Medicaid HIPP Program

ajfsfoundation
2 days ago
2 min read

Help Paying for Health Insurance Premiums Through Medicaid

Many families who qualify for Medicaid are not aware of a valuable program that can help reduce health care costs while keeping private insurance. The HIPP Program (Health Insurance Premium Payment) is designed to help Medicaid members maintain access to care while saving money.

Here is a clear breakdown of what the HIPP program is, who may qualify, and why it matters.

What Is the Medicaid HIPP Program?

The Health Insurance Premium Payment (HIPP) Program allows Medicaid to pay or reimburse the cost of private health insurance premiums when it is more cost-effective than providing coverage through Medicaid alone.

In simple terms:

If you or a family member has private health insurance available (often through an employer), and
You or your child also qualify for Medicaid,

Medicaid may help pay the monthly insurance premiums, and sometimes other cost-sharing expenses.

Why Does This Program Exist?

The HIPP program benefits both families and Medicaid by:

Preserving access to established doctors and specialists
Reducing disruptions in care
Allowing families to keep employer-based or private insurance
Lowering overall health care costs

This is especially important for children, individuals with disabilities, and people with ongoing medical needs.

Who May Qualify?

Eligibility can vary slightly by state, but in general, families may qualify if:

The individual is eligible for Medicaid
Private health insurance is available (often through an employer)
The cost of the insurance is cost-effective for Medicaid
The insurance plan provides adequate coverage

This program often supports:

Families with children on Medicaid
Individuals with disabilities
Households where a parent has employer-sponsored insurance

What Costs Can Medicaid Help With?

Depending on the state and situation, the HIPP program may cover:

Monthly health insurance premiums
Sometimes copays, deductibles, or coinsurance
Continued Medicaid coverage for services not covered by the private plan

Medicaid typically becomes the secondary insurance, helping fill coverage gaps.

Do Families Lose Medicaid If They Use HIPP?

No.Families enrolled in HIPP remain Medicaid eligible.

Medicaid works alongside the private insurance to ensure coverage remains comprehensive, especially for disability-related or specialized services.

How Do You Apply?

Families do not automatically enroll in the HIPP program. Steps usually include:

Being approved for Medicaid
Reporting access to private health insurance
Completing a HIPP application or cost-effectiveness review
Providing insurance plan details and premium costs

Once approved, Medicaid will explain how payments or reimbursements are handled.

Why Families Often Miss This Program

Many families miss out because:

The program is not well advertised
It requires additional paperwork
Families assume they must choose either Medicaid or private insurance

In reality, HIPP allows families to use both, when appropriate.

Why This Matters for Families Raising Children with Disabilities

For families navigating disability-related care, continuity is critical. The HIPP program can help:

Maintain access to trusted providers
Reduce out-of-pocket costs
Avoid frequent insurance changes
Support long-term medical stability

Final Thought

The Medicaid HIPP program is a powerful but underused resource. If your family has access to private insurance and qualifies for Medicaid, it may be worth asking whether HIPP is an option.

Understanding and sharing this information can help families make informed decisions and reduce financial stress.