment (HIPP) Program.

Pennsylvania's HIPP Program consists of five regional offices, covering

areas similar to the Office of Income Maintenance, County Assistance Office

(CAO) regions. Although the HIPP Program receives referrals from many

agencies and departments, the primary source of referrals is from the CAOs.

When the availability of employment related group health insurance is

identified during the intake or re-determination process, the information is

added to the employer screen on the Client Information System (CIS). " Yes "

responses to the HIPP questions on CIS generate weekly letters/applications

to the client. Applications/referrals are received in the HIPP Regional

Office, where they are evaluated for cost effectiveness and eligibility in

the HIPP Program. Those cases determined to be cost effective are negotiated

with employers, insurance carriers, and/or recipients to enroll recipients

in the employer group health insurance and begin premium payments.

Central Office

Program Manager, HIPP Program

PO Box 8195

burg, PA 17105-8195

1-

Questions and Answers about HIPP Program

Q: What is the Health Insurance Premium Payment Program (HIPP)?

A: The HIPP Program is a cost containment program administered by the

Pennsylvania Department of Public Welfare. The purpose of HIPP is to save

taxpayer dollars by purchasing cost effective employment-related medical

insurance available to Medical Assistance clients.

Q: Who qualifies for HIPP?

A: Active Medical Assistance (MA) recipients who have access to medical

insurance through employment are referred to HIPP. HIPP representatives

conduct a cost analysis based on who is eligible for the employer insurance,

the amount of the premium, and the policy benefits. If the anticipated MA

costs of the clients are greater than the cost of the employer insurance,

they are enrolled in the HIPP Program.

Q: Can the client choose not to participate in HIPP?

A: No. If the available employer health insurance is determined to be cost

effective, the client is required to participate in the HIPP Program as a

condition of continued eligibility for Medical Assistance. The client

maintains the ACCESS card, but the employer insurance is used as the primary

medical resource.

Q: What if the client is currently enrolled in a Department Managed Care

Program?

A: When clients are enrolled in the HIPP Program, they are automatically

disenrolled from Managed Care.

Q: Does the Client maintain their Medical Assistance eligibility and their

ACCESS Card?

A: Yes! A client must remain active in Medical Assistance (MA) to be

eligible for HIPP. They use their ACCESS card in the same manner as every

other Fee for Service client. HIPP clients are advised to use MA providers

to ensure that MA is available to pay any policy deductibles or services not

covered by the employer insurance.

Q: Is the client responsible to pay any co-pays or deductibles required by

the employer insurance?

A: No! The client remains on Medical Assistance (MA) and, therefore, cannot

be billed for any MA-covered service administered by a participating MA

provider.

Q: How does HIPP pay for the employer insurance?

A: When a case is determined to be cost effective, HIPP representatives work

with the employer and the client to enroll the client(s) in the employer

insurance. HIPP premium payments are usually sent directly to the employer;

however, payment can be made to the client when necessary.

Q: What about non-Medical Assistance (MA) members in the household?

A: Non-MA members are not considered when determining the cost effectiveness

of the employer insurance. However, when non-MA persons are eligible for

enrollment without increasing the premium amounts, they may enroll in the

coverage.

Q: Does the client have to be referred through the County Assistance Office

(CAO)?

A: No. Although most HIPP referrals are received from the CAO, persons

wishing to be considered for enrollment in the HIPP Program, or other

agencies acting on their behalf, may do so by phoning the toll free number

of their HIPP Program Regional Office.

Health Insurance Premium Payment Regions

Chestnut Ridge Regional Office

Counties: Allegheny, Fayette, Indiana, Jefferson, Somerset

PO Box H

Torrance, PA 15779-0115

1-

s Summit Regional Office

Counties: Bradford, Bucks, Carbon, Centre, Clinton, Lackawanna, Lehigh,

Luzerne, Lycoming, Monroe, Montgomery, Montour, Northampton, Pike, Sullivan,

Susquehanna, Tioga, Wayne, Wyoming

Third Floor Administration Building

Newton Hall

s Summit, PA 18411

1-

burg Regional Office

Counties:, Berks, Blair, Chester, Columbia, Cumberland, Dauphin,

Delaware, lin, Fulton, Huntingdon, Juniata, Lancaster, Lebanon,

Mifflin, Northumberland, , Schuylkill, Snyder, Union, York

PO Box 8195

burg, PA 17105-8195

1-

Torrance Regional Office

Counties: Armstrong, Beaver, Bedford, Cambria, Greene, Philadelphia,

Washington, Westmoreland

PO Box H

Torrance, PA 15779-0115

1-

Warren Regional Office

Counties: , Cameron, Clarion, Clearfield, Crawford, Elk, Erie, Forest,

Lawrence, McKean, Mercer, Potter, Venango, Warren

185 Hospital Drive

Warren, PA 16365

1-

Liz

> <<HIPP is Health Insurance Premium Plan where the state pays for the wage

> earner & the child's insurance premiums whether it be directly to the

> company

> or directly to the wage earner. We are in PA. so I don't know if it is

> available elsewhere.>>

>

> Hi, Everyone...Liz...is it through your MH/MR case worker or CBHMP?

> That's

> the one thing about this site....all the parents give helpful hints to

> all

> the others!!! How and who qualifies for it? Take care,

> Everyone.

> Margaret

>

>

>

>

>

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