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General Information on HIV Health Insurance Premium Payment (HIPP) Program
and OHIO HIV Medicaid Spenddown Payment Program (OHMSDP)
HIPP
The Ohio Department of Health (ODH) administers the HIV Health Insurance Premium Payment for persons living with HIV. The HIPP program makes direct premium payments for consumers to continue existing health insurance policies. The HIPP Program does not purchase new insurance policies.
OHMSDP
The OHMSDP or “spenddown program” enables individuals to access “public health insurance” with the payment of a “spenddown” to the Medicaid program. Individuals must have previously applied for Medicaid with their county Department of Job and Family Services and have an open Medicaid case with a monthly “spend down” already determined. The Medicaid program offers prescription drug coverage, physician office visits, hospitalization, and dental care services.
Eligibility and Enrollment The HIPP and Spenddown Programs are available to individuals who meet the following eligibility requirements:
- You must submit a complete application and demonstrate a willingness to sign all forms and provide necessary documentation.
- You must be a resident of Ohio.
- You must have a monthly gross income of less than $3879.17 per month ($46,550. annually) for one person. The amounts increase based on family size (LINK to financial eligibility guidelines here).
- You must provide proof of monthly income (for yourself as well as your spouse and dependents). This includes copies of pay stubs for 30 consecutive days, income award letters, copies of unemployment compensation stubs, etc.
- You must provide a physician’s verification of HIV infection and lab results (viral load and CD4 counts) no older than 6 months from the date of your application for our program.
- You must provide a copy of an IRS Income Tax Transcript (1722) for the most recent tax year.
- FOR HIPP: You must have current primary health insurance coverage or be eligible for continuation of coverage (COBRA). Your policy must include prescription drug coverage that is as good or better than OHDAP can provide.
- You must provide a signed HIPAA release to permit us to speak with your insurance company.
The covered individual is responsible for notifying ODH of any changes in their income status, mailing address, insurance coverage, insurance premium rate and other information as necessary to maintain program eligibility. Failure to notify ODH may affect your enrollment and/or result in an interruption of services. This program must be the payer of last resort.
Any client found to be knowingly submitting fraudulent information may be expelled from this and other AIDS Client Resources Section programs for a period of up to 12 months.
For More Information
Please contact the Ohio HIV Drug Assistance Program Coordinators, AIDS Clients Resources Section, Ohio Department of Health, P.O. Box 118, Columbus, OH 43216-0118. You may also call (800) 777-4775 for further information.
Last Updated: 7/16/04
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