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

Overview

HIPP Programs pay your monthly health insurance premiums up to $2,996 and certain outpatient medical out-of-pocket (MOOP) costs.

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 enroll into health coverage or make changes to your existing plan(s). 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:

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 (CDPH 8723) (PDF) with all applicable boxes checked and required fields (i.e., family size).
Current health insurance plan billing statement(s) for medical, dental, and/or vision combination plans , as applicable, and/or letter from your insurance plan with the 2025 premium amount. It is most helpful when HIPP clients provide medical, dental, and vision rates separated.
Medication Assistance Program Fax Coversheet (CDPH8730) (PDF), if faxing.

Within two business days of renewing your insurance coverage with 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, 2024 for a January 1, 2025 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, 2025 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, 2024 to January 31, 2025

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 *$900 per adult, and $450 per dependent child under 18 in the household, when you file your 2024 state income tax return in 2025.

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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