What is the HIPP Program?
HIPP is the Health Insurance Premium Payment (HIPP) Program, one of the services available to people who get Medicaid (Title 19). The HIPP Program helps people get insurance or keep insurance they already have by reimbursing the cost of the premiums. The HIPP program is a way for the State of Iowa to save money.
What do I want other insurance?
The health plan may cover services that are not covered by Medicaid.
Other people in your family who are not covered by Medicaid, may be covered by your health insurance.
HIPP helps you get and keep insurance you might not be able to afford.
How can I get HIPP?
- You or someone in your home has to have Medicaid.
- You must have medical insurance or be able to get it through your employer.
- The health plan must be cost-effective.
What is cost-effective?
Cost-effective means that it costs the State less to reimburse all or a portion of your health insurance premium than for Medicaid to pay all of the costs.
Does HIPP cost me anything?
No. When you get medical care for your Medicaid- eligible family members, give the provider your health insurance card and your Medicaid card. Your health insurance is billed first. Then so long as you go to a Medicaid provider, Medicaid is billed for the co-insurance, deductibles and any other services not covered by your health insurance.
How do you decide if my insurance is cost-effective?
The HIPP Program looks at the services covered under your health insurance plan. The program compares the average cost of your Medicaid-eligible family members to the cost of your health insurance premium. Important: To make this decision you need to return any information we may ask for.
What if I do not want to have other insurance?
The HIPP Program is a way for the State of Iowa to save money. If you choose not to give us the information we need or not to work with the Program, your Medicaid may be stopped.
The HIPP Program does not provide premium assistance for:
Someone who does not live in your home.
School plans based on enrollment or attendance as a student.
An insurance plan that pays income to the policyholder or pays only limited amounts for services.
Plans that are limited to a temporary period of time.
Plans that have an absent parent as the policyholder.
Any plan when the policyholder is not part of your Medicaid household
An insurance premium that is used to reduce the Medically Needy Spend-down amount for Medicaid or used as a deduction in computing the client participation
Anyone covered under Medicare, IowaCare, Medicaid Kids with Special Needs (MKSN), Iowa Family Planning Network (IFPN), or Health Insurance Plan Iowa (HIPIOWA).
Toll-Free Number: 1-888-346-9562
How can I get an application for HIPP?
Ask your local DHS worker to refer you to the HIPP Program if:
Someone living with you gets Medicaid.
You have or can get health insurance through your job that will cover the Medicaid-eligible people.
Print an application and fax it to us at 1-515-725-0725 or mail to:
Iowa Medicaid Enterprise (IME)
PO Box 36476
Des Moines, IA 50315-9907
Call us and we will help you complete an application.
1-515-974-3282 or Toll-free at 1-888-346-9562
If you are living with AIDS/HIV-related illness there is a special program to assist you with premiums for your health insurance. Click here for more information.
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