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

Childhood Cancer Lantern
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North Carolina program

Possible help with a work-plan or COBRA premium

NC HIPP can repay a work-plan or COBRA premium when someone in your family has Medicaid.

What it is

NC HIPP can repay a work-plan or COBRA premium when someone in your family has Medicaid.

HIPP repays approved premiums monthly when coverage passes the state’s cost test. At least one family member needs Medicaid and someone needs access to work or COBRA coverage. Approval changes how you use Medicaid.

Eligibility rules
  • At least one family member must have Medicaid and one must have access to qualifying employer or COBRA coverage. Medicare beneficiaries are excluded.
  • The employer coverage must cost the state less than the family’s Medicaid expense.
What you get
  • Approved employer premiums reimbursed monthly by check or direct deposit.
  • Help joining the employer plan when you are not already enrolled.
What the help covers
  • The reimbursement goes to you rather than replacing the employer plan. Direct deposit requires bank details.
If you decide to apply
  1. Ask the social worker and NC HIPP whether premium reimbursement would help without disrupting treatment.
  2. Get the premium amount and plan summary from human resources.
  3. Ask oncology billing how NC Medicaid Direct would work with the treatment team.

The NC HIPP program: 855-696-2447 · Official page ↗

If you decide to apply
  • The request for employer enrollment must be made within 60 days of the HIPP decision.
Good to know

HIPP participants move to NC Medicaid Direct. That can change the offices handling the child’s care.

Other details
  • You do not have to be enrolled already. NC HIPP can review qualifying employer or COBRA coverage and confirm approval and reimbursement. Your social worker can compare the move to Medicaid Direct with your child’s treatment needs.

Federal background: Medicaid premium assistance.

Official sources
Ask your social worker

“Could HIPP repay our work-plan premium, and what would moving to Medicaid Direct change for treatment? If it is worthwhile, could you help us compare plans and apply?”

Why I’m asking: I want help with the premium without disrupting our child’s care.

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

Send the premium figure, the plan summary and bank details for direct deposit.

Your social worker

The employer’s human resources gives the premium figure and opens enrollment within 60 days.

The care team

Records and letters when the application asks for them.

Who decides
The NC HIPP programme decides whether the employer cover is cheaper than the state’s Medicaid cost.
Ask HR
“I have been approved for the state premium-payment programme. Please open enrollment and give me the monthly premium in writing.”

How to apply

First step: Call 855-696-2447 or apply at mynchipp.com once Medicaid is approved.

  1. Call 855-696-2447 or apply online once Medicaid is approved.
  2. Ask the oncology billing office whether NC Medicaid Direct works for them.
  3. Ask the employer for the premium figure and the plan summary.

Official application / program page ↗

Where it starts: Apply online or send form DMA-2069. Call 855-696-2447.

What to gather

  • The Medicaid notice
  • The employer plan summary and the monthly premium
  • Bank details for direct deposit

How long: No decision deadline was published. Ask for a target date when you apply.

Clock: Once the programme says yes, the employer must be asked to enrol the family within 60 days.

What a yes looks like

Monthly reimbursements start, and the employer opens enrollment within 60 days.

What a no looks like, and the next move

Ask which half failed: the Medicaid link or the cost test. If it is the cost test, ask for the figures.

Watch out

  • People in this programme are placed in Medicaid Direct rather than a managed plan. Check with the oncology billing office first.
  • You do not have to be enrolled already: the programme helps you join.
  • Ask for the employer enrollment within 60 days of the decision.

The numbers and the rules

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

What it is worth

The employer premium reimbursed to you monthly, by cheque or direct deposit.

  • $60 — Days the employer has to enrol you once the programme decides

Covers: Monthly reimbursement of the employer or continuation premium · Help enrolling in the employer plan if you are not on it

Legal protection: The reimbursement is paid to the member, not to the employer

What it costs the family: No cost. The premium comes back monthly.

The eligibility facts, as published

Requirement
at least one family member on Medicaid and at least one with access to employer-sponsored insurance
Cost test
the employer cover must cost less than the family’s current Medicaid expense to the state
Exclusions
Medicare beneficiaries
Enrollment
existing employer enrollment is not required first

Expect friction on: Members are placed in NC Medicaid Direct rather than a managed plan · No published decision deadline

The trap: State law puts people in this programme into NC Medicaid Direct rather than a managed health plan. Ask the oncology team’s billing office to confirm that works for them before you switch.

Where I read this

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