|
CALIFORNIA: Medi-Cal Health
Insurance Premium Payment (HIPP) Program |
|
Persons Covered |
Number of Enrollees |
Estimated / Projected Number of
Enrollees |
Financing Information |
|
Medi-Cal beneficiaries with high cost medical conditions (e.g.
pregnancy, HIV/AIDS, and organ transplant) when it is cost effective
Have a Medi-Cal share of cost no greater than $200
Have either a current private health coverage policy or access to
health coverage through an employer (includes COBRA and Cal-COBRA, but
excludes policies issued through the California Managed Risk Medical
Insurance Board (MRMIB) |
1057 |
No projections, however, they are doing outreach to different counties
to increase awareness of this program |
In FY02, the average cost savings per month was
$1,175,133.00. |
|
GEORGIA: Health Insurance Premium
Purchase (HIPP) Program |
|
Persons Covered |
Number of Enrollees |
Estimated / Projected Number of Enrollees |
Financing Information |
|
Anyone who is on Medicaid or is eligible for Medicaid, and has access
to health insurance through an employer or a private plan |
|
|
|
|
IOWA: Iowa Health Insurance Premium
Payment (HIPP) Program |
|
Persons Covered |
Number of Enrollees |
Estimated / Projected Number of
Enrollees |
Financing Information |
|
Any Medicaid recipients who have access to employer-based or private
plans
However, 35% of enrollees are non-Medicaid-eligible family members
|
8,000 + (total)
5,436 (Medicaid-eligible)
3,189 (Non-Medicaid-eligible) |
No projections at this time |
For year 2000, HIPP is budgeted to save the state of Iowa $3 million in
Medicaid costs
IHPS estimates a cost savings of $3.30 for every $1 spent (using 1992
data).
The Commonwealth Fund estimates that the state would save at least $5
per month compared with paying the medical expenses of the eligible
person(s) through the regular Medicaid program.
State pays employee's share of the premium for family coverage using
equal amounts of state and federal matching Medicaid funds.
Employers can decide if they want to receive HIPP payments for the
employee's share of the premium directly or if they want payments to be
sent directly to the employee.
The average premium per case per month is $214.42 (as of
2/1/03) |
|
MARYLAND: Maryland
Children's Health Program (MCHP) - Premium |
|
Persons Covered |
Number of Enrollees |
Estimated / Projected Number of Enrollees |
Financing Information |
|
Families with incomes between 200% and 300% of FPL |
101 children (Employer Sponsored Insurance)
2481 (Health Choice (managed care) - under MCHP -Premium
) |
No projections at this time |
Families with incomes between 200% and 250% of FPL pay a premium of
$38/family/month
Families with incomes between 251% and 300 % of the FPL pay a premium
of $48 family/month
Families enrolled in the premium assistance program will not be
responsible for any copayments, coinsurance or deductibles imposed by the
employer plan.
Required minimum employer contribution for family health coverage is
30% of premium
Cost/Savings analysis is still taking place and results will not be
available until the end of 2003 |
|
MASSACHUSETTS: MassHealth Family Assistance
Plan |
|
Persons Covered |
Number of Enrollees |
Estimated / Projected Number of Enrollees |
Financing Information |
|
Uninsured children with family incomes between 150% and 200% of FPL
|
15,000 |
No projections at this time |
Premiums and cost-sharing for families with children covered through
the premium assistance program vary depending on the employer's plan, the
employer's contribution and the family's income (However, total cost
sharing will not exceed 5% of the family's income)
Small businesses (50 or less FT employees) providing health insurance
to their qualified employees have share their premiums subsidized by the
Commonwealth of Massachusetts, through the Insurance Partnership.
Alaskan natives are exempt from the payment of premiums and other cost
sharing requirements
Savings to state has yet to be realized |
|
MISSOURI: Missouri Health Insurance
Premium Payment (HIPP) Program |
|
Persons Covered |
Number of Enrollees |
Estimated / Projected Number of Enrollees |
Financing Information |
|
Anyone on Medicaid or is Medicaid-eligible, is employed or lost
employment within the last thirty days, and whose employer or former
employer offers group health insurance coverage |
Figures as of FY02:
4,762 (total)
3,660(Medicaid-eligible)
1,102(Non-Medicaid-eligible) |
No projections at this time |
Net cost avoidance for FY02 $11,405,084.75
|
|
NEW JERSEY: New Jersey FamilyCare
Premium Support Program (PSP) |
|
Persons Covered |
Number of Enrollees |
Estimated / Projected Number of Enrollees |
Financing Information |
|
Parents with incomes between 134 and 200% FPL with employer-sponsored
insurance. |
500+ (April 2003 IHPS figure) |
No projections at this time |
Employer must contribute at least 50% of the premium cost.
Cost to the state must be no more than the cost of enrolling the
children in the CHIP plan.
The state estimates that approximately $18.8 million will be saved in
the first year of implementation. |
|
NEW MEXICO: New Mexico State
Coverage Initiative
This waiver has been approved by CMS but the
program is on hold. |
|
Persons Covered |
Number of Enrollees |
Estimated / Projected Number of Enrollees |
Financing Information |
|
Uninsured adults with incomes up to 200% FPL |
Implement-ation is on hold |
Hope to cover 40,000 uninsured adults over 5 years |
Individuals with incomes above 100 FPL would pay premiums of $20 to $35
per month.
Co-payments apply to all individuals from $5 to $20.
Savings to state has yet to be realized
Financed through SCHIP funds and general fund contribution (the amount
is yet to be determined) |
|
OREGON: Family Health Insurance
Assistance Program (FHIAP) |
|
Persons Covered |
Number of Enrollees |
Estimated / Projected Number of Enrollees |
Financing Information |
|
Families with incomes up to 185% of FPL |
The FHIAP program has 4,000 enrollees currently and 22,000 on a
reservation list
The waiver program isn't implemented yet |
Oregon's Goal is to reduce the uninsured rate for individuals with an
income up to 185% FPL by 1% |
Premiums and co-payments are determined according to income
Participants must also pay 25 percent cost sharing on prescription
drugs with no out-of-pocket maximum and an annual deductible of $500 per
enrollee
Funded by the SCHIP allotment and reallocated funds
A Medicaid match for any expenditures exceeding the allotment
Estimated cost to the state will be $154 million over its 5 year
approval period |
|
PENNSYLVANIA: Pennsylvania Health
Insurance Premium Payment (HIPP) Program |
|
Persons Covered |
Number of Enrollees |
Estimated / Projected Number of Enrollees |
Financing Information |
|
Active Medical Assistance recipients who have access to
employer-sponsored medical insurance. HIPP representatives conduct a cost
analysis based on who is eligible for the employer insurance, the amount
of the premium, and the policy benefits. |
15,000 (July 2001 PA OMAP figure)
21,000 (April 2003 IHPS figure) |
No projections at this time |
Net monthly savings is averaging at $4.5 million. |
|
RHODE ISLAND: RIte
Share |
|
Persons Covered |
Number of Enrollees |
Estimated / Projected Number of Enrollees |
Financing Information |
|
Working families with access to employer-based health insurance whose
employer participates in RIte Share:
Family Coverage 185% FPL
Children and Pregnant women 250% FPL |
120,000 individuals
12% of the population
1/3 of the children |
2,840
6,000 anticipated 6/30/03 |
State projects to collect $2.4 million in FY2003.
Representing 2% of Medicaid managed care budget |
|
TEXAS: The Health Insurance Premium
Payment (HIPP) Reimbursement Program |
|
Persons Covered |
Number of Enrollees |
Estimated / Projected Number of Enrollees |
Financing Information |
|
Any Medicaid- eligible person when it is determined to be cost
effective (costs less to buy health insurance to cover medical care than
to pay for the care with Medicaid funds) |
6031 individuals (As of August 2002) |
No projections at this time |
On average, Texas pays out $481, 000 per month for 2,500 families. Per
family, the amount paid out would average $250 (keeping in mind that some
families receive more and some families receive less depending on their
circumstances). |
|
VIRGINIA: Health Insurance Premium
Payment Under Medicaid (HIPP)/Employer Sponsored Health Insurance
(ESHI) |
|
Persons Covered |
Number of Enrollees |
Estimated / Projected Number of Enrollees |
Financing Information |
|
Children in families with incomes up to 200% of FPL who have access to
health insurance coverage through their parent's employer |
Less than 30 (ESHI)
1000 (HIPP) |
No projections at this time |
There are no premiums or copayments for enrollees in the premium
assistance program
Employers must contribute at least 40 percent toward the cost of family
coverage to participate in the program
Cost of family coverage under ESHI is equal to or less than the State's
cost of obtaining coverage under FAMIS only for the eligible targeted
children involved
The source of the state's match comes from the general fund and the
FAMIS Trust Fund
Savings to state has yet to be realized (With so few people enrolled,
it's not information they collect) |
|
WISCONSIN: Health Insurance Premium
Payment (HIPP) |
|
Persons Covered |
Number of Enrollees |
Estimated / Projected Number of Enrollees |
Financing Information |
|
Children up to age 18 in families below 185% FPL and their
Parents |
125 adults
196 children have been enrolled since 1999. |
6,500 children with Medicaid are eligible
56, 500 adults
83,000 "other's" are eligible |
Estimated savings of $132,000 between July, 2000 and December 2001
Federal matching rate varies accordingly
Families above 150% FPL pay premiums of 3-3.5% of the family income
Failure to pay premiums results in disenrollment with a six month
waiting period unless good cause |
