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Health Insurance Premium Payment (HIPP) Program - Off Exchange Clients

Overview

The HIPP Program pays your monthly health insurance premiums up to $1,938 and certain outpatient Medical Out-of-Pocket Costs (MOOPs). 

HIPP Program Off-Exchange

An off-exchange plan is health insurance that is purchased directly from the health insurance plan instead of through the Covered California exchange.

Choosing an Off-Exchange Health Plan

During open enrollment, you may change plans. If you want to keep your doctor, you should call their office to see which health care plans they accept prior to changing your plan. 

The following links provide “report cards” for various Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) plans. This information may assist in your health plan selection process:

https://www.opa.ca.gov/reportcards/Pages/default.aspx

http://reportcard.opa.ca.gov/rc/HMO_PPOCombined.aspx

HIPP Program Renewal

The fastest way to renew your HIPP Program is to work directly with your local Medication Assistance Program Enrollment Worker. Off-exchange HIPP Program applicants must submit:

  • Medication Assistance Program Client Attestation Form (with all applicable boxes checked)
  • Health insurance plan billing statement, and/or letter from your insurance plan with the 2021 premium amount
  • Medication Assistance Program Fax Coversheet, if faxing

Within two days of renewing your insurance coverage through an off-exchange health plan, you must submit your health plan documents to your local Medication Assistance Program Enrollment Worker, or directly to the CDPH Medication Assistance Program.

Please note: Clients who enroll in an off-exchange health plan must submit documents to the CDPH Medication Assistance Program by 

November 30, 2020 for a January 1, 2021 start date. If you submit documents to CDPH after this date, it is recommended you make the initial premium payment to secure your health insurance. Otherwise, you may not receive a January 1, 2021 effective date.

How to Submit Documents

Work with your local Medication Assistance Program Enrollment Worker to submit documents electronically (THIS IS THE FASTEST AND PREFERRED METHOD), or  

Email, fax, or mail the documents to CDPH: 

  • Email:              CDPHMedAssistFax@cdph.ca.gov
  • Fax:                  (844) 421-8008
  • Mail:                 CDPH – Insurance Assistance  

                                      P.O. Box 997426, MS 7704

                                     Sacramento, CA 95899

Open Enrollment Dates 

• November 1, 2020 to January 31, 2021

Tax Penalty

Having health coverage is the law. If you don’t have it, you may have to pay a penalty to the California Franchise Tax Board. The penalty for not having coverage the entire year will be at least $750 per adult, and $375 per dependent child under 18 in the household, when you file your 2020 state income tax return in 2021. 

The penalty will be applied by the California Franchise Tax Board.  For additional information or questions regarding this tax penalty, please visit the State of California State Franchise Tax Board and use their Penalty Estimator Tool, or contact your tax advisor.

Questions?

For questions about Medication Assistance Program eligibility and enrollment, please call: 

  • Your local Medication Assistance Program Enrollment Worker, or 
  • The Medication Assistance Program Client Services call center at (844) 421-7050. Client Services staff are available Monday – Friday, 8 A.M. – 5 P.M. (excluding holidays).
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