Florida program
Help with the work-plan premium (HIPP)
HIPP can repay your work-plan premium after your child qualifies for Medicaid.
What it is
HIPP can repay your work-plan premium after your child qualifies for Medicaid.
A work-plan premium can remain a large monthly cost even after Medicaid begins. HIPP reviews that premium alongside expected treatment costs. If the calculation fits, it pays you back after you show payment.
Eligibility rules
- The child must already have Medicaid and access to an employer plan.
- The cost test compares the Medicaid managed-care premium with your premium share, expected cost sharing and administration.
What you get
- Repayment of your share of the employer health premium when approved.
What the help covers
- HIPP families are outside the Medicaid managed-care program. That can change who arranges care and handles approvals.
If you decide to apply
- If a work plan is offered or in place, its benefits office can give you the plan summary and the premium per pay period.
- Review the HIPP application with the hospital counselor through the Florida HIPP portal.
- Ask AHCA how accepting HIPP would affect your child’s health plan and current approvals.
Florida HIPP portal or 877-357-3268 · Official page ↗
What happens next
- The program requires proof of premium payments and checks cost effectiveness at least every six months.
Good to know
This is reimbursement. It does not pay the premium in advance.
Other details
- The social worker can help compare the current care arrangements before you accept premium reimbursement.
Federal background: Medicaid premium assistance.
Official sources
“Would HIPP repay our premium, and what would leaving our child’s Medicaid health plan change? If the savings are worth it, could you help us gather the plan papers?”
Why I’m asking: I want help with premiums without disrupting treatment arrangements.
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
File the application, keep paying the premium, send proof of each payment.
Your social worker
The social worker helps get the plan summary and checks that leaving the managed-care plan keeps your existing approvals.
The care team
Records and letters when the application asks for them.
- Who decides
- The premium-payment unit at the state Medicaid agency (AHCA), through its online portal.
- Ask HR
- “Can you give me the medical premium I pay per pay period and the plan summary this week? Florida's Medicaid premium program needs both.”
How to apply
First step: Apply at the Florida HIPP portal (hippportal.hms.com) or call 877-357-3268 the week Medicaid is approved. Ask your employer's benefits office what the premium is per pay period.
- Apply the week the Medicaid approval arrives.
- Ask the employer's benefits office for the premium per pay period and the plan summary.
- Keep paying and keep every receipt; reimbursement follows proof.
Official application / program page ↗
Where it starts: Online application at the Florida HIPP portal or 877-357-3268
What to gather
- Medicaid approval notice
- Insurance cards and plan summary
- Pay stubs showing the premium deduction
How long: No published decision time. Florida rechecks whether the plan still saves it money at least every six months.
What a yes looks like
A notice naming the reimbursable premium share and how to send proof.
What a no looks like, and the next move
Ask whether it failed the cost test or the paperwork. Keep the plan while you ask them to look again.
Watch out
- Medicaid first: nothing can start before the child's Medicaid is approved.
- It pays you back; it does not pay ahead. Keep paying and keep receipts.
- State training lists HIPP families among people outside the managed-care plans. Before you accept, ask the state Medicaid agency (AHCA) how your child's plan and current approvals are handled.
The numbers and the rules
The arcane layer, kept on purpose. Checked September 8, 2026.
What it is worth
Your share of the employer premium paid back when keeping the plan is cheaper for Medicaid. Rechecked at least every six months.
Covers: Premium reimbursement after proof of payment · Employer plan pays first; Medicaid pays behind it
What it costs the family: None beyond paying the premium on time and sending proof.
The eligibility facts, as published
- Medicaid
- in place first
- Employer plan
- yes
- Cost effective
- Medicaid managed-care premium must be at least your premium share plus expected cost sharing plus administration
- Redetermination
- at least every six months
- Delivery system
- HIPP recipients are outside the managed-care (MMA) program
The trap: It pays you back; it does not pay ahead. You keep paying the premium and send proof; the money comes later. How long the decision takes is not published.
Where I read this
- Florida Administrative Code — Rule 59G-7.007 — Florida Administrative Code, read September 8, 2026
- Florida Administrative Register 41/17 — HIPP Notice of Change — Florida Administrative Register, read September 8, 2026
- Florida Administrative Register 40/211 — HIPP rule text — Florida Administrative Register, read September 8, 2026
- Florida Elder Affairs — LTC Education Slides — Florida Department of Elder Affairs, read September 8, 2026
- Florida HIPP — Online Application — Florida AHCA / HMS, read September 8, 2026
- U.S. DOL — CHIPRA Premium Assistance Model Notice — U.S. Department of Labor, read September 8, 2026