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VA Medicaid and Insurance Premiums

There are various ways in which Medicaid is related to Medical Insurance Premiums. In some circumstances Medicaid will pay Medicare premiums; in some circumstances Medicaid will pay private insurance premiums; and in the proposed Medicaid Buy-In, recipients of Medicaid coverage pay a premium.

Medicare Premiums

There are two ways in which Medicaid pays Medicare premiums:

·             Medicaid pays the Medicare Part B premiums for Medicare beneficiaries who have full Medicaid coverage (such as SSI recipients).

·             Medicaid pays various combinations of premiums, deductibles and co-insurance payments for those who are in Medicare Related Covered Groups.

Private Insurance

Medicaid will, when it is cost effective, pay the premiums for private insurance through the HIPP (Health Insurance Premium Payment) program for those who have private insurance through an employer but are otherwise eligible for Medicaid.

Medicaid Buy-In

If the proposed Medicaid Buy-In is implemented in Virginia, certain employed individuals with disabilities who would otherwise be ineligible for Medicaid because of excess resources or income will be able to receive Medicaid coverage by paying a monthly premium.

Back to:

VA Medicaid Eligibility

VA Medicaid Covered Groups

VA Medicaid Overview

VA Benefit Information System Welcome and Introduction

Source:

Information for this topic was drawn both from the Department of Medical Assistance Services (DMAS) Medicaid Handbook and communication with DMAS.

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