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

  • From: Deb Coulter <txnana57@xxxxxxx>
  • To: "dbmat@xxxxxxxxxxxxx" <dbmat@xxxxxxxxxxxxx>
  • Date: Tue, 22 Jul 2014 21:44:44 -0500

I called several of Preston doctors and they don't take the insurance from they 
offer , I was told to fight fort radio all Medicaid to keep his doctors since 
he just turned 18 this week. Debbie 

Sent from my iPad

> On Jul 22, 2014, at 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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