[dbmat] Fwd: Policy Changes Regarding Texas Health Insurance Premium Payment (HIPP) Program

  • From: Pwelch <pwelch@xxxxxxxxxxxxx>
  • To: dbmat@xxxxxxxxxxxxx
  • Date: Tue, 22 Jul 2014 16:20:21 -0500


Sent from my iPad

Begin forwarded message:

> From: "Schwartz,Jonas (HHSC)" <Jonas.Schwartz@xxxxxxxxxxxxxxxx>
> Date: July 22, 2014 at 2:55:41 PM CDT
> To: "Paul Welch (pwelch@xxxxxxxxxxxxx)" <pwelch@xxxxxxxxxxxxx>
> Subject: Policy Changes Regarding Texas Health Insurance Premium Payment 
> (HIPP) Program
> 
> Dear Community Partner:
>  
> The Health and Human Services Commission (HHSC) currently is working to 
> implement policy changes concerning the Texas Health Insurance Premium 
> Payment (HIPP) program.  In order to ensure access to long-term services and 
> supports, individuals enrolled in or eligible for the STAR+PLUS program may 
> receive coverage through Medicaid and HIPP. Please see further details below.
>  
>  
> Jonas E. Schwartz M.S.
> Manager for Stakeholder Relations
> Office of Policy
> Medicaid/CHIP Division
> Health and Human Services Commission
> (512) 462-6292-Voice
> (512) 632-2608-Mobile
>  
>  
>  
>  
> Health Insurance Premium Assistance Program
> The Health Insurance Premium Payment (HIPP) program is a Medicaid program 
> that reimburses eligible individuals for their share of an employer-sponsored 
> health insurance premium payment.
>  
> To qualify for HIPP, an employee must either be Medicaid eligible or have a 
> family member who is Medicaid eligible.  A client who is in Medicaid managed 
> care can be considered for enrollment in HIPP. However, if they qualify for 
> HIPP enrollment they cannot stay enrolled in Medicaid managed care, with the 
> exception of STAR+PLUS clients.   
>  
> STAR+PLUS and HIPP
> To ensure access to long-term services and supports, individuals enrolled in, 
> or eligible for, the STAR+PLUS program may receive coverage through Medicaid 
> and HIPP.   Although clients will need to select a Medicaid-enrolled primary 
> care provider (PCP) under STAR+PLUS, clients can continue to see the PCP and 
> specialists they currently see through their employer-sponsored insurance.  
> (Designation of a STAR+PLUS PCP will not impact designation of PCPs under 
> employer-sponsored insurance).  The client is responsible for all associated 
> cost sharing related to their employer-sponsored insurance: (1) for 
> non-Medicaid covered benefits, or (2) if the PCP and specialists they see are 
> not Medicaid-enrolled providers.
>  
> STAR and HIPP
> Clients enrolled in STAR may apply for HIPP, and if found eligible for HIPP, 
> the client will be disenrolled from STAR.
>  
> HIPP Coverage
> The HIPP program may pay for clients and their family members to get 
> employer-sponsored health insurance benefits if it is determined to be cost 
> effective.
>  
> Medicaid-eligible HIPP enrollees do not have to pay out-of-pocket 
> deductibles, co-payments, or co-insurance for health care services that 
> Medicaid covers when seeing a provider that accepts Medicaid. Instead, 
> Medicaid reimburses providers for these expenses. HIPP enrollees who are not 
> Medicaid-eligible must pay deductibles, co-payments, and co-insurance 
> required under the employer-sponsored insurance policy. Additionally, if a 
> Medicaid-eligible HIPP enrollee needs a Medicaid-covered service that is not 
> covered by their employer-sponsored insurance plan, Medicaid will provide 
> this service at no cost to the enrollee as long as the services are provided 
> by an enrolled Medicaid provider.
>  
> Additional information about the HIPP program is available at 
> www.getHIPPTexas.com.  Questions and concerns with HIPP enrollment should be 
> directed to the HIPP helpline (1-800-440-0493).
>  
>  

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