General Program Information

The West Virginia HIPP program is designed to save money for families with high healthcare costs by reimbursing recipients for the cost of their health insurance that is self-funded, provided by an employer, or through COBRA.  Medicaid may also eliminate out-of-pocket medical expenses for qualifying Medicaid recipients.  In some cases, recipients can receive reimbursement for the cost of a family health insurance policy premium, even if some family members are not eligible for Medicaid.

“Can I receive benefits from WV HIPP and Medicaid at the same time?”
Yes. You can receive benefits from both WV HIPP and Medicaid at the same time. In fact, to qualify for the WV HIPP program, you or a dependent will first need to be on Medicaid. Once you are enrolled in the WV 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. When a Medicaid recipient becomes a HIPP member, Medicaid may cover these costs when the member visits a Medicaid provider.

“Will WV 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 available to you, as well as the cost-effectiveness of a family plan. For more information see the “Is WV HIPP Free?” section below.

“Is there retroactive pay for new HIPP members?”
HIPP will only reimburse a recipient’s premium for periods before his/her HIPP membership started if it affects the status of the recipient’s continued coverage.

Example: Some individuals that have access to employer-sponsored insurance through COBRA may be required to pay for coverage back to the beginning of the COBRA coverage start date.

Typically, the start date of premium reimbursement will be effective the month the recipient is enrolled in the HIPP program.

“HIPP sounds too good to be true, what is the catch?”
While WV HIPP offers payment for commercial health insurance, it also helps save state and taxpayer money by decreasing the annual cost of Medicaid recipients’ medical expenditures. It benefits both the State and the HIPP member.