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​​​​​​​​​​​​HIPP FR​EQUENTLY ASKED QUESTIONS (FAQ)

 Questions:

1.​ How can I contact the Department of Health Services (DHCS) Health Insurance Premium Payment (HIPP) program?

2. Do I have to submit original documentation, or will copies be acceptable?

3. How long does it take to process my application?

4. If my application is approved for HIPP, can I be reimbursed for months prior to approval for the program?

5. Can I cancel my private health coverage once approved for the HIPP program?

6. What happens if I lose or change my private health coverage?

7. What happens if I change my address or name?

8. What do I send HIPP to receive reimbursement?

9. How long does it take to receive reimbursement?

10. Why does it take so long to receive a reimbursement?

11. How does the state budget affect my reimbursement?

12. Can I submit proof of payment every month instead of quarterly?

13. What documents do I have to submit for cost-sharing reimbursement?

14. What should I do if my insurance company sends me a refund check?

15. Can I appeal a decision for termination from the HIPP program?

16. Who can I contact for assistance with transitioning to a Medi-Cal Managed Care Plan?

17. What is the mailing address?

18. Under what authority does DHCS have to operate the program?

19. When did the HIPP program begin?

Questions and Answers:

  1. How can I contact the Department of Health Care Services (DHCS) Health Insurance Premium Payment (HIPP) program?

    You may contact HIPP by e-mail at HIPP@dhcs.ca.gov, by fax at (916) 440-5676, or the address below:

    Third Party Liability and Recovery Division
    HIPP Program - MS 4719
    P.O. Box 997425
    Sacramento, CA 95899-7425

  2. Do I have to submit original documentation, or will copies be acceptable?

    Copies of all requested documentation are acceptable.

  3. How long does it take to process my application?

    New applications are processed within 30 days from receiving all of the required documentation.

  4. If my application is approved for HIPP, can I be reimbursed for months prior to approval for the program?

    If you are approved for the HIPP program, reimbursements begin the month of approval.
    If premiums are past due, you must bring the premiums current before eligibility can be determined.

  5. Can I cancel my private health coverage once approved for the HIPP program?

    If you drop your private health coverage, you will no longer be eligible for the HIPP program.

  6. What happens if I lose or change my private health coverage

    If you lose or change your private health coverage, you will no longer be eligible for the HIPP program.

  7. What happens if I change my address or name?

    You will need to complete a new Payee Data Record (STD 204) and submit the form to HIPP for processing.
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  8. What do I send HIPP to receive reimbursements?

    Proof of payment must be received every three months for reimbursement. That proof can be copies of
    paystubs, cancelled checks (front and back), bank statements, annuity letters, etc.

  9. How long does it take to receive reimbursement?

    Reimbursement takes approximately eight weeks to process.

  10. Why does it take so long to receive a reimbursement?

    HIPP prepares an invoice once your proof of payment has been received. Invoices are reviewed and
    forwarded to DHCS Accounting for processing. Once processing has been completed, the invoice is
    forwarded to the State Controller's Office for a warrant to be issued.

  11. How does the state budget affect my reimbursement?

    When a state budget has not been signed, HIPP reimbursements may be delayed. If HIPP payments
    are delayed, HIPP enrollees may be responsible for making their insurance premium payments. DHCS
    will reimburse those payments once a state budget has been signed.

  12. Can I submit proof of payment every month instead of quarterly?

    This is acceptable; however, HIPP reserves the right to hold proof of payment until an entire quarter
    is received for reimbursement.

  13. What documents do I have to submit for cost-sharing reimbursement?

    Three types of documents are needed for each service requested for cost sharing obligation reimbursement:
    1. Proof of payment - the point of sales receipt, cancelled check, or bank statement
      showing the actual payment/deduction for service(s).
    2. Provider Invoice - Invoice from the provider of the service detailing the service
      provided and the cost.
    3. Explanation of Benefits - document from the health insurance provider showing
      the coverage of the service, the amount paid by the carrier, and the amount
      the member is responsible for.


  14. What should I do if my insurance company sends me a refund check?

    If you receive a refund check for payment that was made by the State, you should immediately forward that
    check to DHCS at the address below:

    Third Party Liability and Recovery Division
    HIPP Program - MS 4719
    P.O. Box 997425
    Sacramento, CA 95899-7425​
  15. Can I appeal a decision for termination from the HIPP program?

    In accordance with All County Welfare Directors Letter No. 95-82, there are no appeal rights for the HIPP program.

  16. Who can I contact for assistance with transitioning to a Medi-Cal Managed Care Plan?

    If you are transitioning from the HIPP program into a Medi-Cal Managed Care program and are in a need of assistance,
    please contact the HIPP program using one of the methods below:

    Email: HIPP@dhcs.ca.gov
    Fax: (916) 440-5676
    Address: Third Party Liability and Recovery Division
    HIPP Program - MS 4719
    P.O. Box 997425
    Sacramento, CA 95899-7425


    The HIPP staff will assist with putting you in contact with your selected Managed Care program staff.

    Additional information about managed care can be found using the link below:

    Medi-Cal Managed ​Care

    ​
  17. What is the mailing address?

    Department of Health Care Services
    Third Party Liability and Recovery Division
    HIPP Program- MS 4719
    P.O. Box 997425
    Sacramento, CA 95899-7425
  18. Under what authority does DHCS have to operate the program?

    Title 42, Section 1396e(a)of the United States Code grants broad authority to administer a premium assistance program.

    DHCS further relies on W&I code 14124.91and CCR 50778 as guidance and authority to operate the HIPP program.
  19. When did HIPP program begin?

    The HIPP program became operational on August 1st of 1989.

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Last modified date: 3/23/2021 11:48 AM