Health Insurance Premium Payment (HIPP) Program / Cost Avoidance
The Health Insurance Premium Payment (HIPP) program defers medical costs from Medi-Cal by reimbursing certain Medi-Cal beneficiaries’ private or employer-related health insurance premiums when it is cost effective.
Each applicant must meet all of the program’s eligibility requirements; if approved, each case is periodically re-evaluated to determine ongoing HIPP program eligibility. Please note that HIPP is not an entitlement program; therefore, there are no appeal rights.
Requirements for HIPP:
- Full scope or fee-for-service Medi-Cal
- A high cost medical condition that requires on-going treatment from a medical provider
- Current health insurance coverage (or access to health coverage through an employer at the time of application) – policy must cover the health condition
*Health insurance coverage must not be court-ordered - The California Department of Child Support Services reports any court-ordered
medical insurance to DHCS.
You are not eligible for HIPP if you are eligible for or enrolled in either of the following:
- TRI-CARE (formerly known as CHAMPUS)
Back to TPLRD Home Page