District of Columbia program
Help paying your work-plan premium (HIPP)
Possible help paying a work-plan premium for a family with Medicaid. DHCF confirms whether applications and payments are available.
What it is
Possible help paying a work-plan premium for a family with Medicaid. DHCF confirms whether applications and payments are available.
Premium help could reduce the cost of keeping a work plan alongside Medicaid. DHCF needs to confirm whether applications are available and how its cost review works. This is a question for the agency before including help in your budget.
Eligibility rules
- Medicaid eligibility, plus a cost-effectiveness test comparing the premium and administration against what Medicaid would otherwise spend.
- The 1993 plan says a person still working through a spend-down is not eligible, and excludes someone whose patient-pay deduction already covers the premium.
- District of Columbia.
What you get
- Payment toward a qualifying employer-plan premium if DHCF confirms access.
- Family premiums when covering other family members is necessary to cover the child.
If you decide to apply
- Ask DHCF or your Medicaid plan who handles premium-payment questions.
- Ask your employer's benefits office for the premium amount and a plan summary.
The Department of Health Care Finance · Official page ↗
Before relying on premium help
- DC’s posted state plan authorizes employer-premium assistance. The social worker can ask DHCF to confirm current intake, payment arrangements and family charges in writing before your family relies on it or changes work coverage.
Good to know
DC has this program on paper but may not be running it; ask DHCF whether it is taking applications before you count on it.
Federal background: Medicaid premium assistance requires a cost-effectiveness review.
Official sources
“Is DC currently helping Medicaid families pay work-plan premiums? Could you help us check what it would pay and what keeping both plans would involve?”
Why I’m asking: I want to know whether premium help is available before counting on it.
More background and detailed requirements
Additional program information and published rules
Who does what
The three parts, side by side. The agency decides; nobody on this page does.
You
Ask whether the programme is running, and get the employer plan's premium in writing.
Your social worker
Human resources can give you the premium and the plan summary.
The care team
Records and letters when the application asks for them.
- Who decides
- The Department of Health Care Finance runs the cost test.
- Ask the agency
- “Does DC still operate the Health Insurance Premium Payment programme, and who takes the application now?”
How to apply
First step: Ask the Department of Health Care Finance, or your child's Medicaid health plan, whether the premium payment programme is taking applications.
- Ask the Department of Health Care Finance whether the premium payment programme is taking applications.
- Have the employer plan's premium figure and the summary of benefits ready.
Official application / program page ↗
Where it starts: No current form or dedicated line was found. Ask the Department of Health Care Finance directly, or ask the Medicaid health plan to route the question.
What to gather
The diagnosis letter, the child’s insurance card, and the last two pay stubs cover most applications. The official page lists the rest.
How long: Unknown: no decision clock was published.
What a yes looks like
The premium paid to the employer, with Medicaid still in place behind the work plan.
What a no looks like, and the next move
Ask whether any other help with the premium exists, and keep the child's Medicaid.
Watch out
- The only text found is from 1993. Get a live answer before counting on it.
Dates that change this
1993-07-01: The only version of this programme that could be found is the 1993 state plan attachment. No current form, phone line, decision clock or operating description was located, so whether you can apply today is unknown. (not yet confirmed against the final rule)
The numbers and the rules
The arcane layer, kept on purpose. Checked September 11, 2026.
What it is worth
Medicaid paying an employer-plan premium when that costs it less. How to apply today is unknown.
Covers: Payment of the employer-plan premium, made to the employer · Premiums for family members when their enrolment is needed to cover the child
Legal protection: Joining an employer group plan does not end Medicaid eligibility; that plan simply pays first
What it costs the family: None published.
The eligibility facts, as published
- Income
- Medicaid eligibility, plus a cost-effectiveness test comparing the premium and administration against what Medicaid would otherwise spend
- Other
- The 1993 plan says a person still working through a spend-down is not eligible, and excludes someone whose patient-pay deduction already covers the premium
- Residency
- District of Columbia
The trap: The only text that could be found is from 1993. Do not build a budget on this before you get a live answer from the Department of Health Care Finance.
Where I read this
- DHCF — State Plan Attachment 4.22-C (Health Insurance Premium Payment Program) — DC Department of Health Care Finance, read September 10, 2026