Health Insurance Premium Payment (HIPP) Program Continues to Cover Monthly Premiums for Eligible Medicaid Beneficiaries

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As part of the South Carolina Department of Health and Human Services (SCDHHS) focus on providing the most health for beneficiaries at the least cost to taxpayers, SCDHHS reintroduces its Health Insurance Premium Payment (HIPP) program.  HIPP is a cost containment initiative that maintains premium payments for eligible Medicaid beneficiaries who retain their private health insurance. The HIPP program will focus its outreach to include: medical providers, community and faith-based organizations, educational institutions, state agencies, area municipalities, businesses, as well as other groups, organizations and individuals who are invested in health and wellness initiatives that can benefit the state’s Medicaid beneficiaries. 

Currently the HIPP program serves 260 eligible Medicaid beneficiaries, but seeks to increase participation by launching a comprehensive outreach campaign.  The HIPP program staff expects to identify more eligible Medicaid beneficiaries through provider relations workshops and information sessions, health fairs, community events, trade organization conferences, and targeted distribution of marketing materials.  

HIPP enrollment is contingent upon a HIPP applicant’s Medicaid eligibility and cost effectiveness.  SCDHHS classifies an individual as cost effective when Medicaid savings exceed premium and deductible amounts, as well as SCDHHS’ administrative costs.  Cost effective individuals must be current South Carolina Medicaid beneficiaries (Fee-for-Service Medicaid, only), must have active private health insurance, and must have recent medical claims history on record.

Historical data indicates that many HIPP participants have long-term conditions such as cancer, end stage renal disease, chronic heart problems and HIV/AIDS.  Children with special health care needs are also often considered cost effective. Common short-term cost effective conditions include: high-risk pregnancies, seasonal conditions (asthma and allergies) and upcoming surgeries and/or

diagnostic testings.  Whether long- or short-term, many chronic medical conditions, diagnoses and treatments may result in extensive medical costs, which could be deemed cost effective.

Eligible Medicaid beneficiaries who are interested in the HIPP program must first complete and submit a HIPP referral form and required supplemental documents.  This referral form, a HIPP brochure and a “Frequently Asked Questions” document, is available on the SCDHHS website at:  https://www.scdhhs.gov/service/health-insurance-premium-payment-hipp.  HIPP referral forms will also be available at SCDHHS County Eligibility offices, as well as various provider offices and community-based organizations throughout South Carolina. Interested Medicaid beneficiaries can contact the HIPP program staff directly to request a referral form or to request assistance in completing the application materials.  Below is the contact information for the HIPP program office. 

South Carolina Department of Health and Human Services

Attn: HIPP

P.O. Box 100127

Columbia, SC 29202

803-264-6838 (o)

803-264-6847 (o)             

803-462-2580 (f)

 

The HIPP program is a beneficial cost containment initiative producing savings for South Carolina taxpayers by establishing Medicaid as the payer of last resort.  In addition, Medicaid-enrolled providers can also benefit from the HIPP program by receiving maximum payment amounts for service rendered to those individuals who are HIPP participants with dual coverage, both private health insurance and Medicaid. 

If you have any questions regarding this bulletin, please contact the HIPP program at 803-264-6838 or 803-264-6847.  Thank you for your continued of the South Carolina Medicaid program.

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