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West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 8 Chapter 23 Specific Medicaid Requirements

23.6 HEALTH INSURANCE PREMIUM PAYMENT (HIPP) This program is used to assist Medicaid-eligible individuals who cannot afford available employer group health coverage. The Bureau for Medical Services (BMS) pays health insurance premiums, along with deductibles and co-payments, for Medicaid-eligible individuals when the available policy is determined cost effective. This program can also assist recently unemployed individuals with Consolidated Omnibus Budget Reconciliation Act (COBRA) benefits available from a former employer. Under COBRA provisions, most employees have 60 days to decide if they want to pay to continue under the employer’s health plan after employment is terminated. Once an individual chooses to continue benefits, the benefits can be renewed for the next 18 months. In addition to premiums, deductibles, and copayments, Medicaid pays for services not included in the insurance policy, but covered under Medicaid. To qualify for HIPP, there must be group health insurance available that covers at least one person who is Medicaid-eligible in West Virginia. The individual may also call the DOHS’s Third Party Liability (TPL) contractor at (304) 342-1604 to request an application or to obtain additional information about program requirements and the eligibility determination process.

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Page 1850

Official source

West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 8 Chapter 23 Specific Medicaid Requirements

23.6 HEALTH INSURANCE PREMIUM PAYMENT (HIPP) This program is used to assist Medicaid-eligible individuals who cannot afford available employer group health coverage. The Bureau for Medical Services (BMS) pays health insurance premiums, along with deductibles and co-payments, for Medicaid-eligible individuals when the available policy is determined cost effective. This program can also assist recently unemployed individuals with Consolidated Omnibus Budget Reconciliation Act (COBRA) benefits available from a former employer. Under COBRA provisions, most employees have 60 days to decide if they want to pay to continue under the employer’s health plan after employment is terminated. Once an individual chooses to continue benefits, the benefits can be renewed for the next 18 months. In addition to premiums, deductibles, and copayments, Medicaid pays for services not included in the insurance policy, but covered under Medicaid. To qualify for HIPP, there must be group health insurance available that covers at least one person who is Medicaid-eligible in West Virginia. The individual may also call the DOHS’s Third Party Liability (TPL) contractor at (304) 342-1604 to request an application or to obtain additional information about program requirements and the eligibility determination process.