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HIPP
The Health Insurance Premium Payment Program
For MO HealthNet Participants
WHAT IS THE HEALTH INSURANCE PREMIUM PAYMENT PROGRAM?
The Health Insurance Premium Payment (HIPP) Program is a MO HealthNet program that pays for a
participant's share of cost of health insurance premium when it is cost effective. In addition, MO HealthNet
will pay copays, coinsurance and deductibles charged to participants if the policy is paid by MO HealthNet.
WHAT DOES "COST EFFECTIVE" MEAN?
"Cost effective" means that it costs less to buy health insurance to cover medical care than to pay for the same
services with only MO HealthNet funds.
WILL THE HIPP PROGRAM FIND HEALTH INSURANCE FOR ME?
No. The HIPP Program cannot find a health insurance policy for you. You may have health insurance available
to you through an employer, a former employer, a labor union, a credit union, church affiliations, other
organization, or an individual policy.
WHO CAN CHOOSE TO APPLY?
You can choose to apply to the HIPP program if you or a member of your household is applying for MO
HealthNet or are MO HealthNet eligible and has health insurance available from sources as long as they are not
eligible for or actively covered by a MO HealthNet Managed Care Plan or Medicare. Policies that are court
ordered are also ineligible for participation in the HIPP Program. If MO HealthNet decides the insurance plan is
cost effective, MO HealthNet will pay the premiums and cost sharing.
HOW DO I APPLY?
Apply by completing the HIPP application form located at www.dss.mo.gov/mhd/participants/index.htm or at
your local Family Support Division (FSD) office. You may also get a HIPP application by calling HIPP at
(573) 751-2005 or by writing to:
Cost Recovery Unit
HIPP Section
P.O. Box 6500
Jefferson City, MO 65102-6500
If you or your dependents are not already enrolled in your health insurance plan, contact the HIPP
program before enrolling. It is in your best interest wait to enroll until it is determined to be cost
effective if you would not otherwise purchase this coverage.
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HOW WILL THE PREMIUMS BE PAID?
Whenever possible, the HIPP program will pay the premiums directly to the insurance company or your
employer. If the premium is deducted from your pay check, the HIPP program will pay you directly for the
payroll deduction made for health insurance.
HOW LONG WILL THE HIPP PROGRAM PAY FOR MY INSURANCE?
The HIPP program will continue to pay your health insurance as long as you are eligible for MO HealthNet and
it is cost effective.
ARE MY MO HEALTHNET BENEFITS AFFECTED IF I'M IN HIPP?
Because you have group or private health insurance coverage paid by HIPP does not affect your MO HealthNet
eligibility. The group or private health insurance is the primary payer; MO HealthNet will still pay for services
covered under the MO HealthNet Program that are not paid by the insurance plan. If you choose to drop group
health insurance coverage that MO HealthNet decides is cost effective and is paying for, you may lose your MO
HealthNet benefits (13 CSR 70-97.010).
IF I HAVE MO HEALTHNET, WHY DO I WANT HEALTH INSURANCE?
The main reason MO HealthNet wants to buy group or private health insurance for people getting MO
HealthNet is because it will help lower program costs. However, there are several reasons why having
insurance may be good for you:
1. The policy may cover services that may not be covered under MO HealthNet.
2. Members of your family who are not eligible for MO HealthNet may be covered under the group or private
health insurance plan when MO HealthNet decides that buying a family plan for eligible person(s) is cost
effective.
3. You will have group or private health insurance available to you if you lose MO HealthNet eligibility.
(However, you will be responsible for paying the premiums when you are not MO HealthNet eligible.)
WHAT ARE MY RESPONSIBILITIES?
• Inform your local FSD office of changes in your address, income or resources, household size, or any other
change that may affect your MO HealthNet eligibility.
• Report any changes in your health insurance coverage to your local FSD office or directly to the HIPP
program within ten days of the change. Changes that should be reported include a change in the amount of
the premium, a change in the amount of the deductible, a change in the benefits or services covered by the
policy, a change in the number of persons covered, or if the insurance is discontinued;
• Inform your medical providers of all third-party resources you have (Medicare, private health insurance,
damage suits, MO HealthNet, etc.)
• Refund to MO HealthNet any money that you receive from a person or company to pay medical expenses
that have been paid by MO HealthNet.
Missouri Department of Social Services
MO HealthNet Division
P.O. Box 6500
Jefferson City, MO 65102
Relay Missouri – for hearing and speech impaired
TT: 1-800-735-2966
Voice: 1-800-735-2466
www.dss.mo.gov
(573) 751-2005
AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER
**services provided on a nondiscriminatory basis**
