Chương trình Medi-Cal HIPP là gì ?

What is the Medi-Cal HIPP program?

HIPP stands for Health Insurance Premium Payment. The Medi-Cal/HIPP program pays private health insurance premiums so that individuals with high cost medical conditions may continue their private health coverage rather than relying solely on Medi-Cal.

To be eligible for the Medi-Cal/HIPP program you must:

• have a high-cost medical condition such as HIV/AIDS, cancer, pregnancy and organ transplantation; and
• be insured under a private health insurance policy that does not exclude the individual’s high-cost medical condition. The policy can be individual, group, continuation coverage such as COBRA, Cal-COBRA or OBRA (for self-insured trusts) or COBRA conversion policy.

Those ineligible for the HIPP program include individuals enrolled in:

• Medi-Cal Managed Care program
• Medi-Cal prepaid health plan
• County Organized Health System (COHS)
• Medicare
• TRI-CARE (formerly known as CHAMPUS)
• County Health Initiative
• Geographic Managed Care Program of the County Medical Services Program (CMSP), and
• California’s Major Risk Medical Insurance Pool (MRMIP).

What can I use Medi-Cal/HIPP for?

You can use Medi-Cal/HIPP to cover the cost of private health insurance premiums. Medi-Cal will cover services that are not available under the private policy in addition to deductibles and copayments. If you have a share of cost it must be met before you can use Medi-Cal services.

How do I apply for Medi-Cal/HIPP?

To apply for the HIPP program you must submit the following:

• Medi-Cal/HIPP Department of Health Care Service Form 6172 (HIPP application);
• An insurance policy or description of benefits from the insurer or employer;
• A physician letter of diagnosis of high-cost medical condition; and
• A premium payment notice or election form from COBRA or Cal-COBRA.