Health Insurance Premium Payment Program is a Texas Medicaid program that helps families with at least one person on Medicaid pay for their employer-sponsored health insurance premiums. Premiums are the amount you pay every month for your health insurance.
If you or a family member gets Medicaid and you can get health insurance through your job, you should apply for HIPP.
People enrolled in any Medicaid program, except STAR Health, can be eligible for HIPP. People enrolled in the Children's Health Insurance Program (CHIP) are not eligible for HIPP.
When you apply, you will need your:
- Insurance rate sheet.
- Insurance card.
- Proof of health insurance payment (if enrolled).
After we review your case, we will let you know if your family can get HIPP. If you need help applying for HIPP, call 800-440-0493.
How Does HIPP Work?
HIPP will pay your health plan's premium if it costs less than covering your family through Medicaid. The program allows you to keep the insurance you get through your job and keep your Medicaid benefits.
- The family member who has Medicaid and the family member who can get employer-sponsored health insurance can be any age.
- The employer-sponsored health plan must be able to cover the family member who has Medicaid.
When you join, the state will pay you back for your premiums, and you'll be able to choose from more health care providers than with Medicaid alone.
Deductibles and Co-payments
A deductible is what you pay for covered health services before an insurance company will start to help you with your medical bills.
A co-payment is what you pay for a covered health service after you've paid your deductible.
- If you have HIPP, have Medicaid and choose a Medicaid provider, you don't pay the deductible or co-pay.
- If you have HIPP, have Medicaid and choose a non-Medicaid provider, you must pay the deductible and co-pay, if required.
- If you have HIPP and don't have Medicaid, you must pay the deductible and co-pay, if required.
Every Insurance Plan is Different
To join HIPP, your employer-sponsored health insurance plan must cover at least 60 percent of the costs when you:
- Visit the doctor.
- Have lab tests or X-rays.
- Buy medicine.
- Are in the hospital.
- Get care outside the hospital.
You can find the amount the insurance company pays for medical services like these in the summary of benefits available from your employer.
What if I Don't Have Insurance?
If you don't already have employer-sponsored health insurance, talk to your employer to find out if you can sign up:
- Some jobs will only allow you to sign up for insurance during open enrollment. If that happens at your job, contact HIPP one month before open enrollment begins.
- Eligibility for HIPP is also considered a "qualifying life event." This means employers must let you make changes to your coverage, including your enrollment status.
- COBRA (Consolidated Omnibus Budget Reconciliation Act) is a type of health insurance you can get if you leave a job where you had insurance. If you have COBRA coverage, send us your COBRA rates. We will look at the rates and let you know if you can join HIPP.