A nonprofit publication of the Kentucky Center for Public Service Journalism

Medicaid program for employer-sponsored insurance premiums has new application process

By Melissa Patrick
Kentucky Health News

A program that will pay the premiums of working Medicaid members who have access to insurance through their employers has a “new and improved” application process, the state says.

The voluntary program, called the Kentucky Integrated Health Insurance Premium Payment program or KI-HIPP, allows Medicaid members to sign up for their employer-sponsored health insurance plan and have Medicaid pay their part of the premium.

Starting Nov. 4, KI-HIPP allows primary policyholders who are not on Medicaid to apply for the program if they have at least one Medicaid-eligible person on their policy. In addition, it allows families with anyone enrolled in a 1915(c) Medicaid Home and Community Based Services waiver.

“KI-HIPP is an excellent example of a government partnership that works with the employer-sponsored insurance market to expand insurance coverage options, particularly for families,” Medicaid Commissioner Carol Steckel said in a news release. “It allows Medicaid beneficiaries to choose a plan that meets their needs and empowers them to take control of their health. The added benefit is that this partnership saves the Medicaid program money.”

As of Oct. 30, the program had 220 members enrolled which would translate to a projected annual savings of nearly $800,000 for the Medicaid program, says the release.

Jason Dunn, a policy analyst for Kentucky Voices for Health, told Kentucky Health News that while KI-HIPP could be a great plan for some people and their families, he cautioned that it is important for consumers to carefully examine what he called the “risk” before making a switch, especially those with very low incomes.

For example, he pointed out that those who choose KI-HIPP will have more paperwork to manage, since participants are required to submit a copy of their paystub each pay period as proof of premium payment. It also requires the participant to submit annual re-certifications for both plans.

Dunn also noted that there is a risk that KI-HIPP participants could end up paying more out-of-pocket costs for their health care if they don’t see providers who accept both the employer-sponsored insurance and fee-for-service Medicaid. If the provider only takes the employer’s insurance, the KI-HIPP participant must pay all out-of-pocket costs, including co-pays, deductibles and co-insurance. “And that can be pretty pretty expensive,” he said. “All that can be thousands of dollars a year.”

Dunn added that individuals also need to explore what would happen if they were part of the KI-HIPP program, but then became no longer eligible for Medicaid, or were no longer able to meet the KI-HIPP requirements. In either case, the premium would no longer be reimbursed by Medicaid, and the employer could have to pick up the cost until the next open enrollment if they were not permitted to dis-enroll from the employer’s plan.

Tens of thousands of Kentuckians go on and off Medicaid each month, for various reasons. As an example of that, the health cabinet confirmed that as of Nov. 4, 25 people had left the KI-HIPP program because their incomes rose above the Medicaid eligibility limit; by Nov. 6, the number of KI-HIPP participants had risen from 195 to 199.

To improve the application process, the system now includes a stand-alone application which is designed to make it easier for newly eligible Kentuckians to apply for KI-HIPP or to add it to an existing Medicaid case. “It’s great to make it easier to apply, but we just want to make sure people know what they’re applying for and what the risks are,” Dunn said.

The release notes that Kentuckians enrolled in the existing Health Insurance Premium Payment (HIPP) program will move to KI-HIPP in December, and HIPP program members will get a letter in the mail with guidance on how to make this transition.

Sign up for KI-HIPP at benefind.ky.gov or call 855-459-6328. For more information see chfs.ky.gov.

Click here for a link to a Kentucky Voices for Health explainer about the program.

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