Some workers with Medicaid may now find it affordable to join their employer-based plan
Baton Rouge, La. (May 10, 2017) – Some Louisiana residents who are employed but currently receive
their health care coverage under Medicaid may now be eligible for a program that will allow them to afford coverage from their employer.
The Louisiana Health Insurance Premium Payment Program, or LaHIPP, pays the employee share of employer-sponsored insurance, if the insured person or a member of their family currently receives Medicaid. LaHIPP helps Louisiana residents with private insurance that are eligible for Medicaid maintain their current coverage while lessening the burden on the state’s Medicaid system, saving both consumers and state taxpayers money.
“LaHIPP benefits both the employed Medicaid member and the State,” said Dr. Rebekah Gee, secretary of the Louisiana Department of Health. “By moving to the health insurance plan offered through their job, the individual may find access to more doctors and specialists. The State saves money because the premium amount paid will be less than what we currently pay under Medicaid.”
Employer-Sponsored Insurance
For an employee with access to insurance coverage through their job, to be considered for the LaHIPP program, a person in that household must also be enrolled in Medicaid. Eligibility is based on whether or not it is more cost-effective for the state to pay for the insurance premium and out-of- pocket expenses, such as co-pays and deductibles, rather than Medicaid being the primary payer.
The individual must apply for LaHIPP. If LaHIPP is determined to be cost effective, the person will be notified they are approved. The reimbursement covers all or some of the employee’s share of their employer-sponsored coverage that is withheld by the employer, and will be reimbursed to the employee monthly.
In addition to covering the employee’s share of the monthly premium, LaHIPP will cover the cost of other out-of-pocket medical expenses for the Medicaid recipients.
Individual Policies, including a Qualified Health Plan
For a person with an individual private policy to be considered for LaHIPP, that person must also be eligible for Medicaid. Once again, eligibility is based on whether or not is more cost-effective for the state to pay for the insurance premium and out of pocket expenses, such as co-pays and deductibles rather than Medicaid being the primary payer.
In each of the above cases, if it is found to be cost effective, the member is required to enroll in the plan. If they don’t they may lose their Medicaid eligibility.
