FAQs
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The Alabama HIPP program is designed to save money for families with high health care costs by eliminating most out-of-pocket medical expenses for qualifying Medicaid recipients. The program also helps families by reimbursing recipients for the cost of group health insurance provided by an employer or through COBRA. In some cases, recipients can receive reimbursement for the cost of a family health insurance policy premium.
Can I receive benefits from AL HIPP and Medicaid at the same time?
Yes. You can receive benefits from both AL HIPP and Medicaid at the same time. In fact, to qualify for the AL HIPP program, you will first need to be on Medicaid. Once you are enrolled in the AL HIPP program, you will have access to benefits from both programs.
What are out-of-pocket medical expenses?
Out-of-pocket medical expenses are the fees related to medical care costs that Medicaid or commercial health insurance typically does not pay. HIPP members have most of these costs covered when visiting a Medicaid provider.
Will AL HIPP pay for my entire family’s health insurance coverage?
In some cases, an applicant will qualify to be reimbursed for family health insurance coverage. This depends on the health insurance policies your employer provides as well as the family plan’s cost-effectiveness. For more information see the “Is AL HIPP Free?” section below.
Is there retroactive pay for new HIPP members?
HIPP will only reimburse a recipient’s premium for prior periods (before HIPP membership started) if it affects the status of their continued coverage.
Example: If you had access to employer-sponsored insurance through COBRA, in order for coverage to continue, premiums must be paid back to the beginning of the COBRA coverage start date.
Typically, the begin date of premium reimbursement will be effective the month the recipient is enrolled in the HIPP program.
This sounds too good to be true, what is the catch?
While AL HIPP offers you commercial health insurance at no cost, it also helps Alabama save money on medical expenditures. The state is responsible for covering most of Medicaid recipients’ medical expenses. Once you are on AL HIPP and have employer-sponsored insurance, most of these medical costs are transferred to your health insurance policy, while Alabama Medicaid only covers the cost of your policy.
What is COBRA?
Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal law that allows employees to continue health insurance coverage for up to 18 months after leaving a job. If an applicant has access to employee-sponsored health insurance through COBRA, the applicant meets the insurance requirement for AL HIPP. If all other qualifications for membership are met, AL HIPP will reimburse the cost of the COBRA plan.
What is employer-sponsored insurance (ESI)?
Employer-sponsored insurance (ESI) is health insurance that employers offer to their employees, and is typically offered as part of an employee benefits package. ESI is offered to current employees, but in some cases is offered to employees who have resigned or been terminated for up to 18 months. This is known as having ESI through COBRA.
Am I eligible for AL HIPP if I have private insurance that is not provided by an employer?
No. AL HIPP is only offered to Medicaid recipients who have access to employer-sponsored insurance or coverage through COBRA.
Yes. AL HIPP members will pay their monthly premium and the program will provide a monthly reimbursement for the exact cost of the monthly premium.
“What about COBRA members?”
HIPP is also offered to qualified COBRA members, at no cost. It works the same way as any other HIPP membership; the policyholder will receive the monthly reimbursement for the exact cost of their monthly premium.
“What if I want to enroll in a family plan? Is it still free? “
In some cases, a recipient may qualify to be reimbursed for the cost of family health insurance coverage. In this case, the recipient and their entire family can enroll in a family plan provided by an employer, at no cost. This type of plan would provide health care for the entire family, even those that are not Medicaid eligible.
“What if we don’t qualify to receive reimbursements for a family plan?”
If a recipient does not qualify for family coverage reimbursement, a policyholder still has the option to enroll in a family plan provided by an employer. However, the policyholder will only be reimbursed for the cost of the plan that is necessary to cover the Medicaid recipient(s).
For example: An employee that has one Medicaid dependent is given the following options for healthcare plans: Employee, Employee plus Spouse, Employee plus Children, Employee plus Family. The Medicaid dependent is his spouse. The Medicaid recipient did not qualify for family coverage reimbursements but the policyholder enrolled in the Family plan anyway. HIPP will only reimburse the policyholder for the cost of the Employee plus Spouse plan. You may still see this as a benefit, since you will not be paying the entire cost of a Family Plan.
Can I receive benefits from AL HIPP and Medicaid at the same time?
Yes. You can receive benefits from both AL HIPP and Medicaid at the same time. In fact, in order to qualify for the AL HIPP program, you will first need to be on Medicaid. Once on the AL HIPP program, you will have access to benefits from both programs.
