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

  • From: Denise Sewell <justhemom@xxxxxxxxxxx>
  • To: "dbmat@xxxxxxxxxxxxx" <dbmat@xxxxxxxxxxxxx>
  • Date: Tue, 22 Jul 2014 21:32:03 -0500

Hey Jillana, let me know what you find out! We got the letter today about STAR 
PLUS enrollment and I'm a little confused!     So any suggestions are greatly 
appreciated! Talk to you soon! Thanks, Denise .

Sent from my iPhone

On Jul 22, 2014, at 7:38 PM, "Jillana Holt-Reuter" <jillanaoftx@xxxxxxxxx> 
wrote:

> I will be attending this meeting.
> 
> On Jul 22, 2014 4:21 PM, "Pwelch" <pwelch@xxxxxxxxxxxxx> wrote:
>> 
>> 
>> 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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