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

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Kentucky program

Help with your work-plan premium (KI-HIPP)

Kentucky can reimburse an employer-plan premium when a covered family member has Medicaid.

What it is

Kentucky can reimburse an employer-plan premium when a covered family member has Medicaid.

This can reduce the cost of keeping employer insurance alongside Medicaid. The state compares the employer plan’s costs with Medicaid’s costs. Approval also changes how the Medicaid member receives care.

Eligibility rules
  • At least one person on the employment-related policy must have Medicaid.
  • You must live in Kentucky.
  • The state compares premiums, cost sharing, covered services and administration against what the same care would cost Medicaid.
What you get
  • The approved cost-effective premium amount reimbursed each month by check or direct deposit.
Which costs it can help with
  • DMS decides the reimbursable premium after checking the employee’s actual cost, the policy and the state’s cost comparison.
  • An approved family premium can include people without Medicaid. That does not give those people Medicaid or payment of all their own deductibles and copays.
If you decide to apply
  1. Ask the hospital financial counselor about the KI-HIPP application through kynect or the program office.
  2. Have the employer premium statement and plan details ready.

KI-HIPP: 855-459-6328 · Official page ↗

If you decide to apply
  • The decision comes from the Department for Medicaid Services.
  • Approval moves the Medicaid member to fee-for-service Medicaid at the end of the approval month. Treatment access needs checking before the change.
Good to know

Approval moves the Medicaid member to a different way of receiving Medicaid care. The treatment team’s participation needs checking first.

Before a coverage change
  • If your child’s coverage is KCHIP rather than ordinary Medicaid, ask KI-HIPP whether it qualifies before you count on the reimbursement.
  • The program can identify the approved premium level and who it includes. The hospital counselor can check treatment access before the Medicaid member moves to fee-for-service coverage.

Federal background: Medicaid premium assistance.

Official sources
Ask your social worker

“What would KI-HIPP save us, what would change in our child’s Medicaid care, and could you help us decide whether to apply?”

Why I’m asking: I want to understand both the premium savings and the effect on our child’s 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

Apply, send the premium statement, and keep the employer enrolment.

Your social worker

The employer's benefits office confirms the premium and the plan details.

The care team

Records and letters when the application asks for them.

Who decides
The Department for Medicaid Services runs the cost-effectiveness test.
Ask the agency
“My child is on Medicaid and I pay an employer premium. Can Kentucky pay that premium back, and what happens to my child's managed-care plan if it does?”

How to apply

First step: Call 855-459-6328 or use the paper application on the programme page, with the employer's premium statement.

  1. Ask the programme whether a child covered under the children's category can take part.
  2. Ask what happens to the managed-care plan before you agree.
  3. Send the employer's premium statement with the application.

Official application / program page ↗

Where it starts: Use the paper application on the programme page, apply through kynect, or call 855-459-6328.

What to gather

  • The employer's premium statement
  • The plan booklet
  • The child's Medicaid number

How long: Kentucky publishes no decision deadline for this programme.

What a yes looks like

A monthly reimbursement by cheque or direct deposit to the policyholder, and a change of Medicaid delivery system.

What a no looks like, and the next move

Ask whether the reason was the cost-effectiveness test or the category, and ask for that in writing.

Watch out

  • Joining moves the Medicaid member to fee-for-service Medicaid at the end of the approval month.
  • An old manual section excludes the children's category. Kentucky has not said whether that still applies after the 2022 change; ask.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

The employer premium reimbursed to the policyholder each month, by cheque or direct deposit.

Covers: Monthly reimbursement of the employer premium to the policyholder · A cost-effectiveness comparison done by the state, not by you

Legal protection: You can apply before the employer enrolment is complete, though enrolment is needed to take part

What it costs the family: Nothing to apply.

The eligibility facts, as published

Coverage
at least one Medicaid member on an employment-related policy
Residency
Kentucky
Test
the state compares premiums, cost sharing, covered services and administration against what the same care would cost Medicaid

The trap: Joining this programme moves the Medicaid member out of a managed-care plan and onto plain fee-for-service Medicaid at the end of the approval month. If your child's oncology care is arranged through a managed-care plan's authorisations, ask what changes before you say yes.

Where I read this

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