Family Healthcare (FAMIS) Manual

0920.020.05.05 HIPP Effect on Uninsured Status (MC+)

IM-98 July 29, 2003

Individuals insured simply because the Health Insurance Premium Payment (HIPP) program is paying the premium will be treated as though they were uninsured. If a child in the non-CHIP group has insurance through HIPP, and a change in income occurs which changes eligibility to one of the CHIP groups, the children continue to be eligible for MC+ as though uninsured.

If the HIPP Unit stops paying the premiums for CHIP eligible children because it is determined it is no longer cost-effective and the recipient does not pick up the coverage, we would allow ‘good cause’ and the six month penalty does not apply.� Families picking up the coverage pending an appeal concerning discontinuance of HIPP will be allowed ‘good cause’ for dropping coverage if Division of Medical Services is upheld and the insurance is dropped at that time.� This is because DMS will not continue payment of premiums pending the outcome of an appeal.� However, if the family chooses to continue the coverage after the appeal is upheld the child is considered insured.� If at some point in time later the family decides to drop the coverage, ‘good cause’ is not allowed and the six-month penalty applies.� If the family’s income is above the non-CHIP limit, the child is ineligible.