Written by a parent, not a doctor. Nothing here is medical advice.

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Georgia program

Help paying your work-plan premium (HIPP)

After Medicaid approval, Georgia can repay the medical part of your work-plan premium when keeping it saves Medicaid money.

What it is

After Medicaid approval, Georgia can repay the medical part of your work-plan premium when keeping it saves Medicaid money.

Keeping work insurance can cost a lot even after your child gets Medicaid. HIPP reviews whether repaying the medical premium saves the state money. Approval depends on the plan and premium details.

Eligibility rules
  • Your child must already have Medicaid, including Medicaid through Katie Beckett. An employer health plan and a favorable cost review are required.
  • Dental and vision deductions must be separated from the medical premium on the employer form.
What you get
  • Monthly repayment of the approved medical-only employee premium.
  • The employer plan remains the first insurer billed.
What the help includes
  • HIPP reimburses the amount in the approval notice. It does not reimburse every payroll deduction automatically.
  • A Georgia Families managed-care member moves to fee-for-service Medicaid after HIPP approval. The oncology team needs to check care authorizations and billing under the new arrangement.
If you decide to apply
  1. Ask the DCH premium-help unit about the HIPP packet after your child has Medicaid.
  2. Have ready: Medicaid approval, insurance cards, the plan summary and the policyholder’s signature on DMA-124.
  3. Ask your benefits office for the medical-only premium per pay period, and the clinic about the Medicaid change.

Georgia HIPP: 678-564-1162, option 1; HIPP portal · Official page ↗

After you ask
  • Proof of each month’s paid premium is due by the 15th of the following month. Missing proof can stop reimbursement.
  • The 30-day target concerns renewals, not an initial-decision guarantee. The unit can explain the expected first-review timing.
Good to know

Approval changes your child’s Medicaid arrangement. The clinic needs to check existing treatment approvals and billing before that change.

Other details
  • If HIPP does not fit, the same unit can consider CHIPRA premium assistance. Both cannot pay for the same premium.

Federal background: Medicaid premium assistance.

Official sources
Ask your social worker

“Could HIPP repay our work premium, and how would the Medicaid change affect treatment approvals? What are the benefits and drawbacks, and would you help us apply if you recommend it?”

Why I’m asking: I want to reduce the premium cost without interrupting treatment.

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 monthly proof.

Your social worker

The social worker helps the clinic send treatment costs if requested. The clinic's insurance navigator checks that changing from managed care to direct Medicaid billing will keep existing care approvals in place.

The care team

Records and letters when the application asks for them.

Who decides
Georgia's Department of Community Health premium-payment unit (Gainwell).
Ask HR
“Can you complete Georgia's 2026 HIPP medical-premium form this week? It needs the medical-only premium per pay period.”

How to apply

First step: Apply at hippportal.hms.com or call 678-564-1162, option 1, when Medicaid is approved. Ask your employer's benefits office for the medical-only premium per pay period.

  1. Apply the week the Medicaid approval arrives.
  2. Hand HR the 2026 employer data form the same day.
  3. Send proof of premium every month by the 15th.

Official application / program page ↗

Where it starts: hippportal.hms.com or 678-564-1162 option 1; DMA-124 signed by the policyholder

What to gather

  • Medicaid approval notice
  • Insurance cards and plan summary
  • the employer benefits office's completed employer health-insurance data form with the medical-only premium per pay period
  • The policyholder's signature on the DMA-124 application

How long: No published initial-decision standard (the 30-day target is for renewals). Proof of premium is due monthly by the 15th.

What a yes looks like

A notice naming the reimbursable premium. Keep the employer plan and send proof every month.

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 for reconsideration. A CHIPRA premium help review through the same unit is the other option.

Watch out

  • Medicaid first: help paying the work-plan premium cannot start before the child's Medicaid (Katie Beckett counts) is approved.
  • the employer benefits office's form must give the medical-only premium per pay period. A payroll deduction that includes dental or vision is the wrong number.
  • After approval a child in a Georgia Families plan (managed-care plan (CMO)) moves to fee-for-service Medicaid. Proof of each month's premium is due by the 15th of the next month or the payment stops.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 8, 2026.

What it is worth

Monthly reimbursement of the approved medical-only employee premium. The employer plan stays primary.

Covers: Premium reimbursement · Employer plan stays primary. 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
yes
Delivery system
CMO member moves to fee-for-service after approval

Decisions this site cannot make: HIPP cost-effectiveness

Expect friction on: HR data form · Monthly proof of premium by the 15th

The trap: the employer benefits office's form must give the medical-only premium per pay period. A payroll deduction that includes dental or vision is the wrong number.

Where I read this

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