What is the HIPP Program?
The Health Insurance Premium Payment (HIPP) program is a state program that pays for health care premiums. If you get Medical Assistance (MA) and you also have health insurance where you or a family member works, through a Medicare supplemental insurance (Medigap) plan, or through a former employer you may be able to join. In fact, you may be required to join.

HIPP will pay for your Medigap or employer's plan premiums if it costs less than it would to cover all of your health care with MA.

Do I still get MA?
Yes, you still have MA to fall back on for services that are not fully covered by your other plan.

Who can join HIPP?
HIPP decides if you can join the program. If HIPP wants you to join the program, you have to join unless you ask and are allowed to stay out so that you can join a HealthChoices managed care plan (see the back of this brochure for more information).

How long will I stay in HIPP?
You will stay in HIPP as long as HIPP pays for your other health insurance. If HIPP decides to stop paying for your other insurance, you still get MA.

How does HIPP work with Medicare?
After you get MA, HIPP will send you a letter and an application. Pick three options for your Medigap insurance plan from the list.

Then HIPP will decide if you can join the program. If they decide you can join, they will sign you up for one of the three Medigap plans that you picked. You will get your Medigap insurance card and your MA ACCESS card in the mail.

The ACCESS card is important because it covers more services than your Medicare and Medigap insurance. For example, most categories of MA include prescription drug and transportation services.

How does HIPP work with my employer's health insurance plan?
After you get MA, HIPP may send you a letter and an application. Fill out the application and return it to HIPP.

HIPP will decide if you can join the program. After you join HIPP you have to sign up for your employer's plan. You will get a card for your employer's plan and the MA ACCESS card.

You have to go to providers that take the employer's plan if you want the employer's plan to pay anything. You have to go to providers who take MA if you want MA to pay anything. The easiest thing is to go to providers who take both. Show both cards when you got to get services.

The ACCESS card probably covers more services than the employer's plan. It may also pay the co-payments and deductibles from your employer's plan.

If I'm in HIPP, do I have to join a plan in HealthChoices in Southwestern or Southeastern Pennsylvania?
● If you live in Southwestern Pennsylvania, (Allegheny, Armstrong, Beaver, Butler, Fayette, Greene, Indiana, Lawrence, Washington, and Westmoreland counties) you do not have to join a HealthChoices plan. HIPP members are not part of this program. You can still use your ACCESS card. (This policy may change in the fall of 1999 for people with Medigap insurance.)

You may have to choose a HealthChoices plan when you first get MA because you won't be in HIPP yet. Once you join HIPP the state will take you out of the HealthChoices plan.

Providers may think you can't use the ACCESS card in your area anymore because of this new program. This is wrong. The state puts most MA recipients who live in the Pittsburgh 10 county area into HealthChoices and they use their plan cards to get benefits. But the ACCESS card still works.

If a provider says your ACCESS card won't work, you should tell him or her that it does and say to try it. If he or she refuses, call the numbers on the back of this brochure for help.

If you are part of the HIPP program because you have a Medigap plan, you can get out of HIPP if you want to enroll in a HealthChoices plan because you need services they provide. Just write to the HIPP program and explain why you want to get out of HIPP in your letter. Again, this works only if you have a Medigap plan, not if you have an employer's plan. Write or call:

HIPP Program Attn.: Medigap
P.O. Box 8195
Harrisburg, PA 17105-8195
1-800-644-7730

● If you live in Southeastern Pennsylvania (Bucks, Chester, Delaware, Montgomery, and Philadelphia counties) HIPP members with employer-sponsored health insurance are not part of HealthChoices. The same rules apply for you as in the Southwest, above. If you live in the Southeast and have a Medigap plan, you will have to join HealthChoices and pick an HMO. You will not be able to be in the HIPP program and the state will not pay your Medigap premiums. Your benefits will not change.