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

  • From: Jillana Holt-Reuter <jillanaoftx@xxxxxxxxx>
  • To: dbmat@xxxxxxxxxxxxx
  • Date: Tue, 22 Jul 2014 21:42:19 -0500

You can be enrolled in Star plus and HIPP at the same time.  It has some
caveats and I can tell you about it. Much easier to discuss it and I am
hoping to have more documentation for everyone.
On Jul 22, 2014 9:39 PM, "Denise Sewell" <justhemom@xxxxxxxxxxx> wrote:

> 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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