The American Kidney Fund’s Health Insurance Premium Program (HIPP) has provided financial assistance to financially eligible ESRD patients since 1997, helping patients afford Medicare Part B, Medigap, employer group health, COBRA and commercial plans. With the advent of the Affordable Care Act, we have also been providing premium payments for qualified health plans (QHPs) in the exchange.

CMS has issued guidance regarding premium payments for QHPs. AKF’s HIPP program complies with this guidance* which encourages insurance companies to accept premium assistance from non-profit organizations assisting patients with their insurance which meet certain criteria.  Specifically, AKF:

a) Assists patients “who satisfy defined criteria that are based on financial status”;
b) Does “not consider enrollees’ health status” as a criteria of receiving assistance; and
c) Assists the patient with “premiums [that] cover the entire policy year.”

To ensure the patient’s insurance coverage remains in effect, our policy has always been to make grant payments directly to the patient’s health insurance carrier.  In instances where an insurer will not accept a payment from a third party, our longstanding policy has been to send grant funding directly to the patient.   In these instances, we send either a grant check or a debit card to the patient.  The patient uses those charitable assistance funds to make the premium payment directly to their insurance carrier.

 

*February 7, 2014 CMS FAQ