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- What is HIPP ... ?
- What does the state pay for ... ?
- How is Eligibility Determined ... ?
- Who is eligible... ?
- Recipients' Responsibilities ... ?
- Created under the Omnibus Budget Reconciliation Act (OBRA) of 1990
- Attempt to enhance the cost avoidance efforts of the State's Medicaid
program by the payment of Health Insurance policy premiums for medically
expensive Medicaid recipients.
- Saves both WV and Federal tax dollars.
- OBRA '97 made this program optional however, WV continues to find success
in its operation.
- HIPP only pays for the Medical portion of coverage - no Dental or Vision
- HIPP will try to pay for the Medicaid recipient ONLY, if the policy can
not be purchased separately, if cost effective, HIPP will pay for the
entire family
- HIPP will pay for cost effective COBRA policies
- HIPP will pay for all cost effective major medical plans (HMO, PPO or
indemnity)
- HIPP will pay for either individual or group polices
- Comparison of actual costs to individuals in the same category of aid/sex/age
- All cost effective Medicaid recipients with 3rd party insurance policies
(primary policies - NO Medicare)
- Enrollment is not automatic - the policyholder must apply for the program.
- All applicants are not automatically approved - approximately 35% of
applicants are approved. Specific cost effectiveness algorithms are
used to determine eligibility.
- Fill out the application (online or physical) COMPLETELY
- Once approved, submit proof of payment monthly
- Notify the HIPP office of any changes to policy/coverage
- Notify the HIPP office of an changes in medical condition
- Allow 30 days for reimbursement of premium expense
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