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 1. Home
 2. Health Care & Coverage
 3. BadgerCare Plus
 4. Health Insurance Premium Payment (HIPP) Program


HEALTH INSURANCE PREMIUM PAYMENT (HIPP) PROGRAM

If you are enrolled in BadgerCare Plus or the Medicaid Purchase Plan (MAPP) and
your employer offers health insurance, you may be eligible for the Health
Insurance Premium Payment (HIPP) Program. The Wisconsin Department of Health
Services (DHS) HIPP Program can help you afford health insurance through your
employer.

HIPP will pay for:

 * Your family's monthly premium, as well as the coinsurance and deductibles
   associated with the employer-sponsored health insurance plan for BadgerCare
   Plus or MAPP members.
 * Any BadgerCare Plus or MAPP covered services not covered by the
   employer-sponsored health plan. These services will be paid through
   BadgerCare Plus or MAPP

Enrolling in HIPP is voluntary. If you choose not to enroll in HIPP, even if you
are eligible, you will still have access to BadgerCare Plus or MAPP.

You may have to pay a small BadgerCare Plus or MAPP copayment for services
received. You don’t have to pay a copayment if you are:

 * Under 18 years old.
 * Receiving pregnancy related services
 * Otherwise exempt (for example, if you are a tribal member) 


ELIGIBILITY

You may be eligible for the HIPP Program if all of the following are true:

 * One of your family members who is in BadgerCare Plus or MAPP is employed, and
   their employer offers a family health plan. It must be a major medical plan
   that at least covers physician services, like seeing a primary health care
   physician.
 * None of your family members are currently covered by any employer-sponsored
   family health plan.
 * The employer pays between 40 percent and 80 percent of the cost of the
   monthly premium for the health plan.
 * It is more cost effective than BadgerCare Plus or MAPP coverage for your
   family.

If you are eligible, you will have the choice to enroll in HIPP.

If you are not eligible, you will not have the option to enroll in HIPP.
However, you will continue to be enrolled in BadgerCare Plus or MAPP.


HOW ELIGIBILITY IS DETERMINED

If the employer reports that your family has access to health insurance, DHS
will send a HIPP Employer Verification of Health Insurance Coverage form to the
employer. This form is used to gather more information about the type of health
insurance offered, the cost of the plan, and the employer's share of the
premium.    

While eligibility is being determined, your family will be enrolled in
BadgerCare Plus HMO coverage. If you are a MAPP member, you are not required to
enroll in an HMO for coverage but you can choose to if you want to. 


HOW TO ENROLL

 1. DHS will let you know if you are eligible for the HIPP Program, and that
    HIPP will pay your share of the employer-sponsored health insurance premium.
 2. DHS will help you enroll in the employer-sponsored health insurance plan as
    soon as possible. You will not have to wait until the next open enrollment
    period.
    * If the employer offers more than one cost-effective health insurance plan,
      you will be able to choose the plan you prefer. DHS can provide
      information to help you choose.


PAYING THE EMPLOYER-SPONSORED HEALTH INSURANCE PREMIUM

DHS will work with you and the employer to set up the most convenient way to pay
the health insurance premium. There are three options:

 * The employer withholds from your wages (this is the most common). You will
   send a copy of your check stub to DHS that shows the health insurance premium
   deduction. DHS will mail you a check for your share of the cost of the
   employer-sponsored health insurance premium.
 * The employer directly pays the premium without any withholding from your
   wages. DHS will mail a check to the employer for your share of the
   employer-sponsored health insurance premium.
 * DHS directly pays the premium to the insurance company. DHS will mail a check
   to the insurance company for your share of the employer-sponsored health
   insurance premium.


FOR MORE INFORMATION

For more information about BadgerCare Plus, MAPP, or the HIPP Program:

 * Visit the BadgerCare Plus webpage.
 * Visit the MAPP webpage.
 * Call Member Services at 1-800-362-3002.
 * Contact your agency.

Last Revised: June 10, 2022
 * BadgerCare Plus: Home
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