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Louisiana Medicaid Eligibility Manual Eligibility Determinations

Issued February 3, 2026

Page 1 of H-3900

Revised/added text indicated by underscore

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H-3900 Louisiana Health Insurance Premium Payment Program (LaHIPP) H-3901 General Information

The Louisiana Health Insurance Premium Payment (LaHIPP) program is a Medicaid benefit that helps individuals and families pay for employer- sponsored insurance (ESI) or Individual Health Insurance (IHI) when it is cost-effective for Medicaid. The program enables eligible individuals and their families to maintain private health coverage while reducing Medicaid program costs.

LaHIPP may reimburse premiums for the policyholder and Medicaid eligible family members who are enrolled or have access to employer-sponsored health insurance or Individual Health Insurance (IHI) when it is determined that the cost of premiums is less than the projected Medicaid expenditures.

LaHIPP enrollment requires a determination that pays the employer- sponsored insurance premium or individual health insurance (IHI) is cost- effective.

An applicant/beneficiary may qualify for LaHIPP if:

• The employee is Medicaid eligible or have a family member who is Medicaid eligible; and • The individual must be enrolled or have access to employer- sponsored or individual health insurance coverage; and • The coverage must be determined cost-effective by the Louisiana Department of Health (LDH).

The following individuals do not qualify for LaHIPP:

• Individuals enrolled in spenddown; • Medicaid beneficiaries entitled to Medicare Part B, but refuse to enroll; • Long-Term Care (excluding TEFRA), Waiver, Chisolm and CSoC beneficiaries; • Persons with only Hospital Indemnity Insurance; • Persons with single scope of coverage insurance, such as dental or vision insurance under a separate premium; • A self-employed individual, unless this individual offers insurance to employees in his company or • A child receiving court ordered medical support