[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 21:38:46 -0500

Ok I will! So we basically have to enroll , right? He is on my insurance and 
Medicaid now. He turns 18 on the 1st of August. And we are enrolled in HIPP as 
well. So if we don't enroll with STAR PLUS then we can't be enrolled with HIPP? 
Is that what I'm understanding?

Sent from my iPhone

On Jul 22, 2014, at 9:34 PM, "Jillana Holt-Reuter" <jillanaoftx@xxxxxxxxx> 
wrote:

> I will but if you need help with enrolling, just give me a call.  Maybe I can 
> help. ;)
> 
> On Jul 22, 2014 9:32 PM, "Denise Sewell" <justhemom@xxxxxxxxxxx> wrote:
>> 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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