[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 22:05:02 -0500

Sounds like a phone call!!! Maybe later this week? Thanks!

Sent from my iPhone

On Jul 22, 2014, at 9:42 PM, "Jillana Holt-Reuter" <jillanaoftx@xxxxxxxxx> 
wrote:

> 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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