Private Health Coverage through Medicaid

“Before, my son had Medicaid, but I didn’t. Now with
HIPP, our whole family has health insurance.”

Common Questions

HIPP Applicant

  • What are premiums?

    The private health insurance program’s membership cost. For most insurance programs, a premium is a monthly payment.

  • What are co-payments (co-pay)?

    The amount that must be paid when you go to the doctor, hospital, or get tests done.

  • What are deductibles?

    The amount that must be paid for services before insurance will pay.

  • How old do you have to be to join HIPP?

    Age doesn't matter. Your family member who has Medicaid can be any age. So can the family member who can get private health insurance.

  • Who counts as a family member?

    For HIPP, a family member means anyone the private health insurance plan will allow on your insurance. It is usually limited to the person who gets the insurance, their spouse, and children who depend on them.

    After we review your case, we will let you know which family members can get HIPP.

  • When will I find out if I can join HIPP?

    You should get a letter from us about 7 work days after you send in your form. If you haven’t heard from us within 10 work days after sending us your form, give us a call at 1-800-440-0493.

  • To get HIPP, what does the private health insurance need to cover?

    Every insurance plan is different. Each has a different premium cost and covers different things. To join HIPP, your private insurance plan must:

    1. Have a lifetime maximum of $500,000 or more. This is the amount your insurance will pay over the life of your policy.
    2. Pay at least 60 percent of the costs when you:
      • Go to the doctor
      • Buy medicine
      • Get care out of the hospital
      • Have lab tests or X-rays
      • Are in the hospital

    To find this information, look at your summary of benefits. You can get this from your employer.

  • When I started work, I didn’t sign up for insurance. How do I sign up now?

    Talk to your employer to find out if you can still sign up for insurance. For most employers, signing up for HIPP is called a “qualifying event.” That means you can sign up any time.

    If you can sign up, ask your employer for a list of all the insurance plans and the rates sheets. Then call us at 1-800-440-0493.

    Note: Some jobs will only let you sign up at a certain time (called “open enrollment”). If that happens at your job, you can still sign up for HIPP. Just contact us 1 month before open enrollment begins.

  • What is private health insurance?

    We can repay premiums only after you get a welcome letter from us that says you can join HIPP. We can’t repay premiums you paid before the date on that letter.

  • When do my repayments start?

    For HIPP, private health insurance must be a group health plan you can get through your job (employer-sponsored). The family member who gets Medicaid must be able to get coverage on this plan.

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