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

Childhood Cancer Lantern
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Virginia program

Help paying your work-plan premium (HIPP for Kids)

Virginia can reimburse a qualifying work-plan premium when your child has full Medicaid.

What it is

Virginia can reimburse a qualifying work-plan premium when your child has full Medicaid.

Premium help is a separate review after Medicaid. Your employer’s contribution and the plan’s deductible matter. FAMIS Select is a different premium route for children eligible for FAMIS.

Eligibility rules
  • HIPP for Kids covers children under 19 with full Medicaid and a qualifying employer plan. The employer must pay at least 40% of the premium.
  • A high-deductible plan does not qualify for HIPP for Kids, with or without a health savings account. Send the actual plan documents; the premium-assistance unit decides.
What you get
  • Reimbursement of a qualifying employer-plan premium.
  • FAMIS Select pays up to $100 per child monthly, capped at the family premium.
What the rules cover
  • HIPP uses fee-for-service Medicaid instead of a managed-care plan.
  • FAMIS Select has separate rules and cannot pay more than the family premium.
If you decide to apply
  1. Ask the premium-assistance unit for the application and employer verification form.
  2. Have your employer complete its section, and send both forms with premium and plan details.

The state premium-assistance unit · Official page ↗

If you decide to apply
  • A decision is due within 45 days of the application and the employer's form arriving.
Good to know

HIPP participants move to Medicaid paid directly by the state. Your oncology team needs to accept that arrangement.

Other details
  • HIPP for Kids checks full Medicaid, age under 19 and an employer premium contribution of at least 40%. It also checks the plan’s high-deductible status. FAMIS Select replaces FAMIS with the employer plan. It does not keep a second complete FAMIS plan for deductibles, copays, services or the network. Its limited supplement covers immunizations the employer plan does not cover. Your social worker and the premium-assistance unit can compare these tradeoffs before a change.

Federal background: Premium assistance

Official sources
Ask your social worker

“Could HIPP help with our premium, and would the change in Medicaid affect our cancer team? If it is worthwhile, could you help with the forms?”

Why I’m asking: The premium is a large bill even if Medicaid helps with treatment costs.

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

Get the employer verification form filled in and send both forms together.

Your social worker

The employer's benefits office completes its half of the form.

The care team

Records and letters when the application asks for them.

Who decides
The state premium-assistance unit
Ask HR
“Our child is on Medicaid. Can you complete the employer verification form so the state can reimburse our share of the premium, and tell me what percentage the company pays?”

How to apply

First step: The premium-assistance unit at 1-800-432-5924 can explain the application and employer verification requirements.

  1. Ask the employer's benefits office to complete the employer verification form.
  2. After the Medicaid decision, the social worker can help compare premium assistance and obtain employer verification requirements.

Official application / program page ↗

Where it starts: Send the application and the employer verification form together. One line covers both programmes: 1-800-432-5924.

What to gather

  • The plan premium and the employer's share
  • The Medicaid approval notice
  • The employer benefits contact

How long: The August 31, 2022 HIPP manual gives a 45-calendar-day processing standard from application receipt. The application and employer verification are both needed. The premium-assistance unit can confirm the current process and your application’s status; the standard is not a promised turnaround.

What a yes looks like

A reimbursement schedule, and a cheque or deposit to you, the employer or the insurer.

What a no looks like, and the next move

A letter saying the plan is not cost-effective or is a high-deductible plan. Ask which test failed and whether the state child plan route fits instead.

Watch out

  • Both the application and the employer verification form have to go in; one alone stalls.
  • HIPP for Kids excludes a high-deductible health plan as defined in federal tax law, whether or not it has a health savings account. Ordinary HIPP has its own deductible rule. The premium-assistance unit needs the actual plan documents; the questionnaire does not establish whether either exclusion applies.
  • Families in this programme move to fee-for-service cover; check the oncology group bills that way.

The numbers and the rules

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

What it is worth

The employer-plan premium reimbursed when the employer pays at least 40% of it; or $100 a child a month on the state child plan route, never more than the family premium.

  • $40 — Least the employer must pay toward the premium
  • $100/month — Payment for a child on the separate premium route
  • $45 — Published maximum to process an application

What it costs the family: HIPP and FAMIS Select have different cost-sharing protections. FAMIS Select leaves employer-plan deductibles and copays with the family except for its limited immunization supplement.

The eligibility facts, as published

Age
under 19 for the children's programme
Coverage
full Medicaid plus a qualifying employer plan; the employer pays at least 40% of the premium
Exclusions
HIPP for Kids excludes a high-deductible health plan as defined in federal tax law, whether or not it has a health savings account. Ordinary HIPP has its own deductible rule. The premium-assistance unit needs the actual plan documents; the questionnaire does not establish whether either exclusion applies.
Delivery
participants use fee-for-service Medicaid rather than a managed-care plan
Processing standard
45 calendar days (a 2022 manual, still linked)

The trap: The website says the family must already be enrolled in the employer plan. The regulation actually says the programme enrols members who are eligible for coverage under a qualifying plan, so it is worth asking before you assume being merely eligible shuts the door. Families in this programme use fee-for-service Medicaid rather than a managed-care plan.

Where I read this

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