Cost Avoidance /Health Insurance Premium Payment

Health Insurance Premium Payment Program (HIPP):

Health Insurance Premium Payment Program pays private health insurance premiums for certain Medi-Cal beneficiaries.

Under Federal and State law, the Medi-Cal program provides financial assistance to certain Medi-Cal beneficiaries by purchasing private or employer related health coverage, when it is available and cost-effective. By purchasing health coverage for Medi-Cal beneficiaries, the Medi-Cal program defers the cost of medical care to private health insurance carriers or plans.

The Health Insurance Premium Payment Program is not an entitlement program; therefore, there are no appeal rights. Each applicant must meet all of the program eligibility requirements. Once approved for the Health Insurance Premium Payment Program, each enrollee is re-evaluated annually to determine ongoing Health Insurance Premium Payment Program eligibility.                          

To enroll in the State's Health Insurance Premium Payment Program, beneficiaries must:

• Have full scope Medi-Cal;
• Have a medical condition;                                                                 Back to Top
• Be determined cost-effective for the Health Insurance Premium Payment Program;
• Have either current health coverage or access to health coverage through an employer at the time of application (The policy must cover the medical condition);
• Not be enrolled in a Medi-Cal managed care plan;
• Not be enrolled in a County Organized Health Plan;
• Not be Medicare eligible, CCS or GHPP; and
• Not have an insurance policy issued through the California Managed Risk Medical Insurance Board including Post-Graduate plans.

HIPP State Plan Amendment (Page 3).pdf

Any questions about the Health Insurance Premium Payment Program should be directed to:

The Health Insurance Premium Payment Program's toll free number at 1-866-298-8443

or online at HIPP@dhcs.ca.gov