Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)

Posted on May 6, 2015 in . . . .

If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov.

If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan.

If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272).

If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is current as of July 31, 2014. Contact your State for more information on eligibility –

ALABAMA – Medicaid

ALASKA – Medicaid

COLORADO – Medicaid

  • Medicaid Website: http://www.colorado.gov
  • Medicaid Phone (In state): 1-800-866-3513
  • Medicaid Phone (Out of state): 1-800-221-3943

FLORIDA – Medicaid

GEORGIA – Medicaid

  • Website: http://dch.georgia.gov – Click on Programs, then Medicaid, then Health Insurance Premium Payment (HIPP)
  • Phone: 1-800-869-1150

INDIANA – Medicaid

IOWA – Medicaid

KANSAS – Medicaid

KENTUCKY – Medicaid

LOUISIANA – Medicaid

  • Website: http://www.lahipp.dhh.louisiana.gov
  • Phone: 1-888-695-2447

MAINE – Medicaid

MASSACHUSETTS – Medicaid and CHIP

MINNESOTA – Medicaid

MISSOURI – Medicaid

MONTANA – Medicaid

NEBRASKA – Medicaid

NEVADA – Medicaid

NEW HAMPSHIRE – Medicaid

NEW JERSEY – Medicaid and CHIP

NEW YORK – Medicaid

NORTH CAROLINA – Medicaid

NORTH DAKOTA – Medicaid

OKLAHOMA – Medicaid and CHIP

OREGON – Medicaid

PENNSYLVANIA – Medicaid

RHODE ISLAND – Medicaid

SOUTH CAROLINA – Medicaid

SOUTH DAKOTA – Medicaid

TEXAS – Medicaid

UTAH – Medicaid and CHIP

VERMONT– Medicaid

VIRGINIA – Medicaid and CHIP

WASHINGTON – Medicaid

WEST VIRGINIA – Medicaid

WISCONSIN – Medicaid

WYOMING – Medicaid

To see if any other states have added a premium assistance program since July 31, 2014, or for more information on special enrollment rights, contact either:

  • U.S. Department of Labor
    • Employee Benefits Security Administration
    • www.dol.gov/ebsa
    • 1-866-444-EBSA (3272)
  • U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services
  • www.cms.hhs.gov
  • 1-877-267-2323, Menu Option 4, Ext. 61565

OMB Control Number 1210-0137 (expires 10/31/2016)