The Health Insurance Premium Payment (HIPP) Program is a program developed to help families, who have at least one person enrolled in Medical Assistance (MA), pay for private health insurance through an employer.
HIPP is administered by Pennsylvania’s Department of Human Services (DHS). It was designed as a cost containment program in order to save taxpayers money by purchasing cost effective employment related health insurance available to a Medical Assistance recipient.
Active Medical Assistance recipients who are eligible for medical insurance through employment are referred to HIPP.
A HIPP Operation Specialist (HOS) conducts a review of the medical insurance that is available through the employer. They will conduct a cost analysis based on the amount of the premium and the policy benefits that are offered. If the Medical Assistance costs for a client are greater than the cost of the employer insurance, the client is enrolled into the HIPP Program.
No. If the employer health insurance is determined to be cost effective, the client is required to participate in the HIPP Program as a condition of continued eligibility for Medical Assistance. The client maintains the ACCESS card, but the employer insurance is used as the primary medical resource.
Yes! A client must remain active in Medical Assistance to be eligible for HIPP. They use their ACCESS card in the same manner as every other Fee-for-Service Client. HIPP clients are advised to use Medical Assistance providers to ensure that Medical Assistance is available to pay any policy deductibles or services not covered by the employer insurance.
When clients are enrolled in the HIPP Program, they are automatically disenrolled from Managed Care and entered into a Fee-For-Service program.
No! The client remains on Medical Assistance and, therefore, cannot be billed for any MA covered service administered by a participating MA provider.
When a case is determined to be cost effective, a HOS works with the employer and the client to enroll the client(s) in the employer insurance. HIPP premium payments are usually sent directly to the employer; however, payment can be made to the client when necessary.
Non-MA members are not considered when determining the cost effectiveness of the employer insurance. However, when non-MA persons are eligible for enrollment without increasing the premium amounts, they may enroll in coverage.
No. Although most HIPP referrals are received from the CAO, persons wishing to be considered for enrollment in the HIPP Program, or other agencies acting on their behalf, may do so by phoning the toll free number of their HIPP Regional Office.
For more information pertaining to our program, please see the Other Information Section at the bottom to access the Employer Packet.
For more information or an application, please contact your local HIPP Office or e-mail firstname.lastname@example.org. You may also download and print the application that is located at the bottom of the page under the Other Information section.
Health Insurance Premium Payment Regions
|Chestnut Ridge Regional Office||P.O. Box H|
Torrance, PA 15779-0115
|Allegheny, Armstrong, Beaver, Clarion, Elk, Greene, Jefferson, Washington|
|Clarks Summit Regional Office||1451 Hillside Drive - Newton Hall|
Clarks Summit, PA 18411
|Bucks, Chester, Delaware, Lackawanna, Luzerne, Monroe, Montgomery, Northampton, Philadelphia, Pike, Susquehanna, Wayne, Wyoming|
|Harrisburg Regional Office||P.O. Box 8195|
Harrisburg, PA 17105-8195
|Adams, Armstrong, Bradford, Carbon, Centre, Clinton, Columbia, Cumberland, Dauphin, Lancaster, Lebanon, Lehigh, Lycoming, Mifflin, Montour, Northumberland, Perry, Schuylkill, Snyder, Sullivan, Tioga, Union, York|
|Torrance Regional Office||P.O. Box H|
Torrance, PA 15779-0115
|Bedford, Blair, Cambria, Cameron, Clearfield, Fayette, Franklin, Fulton, Huntington, Indiana, Juniata, Potter, Somerset, Westmoreland|
|Warren Regional Office||589 Hospital Drive, Suite D|
Warren, PA 16365
|Butler, Crawford, Erie, Forest, Lawrence, McKean, Mercer, Venango, Warren|